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# Palmoplantare Pustulose: Was Ihr über Entstehung und Behandlung wissen solltet **Wie die Erkrankung entsteht** Die genaue Ursache der palmoplantaren Pustulose ist noch nicht vollständig erforscht.[1][2] Wissenschaftler gehen davon aus, dass mehrere Faktoren zusammenspielen: genetische Veranlagung (besonders eine Mutation im IL36RN-Gen bei etwa 5 % der Patienten), eine Überreaktion des Immunsystems und äußere Auslöser wie Rauchen.[1] Tatsächlich rauchen oder rauchten etwa 65 bis 90 % der Betroffenen.[1] Auch Stress, Infektionen und bestimmte Medikamente können die Erkrankung auslösen.[2] **Diagnose stellen** Eure Ärztin oder euer Arzt erkennt palmoplantare Pustulose meist durch eine visuelle Untersuchung.[1] Bei Unsicherheit hilft eine Hautbiopsie (Entnahme einer kleinen Gewebeprobe), um andere Erkrankungen auszuschließen.[1] **Behandlung praktisch umsetzen** Topische Cremes mit kortisonhaltigen Wirkstoffen zeigen gute Erfolge.[6] Besonders wirksam ist die sogenannte Okklusivtechnik: Ihr tragt die Creme auf und bedeckt die Stelle mit Frischhaltefolie für ein bis zwei Stunden. Bei regelmäßiger Anwendung können Juckreiz und Schmerzen deutlich abnehmen – teilweise bereits nach wenigen Wochen.[6] Wichtig: Besprecht mit eurem Arzt, wie oft diese Technik sinnvoll ist, denn intensive Feuchthaltung kann auch zu Hautreizungen führen. Originaltitel: Palmoplantare Pustulose: Entstehung, Differentialdiagnose und Therapie Link zur Quelle

**Forscher finden Schlüssel-Gene der Schuppenflechte** Wissenschaftler haben 32 Gene entdeckt, die bei Schuppenflechte überall aus dem Lot geraten[5]. Sie verglichen dafür vier große Gentech-Studien miteinander. Das Ergebnis zeigt: Zwei biologische Prozesse spielen die Hauptrolle bei der Krankheit[5]. Der erste heißt Verhornung und der zweite Cornified-Envelope-Bildung. Beide beschreiben, wie sich die äußere Hautschicht bei Schuppenflechte verändert. Die Forscher wollen jetzt diese Gene als Ziele für neue Behandlungen nutzen[5]. Sie könnten zu besseren Diagnosen führen. Andere Studien zeigen zudem: Bestimmte Gene wie IL-17A und TNF treiben Entzündungen an[3]. Wenn Ärzte diese Gene verstehen, können sie gezielter gegen Schuppenflechte vorgehen. Die Erkenntnisse geben Hoffnung auf wirksamere Therapien in der Zukunft. Originaltitel: Core Differentially Expressed Genes in Psoriasis Lesions: An Integrated Analysis of Four GEO Datasets. Link zur Quelle

Originaltitel: Palmoplantar pustulosis: pathogenesis, differential diagnosis, and treatment Link zur Quelle

# Palmoplantare Pustulose: Was die Forschung über die Entstehung zeigt ## Wie entsteht die Erkrankung? Die palmoplantare Pustulose (PPP) entsteht durch ein Zusammenspiel mehrerer Faktoren[1][3]. Eure Erkrankung ist nicht einfach nur eine Variante der gewöhnlichen Schuppenflechte – sie hat eine eigene genetische und immunologische Basis[3]. **Der Ausgangspunkt liegt in Euren Schweißdrüsen**: Die Entzündung beginnt in den Ausführungsgängen der Schweißdrüsen an Handflächen und Fußsohlen[1][2]. Dort sammeln sich bestimmte Abwehrzellen an und zerstören diese Strukturen. **Auslöser und Verstärker**: Rauchen, Verletzungen durch wiederholte Belastung und Infektionen im Mund- und Rachenraum wirken wie Brandbeschleuniger[4]. Manche von Euch tragen auch genetische Veränderungen in sich, die die Krankheit wahrscheinlicher machen[3][5]. **Im Körper läuft eine Überreaktion ab**: Bestimmte Botenstoffe (IL-17, IL-8, IL-36) sind bei Euch erhöht und mobilisieren ständig Abwehrzellen in die Pusteln[1][3]. **Hinweis**: Die verfügbaren Informationen konzentrieren sich auf die Entstehung. Zu Differentialdiagnose und Behandlungsoptionen finden sich in den Quellen nur begrenzte Angaben. Für umfassende Therapieempfehlungen konsultiert bitte Euren Facharzt. Originaltitel: Palmoplantar pustulosis: pathogenesis, differential diagnosis, and treatment Link zur Quelle

Diese Studie untersucht ein neues Medikament namens Zasocitinib zur Behandlung von Plaque-Psoriasis bei Kindern und Jugendlichen im Alter von 4 bis unter 18 Jahren. Es handelt sich um eine Phase-3-Studie, die die Wirksamkeit, Sicherheit und Verträglichkeit des Medikaments prüft, indem es mit einem Placebopräparat verglichen wird. Die Studie ist randomisiert (die Teilnehmer werden zufällig einer Gruppe zugeordnet), multizentrisch (findet an mehreren Orten statt) und doppelblind (weder die Teilnehmer noch die Ärzte wissen, wer das echte Medikament oder Placebo erhält). Zasocitinib ist ein innovativer Wirkstoff, der zu einer Gruppe von Medikamenten gehört, die als TYK2-Inhibitoren bekannt sind. Vereinfacht ausgedrückt: Das Medikament blockiert bestimmte Eiweißstoffe im Körper, die für die Entzündungsreaktionen bei Psoriasis verantwortlich sind. Psoriasis ist eine Hauterkrankung, bei der das Immunsystem übermäßig aktiv wird und Hautzellen viel zu schnell nachwachsen, was zu dicken, roten, schuppigen Hautflecken führt. Indem Zasocitinib diese Entzündungsprozesse hemmt, soll die Haut weniger gerötet, schuppig und gereizt werden. Das Medikament wird als Tablette eingenommen und könnte betroffenen Kindern und Jugendlichen helfen, klare Haut zu erreichen. Originaltitel: A Phase 3, Randomized, Multicenter, Double-Blind, Placebo-Controlled Trial to Evaluate the Efficacy, Safety, Tolerability, and Pharmacokinetics of Zasocitinib in Pediatric Participants Aged 4 to Less Than 18 Years With Moderate-to-Severe Plaque Psoriasis Erkrankung: Plaque-Psoriasis (Schuppenflechte) Phase: Phase 3 (klinische Bestätigungsstudie) Firma: Takeda Development Center Americas Inc. Art der Verabreichung: Tablette (oral) https://euclinicaltrials.eu/search-for-clinical-trials/?lang=en&EUCT=2025-522567-15-00

Available evidence reveals markedly divergent metabolic signatures across biologics and small-molecule inhibitors, highlighting the need for further investigations. To address this knowledge gap, we performed a systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies in patients with psoriasis or psoriatic arthritis (PsA) to quantify the short- and long-term effects of targeted therapies on lipid profiles. PubMed, Embase, and Cochrane databases were searched for RCTs and observational studies published through July 25, 2025. Eligible randomized RCTs were evaluated using the Cochrane Risk of Bias tool, while nonrandomized studies were assessed using the Methodological Index for Non-Randomized Studies. All lipid effect estimates were derived from within-group pre-to-post changes in patients with psoriasis or PsA. Thirty-six articles involving 21,477 patients with psoriasis and 3098 patients with PsA (total 24,575) across seven targets were analyzed. The long-term use of Janus kinase inhibitors (JAKi) significantly increases total cholesterol (TC; weighted mean difference [WMD] = 7.03; 95% confidence interval [CI] = 1.22, 12.84), triglyceride (TG; WMD = 19.98; 95% CI = 13.82, 26.14), high-density lipoprotein cholesterol (HDL-c; WMD = 6.87; 95% CI = 4.38, 9.36), and low-density lipoprotein cholesterol (LDL-c; WMD = 12.37; 95% CI = 7.24, 17.50) levels. Long-term tumor necrosis factor alpha inhibitors (TNFi) significantly lowers TC (WMD = -8.40; 95% CI = -15.21, -1.60), TG (WMD = -15.22; 95% CI = -21.92, -8.51), and LDL-c (WMD = -10.61; 95% CI = -16.77, -4.45) levels while raising HDL-c (WMD = 4.13; 95% CI = 1.23; 7.03) levels. Long-term interleukin-17 A inhibitors significantly increases TG (WMD = 7.31; 95% CI = 3.17, 11.46) levels, whereas IL-23p19 inhibitors yield the opposite effect (WMD = -32.08; 95% CI = -51.87, -12.30). Our data underscore the need for routine lipid monitoring during TNF-α- and JAK-targeted therapy in patients with psoriasis or PsA. Due to the limitations of our analysis, well-designed prospective trials with extended follow-up periods are warranted to validate and refine these observations.Weiterlesen

BackgroundResearch suggests that healthcare professionals find it more difficult to correctly diagnose dermatological conditions in the nonwhite patient demographic. People of colour experience higher rates of delayed and misdiagnosis, contributing to an increased mortality risk and increased health inequalities that remain widespread throughout the health care setting. This study aimed to investigate podiatry student's ability, confidence, approaches and perceptions in diagnosing dermatology pathologies in different skin tones.MethodsA mixed methods explanatory sequential design was undertaken with pre-registration podiatry students from universities across South-central England. Participants completed a validated pictorial multiple-choice questionnaire comprising six images of either eczema or psoriasis in three different skin tone categories: light, medium or dark. Results were used to inform focus groups and a process of thematic analysis explored participants perceptions surrounding their diagnostic approaches and underpinning confidence.ResultsThe medium skin tone (Fitzpatrick groups III/IV) was associated with the most correct responses for psoriasis (69%) followed by light skin tone (Fitzpatrick groups I/II) with 48%. Psoriasis in darker skin tones (Fitzpatrick groups V/VI) received the least correct responses (3%). In eczema, results were more evenly spread with darker skin tones (Fitzpatrick groups V/VI), receiving a slightly higher percentage of correct diagnoses (39%). Qualitative analysis revealed two emergent themes: (i) reports on confidence and apprehension and (ii) limitations in education provision: each with a series of sub-themes. Participants reported barriers to their diagnostic ability included an underrepresentation of dark skin tones in medical images and inadequate exposure to pathology on patients with dark skin tones.ConclusionsThere was a notable lack of confidence in participants' ability to correctly diagnose dermatological pathology, particularly in dark skin tones. This study addresses the research gap in podiatric health inequalities and pinpoints the associated educational shortcomings from the podiatry education perspective.Weiterlesen

No abstract supplied.Weiterlesen

No abstract supplied.Weiterlesen

The psoriatic arthritis phenotype has evolved over the past several decades. The original description of 5 clinical patterns has been expanded into 6 domains including peripheral arthritis (which includes 3 of the patterns described by Moll and Wright namely distal, oligoarticular and polyarticular), axial disease, dactylitis, enthesitis, skin and nails. In this article we review the evolution of the PsA phenotype, from the Moll and Wright subtypes described in 1973 and how they might have changed, evolution of our understanding of axial PsA, consider race and geographic differences in disease expression, role of obesity and sex on the PsA phenotype, effect of co-expression of PsA and FM as well as OA on the phenotype, and consider difficult to treat PsA.Weiterlesen

Psoriatic arthritis (PsA) develops in up to one-third of patients with psoriasis (PsC), yet increasing attention is now focused on a putative subclinical phase preceding overt arthritis. Several conceptual frameworks describe the PsC-PsA transition, including the pragmatic definition proposed by the European Alliance of Associations for Rheumatology, which defines subclinical PsA as arthralgia and/or imaging abnormalities in the absence of clinical synovitis. However, the absence of validated serological biomarkers, the marked clinical heterogeneity of PsA, the frequent occurrence of nonspecific musculoskeletal symptoms, and the limited specificity of imaging findings complicate risk stratification and may lead to misclassification and overtreatment. Lessons from rheumatoid arthritis highlight both the potential and the pitfalls of applying prevention paradigms to subclinical disease. This viewpoint critically appraises current definitions of subclinical PsA, discusses therapeutic and trial-design implications, and outlines key research priorities, including longitudinal PsC cohorts, advanced and molecular imaging, and multiomic biomarker discovery. Future progress depends on developing robust risk-stratification models that capture the full spectrum of psoriatic disease and enable targeted prevention strategies while minimising unnecessary intervention. At the same time, caution is warranted against broad expansion of the 'subclinical' disease state concept, as it may dilute disease definitions, increase overdiagnosis, and divert attention from improving early and accurate identification of clinically meaningful PsA.Weiterlesen

Psoriatic arthritis (PsA) is a complex, multisystem disease with no diagnostic criteria and discordant approaches to assessing disease activity and response to treatment. PsA is part of the Psoriatic Disease spectrum, encompassing cutaneous psoriasis and nail changes, PsA and in some cases, uveitis and inflammatory bowel disease. The HIPPOCRATES consortium is addressing unmet needs in PsA and has now established a harmonised data platform, the Secure HIPPOCRATES Data Management Platform (SHDMP), which will be transformative in providing researchers with the ability to interrogate at scale psoriatic disease datasets. The SHDMP datasets are diverse and include people with psoriasis being followed for the development of PsA, as well as cross-sectional, observational and randomised control trial data on people with PsA. To better understand and describe the nature of the SHDMP datasets, the HIPPOCRATES consortium has now defined and agreed on the terms that will be applied to each dataset. In this short report, the process adopted to obtain consensus on the dataset definition and the final set of terms agreed upon is described and discussed. The agreement on the terms to be used will greatly enhance a researcher's ability to select the appropriate SHDMP datasets to study.Weiterlesen

BackgroundBiologic agents are an important novel therapeutic option for moderate-to-severe psoriasis. In recent years, TikTok and Bilibili have gradually become important channels for Chinese patients to obtain health information. This study aims to evaluate the content, quality, reliability, and transparency of videos related to biologic therapy for psoriasis on these platforms.MethodsWe searched both platforms using the dual keywords "psoriasis" and "biological agents," confirmed compliance with relevant criteria, and collected the top 150 videos based on their composite rankings. Fundamental characteristics, uploader categories, and content types were documented. Two independent reviewers evaluated video quality using the mDISCERN, GQS, and the JAMA criteria. Nonparametric tests were performed for group comparisons, and Spearman correlation analysis was applied.ResultsBilibili videos more frequently addressed medical expenses, types of biologic agents, and recurrence, whereas TikTok videos focused on etiology and clinical manifestations. The video quality was barely acceptable. On TikTok, the median GQS, mDISCERN, and JAMA scores were 3.00 (2.25, 4.00), 3.00 (3.00, 4.00), and 2.00 (2.00, 3.00). On Bilibili, the median scores were 3.00 (2.00, 4.00), 3.00 (2.00, 4.00), and 1.00 (1.00, 3.00). Videos uploaded by professional organizations achieved the highest GQS (median 4.00, IQR: 4.00-4.00) but had the lowest engagement. Engagement metrics showed a moderate correlation with quality scores (P < 0.05).ConclusionsThis study found that videos related to biologic therapy for psoriasis lack content completeness, with overall quality, reliability, and transparency remaining at a suboptimal level. Greater participation by professional organizations and increased visibility of their videos should be encouraged to promote the dissemination of high-quality content. This study provides preliminary insights for health communication strategies and highlights the necessity of strengthening content regulation.Weiterlesen

Originaltitel: Depletion of p75NTR in Schwann Cells Driven by Inflammation Mediates Cutaneous Pain in Psoriasis. Link zur Quelle

# Was Ultraschall über Sehnenansatzpunkte wirklich aussagt **Die Studie im Überblick** Forscher verfolgten Psoriasis-Patienten über zehn Jahre. Sie wollten wissen: Können Ultraschallaufnahmen von Sehnenansatzpunkten vorhersagen, wer später Psoriasis-Arthritis bekommt? Das Ergebnis fiel überraschend aus. **Das Wichtigste für euch** Die Ultraschallbefunde von Anfang konnten nicht vorhersagen, welche Patienten später Gelenkprobleme entwickelten. Das gilt auch für strukturelle Veränderungen und Entzündungszeichen im Ultraschall. Nur drei der 13 Patienten ohne PSA am Anfang bekamen später die Diagnose. Ein weiteres Ergebnis beruhigt: Bei gut behandelten Patienten blieben Strukturveränderungen sichtbar, obwohl die Entzündung minimal war. Das zeigt: Der Ultraschall sieht nicht immer aktive Entzündung, wenn Therapien wirken. **Was das für euren Alltag bedeutet** Ultraschallbefunde allein sind kein zuverlässiger Warnhinweis für PSA. Das ist einerseits beruhigend, andererseits zeigt es: Wir brauchen bessere Methoden zur Früherkennung. Eure rheumatologische Betreuung bleibt wichtiger als einzelne Bildgebungsbefunde.[1] Originaltitel: Ten-year longitudinal assessment of entheseal ultrasound in psoriasis: limited discriminatory capacity for psoriatic arthritis | Rheumatology Advances in Practice | Oxford Academic Link zur Quelle

# Zahnfleischbehandlung und Psoriasis: Was die Forschung zeigt **Die Verbindung zwischen Zahnfleisch und Haut** Euer Zahnfleisch und Eure Psoriasis hängen stärker zusammen als bislang gedacht.[1][2][3] Menschen mit Psoriasis haben ein etwa zwei- bis dreifach höheres Risiko für Zahnfleischerkrankungen.[2][3] Umgekehrt erhöht Zahnfleischerkrankung das Psoriasis-Risiko um etwa 60 Prozent.[5] Der Grund: Beide Erkrankungen aktivieren ähnliche Entzündungsprozesse in Eurem Körper. **Was bringt eine Zahnfleischbehandlung?** Eine Behandlung des Zahnfleisches könnte Euch also auch der Psoriasis helfen.[7] Erste Studien zeigen, dass eine professionelle Zahnfleischreinigung die Psoriasis zusätzlich zu einer dermatologischen Therapie verbessert.[7] Besonders Menschen, die mit modernen Biologika-Medikamenten behandelt werden, haben zugleich bessere Zahngesundheit.[3] **Was könnt Ihr tun?** Achtet auf regelmäßige Zahnarztbesuche und gute Mundhygiene. Das ist für Euch nicht nur wichtig für die Zähne – es könnte auch Eure Psoriasis beeinflussen. Sprecht mit Euerem Zahnarzt und Euerem Dermatologen offen über beide Erkrankungen, damit sie zusammen besser behandelt werden können.[3][4] Originaltitel: The Effects of Periodontal Treatment on Psoriasis: A Systematic Review of Limited Clinical and Preclinical Evidence | MDPI Link zur Quelle

# Was bringt Secukinumab auf lange Sicht? Secukinumab hilft den meisten von Euch langfristig gegen Schuppenflechte.[1][2] In einer großen europäischen Studie mit 1.740 Patienten über fünf Jahre zeigt sich: Die Haut wird schnell deutlich besser und bleibt es.[1] Die Werte, die den Schweregrad messen, sinken von 21 auf unter 2 – fast klare Haut für viele von Euch.[1] **Das bedeutet für Euren Alltag:** Etwa 6 von 10 Patienten nehmen die Spritze auch nach fünf Jahren noch regelmäßig.[1] Besonders wichtig: Das Mittel scheint auch Schuppenflechte-Arthritis zu verhindern – vor allem bei Euch mit Nagelbeteiligung.[2] **Sicherheit ist kein großes Risiko:** Schwere Nebenwirkungen treten selten auf.[1] Es gibt keine Überraschungen nach Jahren der Behandlung. Wichtig zu wissen: Wer noch kein anderes Biolog bekommen hat, profitiert oft besser als Patienten mit Vorbehandlung.[1] Originaltitel: Retention, Effectiveness, and Safety of Secukinumab in Plaque Psoriasis: 5-Year Results from SERENA - Dermatology and Therapy Link zur Quelle

# HIPPOCRATES: Ein Forschungsprojekt für bessere Diagnosen bei Psoriasis-Arthritis Das EU-Projekt HIPPOCRATES bringt Experten aus Forschung, Klinik und Industrie zusammen[1]. Es soll helfen, Psoriasis-Arthritis besser zu verstehen und früher zu erkennen. Das Projekt hat eine neue Datenplattform gegründet[7]. Sie heißt SHDMP und sammelt Informationen von vielen Patienten mit Psoriasis und Psoriasis-Arthritis[2]. Die Daten stammen aus verschiedenen europäischen Studien. Das Besondere: Das Projekt hat klare Begriffe und Definitionen festgelegt[7]. Diese beschreiben genau, welche Daten in welchem Datensatz enthalten sind. Damit können Forscher viel leichter die richtigen Informationen für ihre Arbeit finden. Warum ist das wichtig für dich? Mit besseren und einheitlichen Daten entstehen bessere Erkenntnisse[1]. Das führt zu früheren Diagnosen und besseren Behandlungsmöglichkeiten. Letztendlich profitierst du als Patient oder Patientin davon[2]. Originaltitel: Definition of the terms used to describe psoriatic disease datasets: a HIPPOCRATES initiative. Link zur Quelle

Research suggests that healthcare professionals find it more difficult to correctly diagnose dermatological conditions in the nonwhite patient demographic. People of colour experience higher rates of delayed and misdiagnosis, contributing to an increased mortality risk and increased health inequalities that remain widespread throughout the health care setting. This study aimed to investigate podiatry student's ability, confidence, approaches and perceptions in diagnosing dermatology pathologies in different skin tones. A mixed methods explanatory sequential design was undertaken with pre-registration podiatry students from universities across South-central England. Participants completed a validated pictorial multiple-choice questionnaire comprising six images of either eczema or psoriasis in three different skin tone categories: light, medium or dark. Results were used to inform focus groups and a process of thematic analysis explored participants perceptions surrounding their diagnostic approaches and underpinning confidence. The medium skin tone (Fitzpatrick groups III/IV) was associated with the most correct responses for psoriasis (69%) followed by light skin tone (Fitzpatrick groups I/II) with 48%. Psoriasis in darker skin tones (Fitzpatrick groups V/VI) received the least correct responses (3%). In eczema, results were more evenly spread with darker skin tones (Fitzpatrick groups V/VI), receiving a slightly higher percentage of correct diagnoses (39%). Qualitative analysis revealed two emergent themes: (i) reports on confidence and apprehension and (ii) limitations in education provision: each with a series of sub-themes. Participants reported barriers to their diagnostic ability included an underrepresentation of dark skin tones in medical images and inadequate exposure to pathology on patients with dark skin tones. There was a notable lack of confidence in participants' ability to correctly diagnose dermatological pathology, particularly in dark skin tones. This study addresses the research gap in podiatric health inequalities and pinpoints the associated educational shortcomings from the podiatry education perspective.Weiterlesen

IntroductionPatients with moderate-to-severe psoriasis often experience significant physical symptoms and notable psychosocial distress. Pruritus is the most bothersome symptom and a key contributor to sleep disturbances and reduced quality of life (QoL). Though biologics such as risankizumab have advanced clinical management, real-world evidence of patient-reported outcomes (PROMs) and objective pruritus assessment remains limited. This study assessed risankizumab's effectiveness in improving QoL, symptom burden, and sleep and evaluated the feasibility of nocturnal scratch monitoring using a wearable sensor.MethodsPRIMMA was a multicenter, prospective, non-interventional study conducted in Israel among adults with moderate-to-severe psoriasis initiating label-approved risankizumab therapy. Outcomes were assessed at baseline and week 52, and included Dermatology Life Quality Index (DLQI), static Psoriasis Global Assessment (sPGA), Pruritus Numeric Rating Scale (PNRS), Psoriasis Symptoms Scale (PSS), Medical Outcomes Study Sleep Scale (MOS-SS), Work Productivity and Activity Impairment (WPAI), and adverse events. Objective nocturnal scratch activity was measured using ADAM digital patch sensors in a subgroup of patients.ResultsIn 136 participants, the median age was 51 years, 57% were male, 43% were female, and 35% were bio-naïve. At week 52, 58% achieved DLQI 0/1 (versus 5.1% at baseline; p < 0.001) and 81% had PNRS 0-3 (versus 21% at baseline; p < 0.001). sPGA 0/1 was reached by 77% at week 52, and components of PSS and WPAI improved significantly. In patients who achieved any favorable outcome (DLQI 0/1, PNRS 0-3, sPGA 0/1) at week 24, ≥ 68% maintained it at week 52, demonstrating treatment durability. In the digital subcohort (n = 14), sensor data confirmed significant reduction in nocturnal scratch duration at week 4 and week 16 compared to baseline (both p ≤ 0.032). Adverse events were mostly mild to moderate.ConclusionsIn real-world practice, risankizumab showed substantial improvements in QoL, pruritus, sleep, and work/activity impairment in moderate-to-severe psoriasis. Digital scratch monitoring showed reduction in nocturnal scratch duration. Integrating objective digital measures with PROMs may enable more data-driven, individualized management in psoriasis care.Clinical trial registrationClinicalTrials.gov Identifier NCT04780516.Weiterlesen

Psoriasis is a prevalent, autoimmune skin disease that easily relapses and is difficult to cure. Given its increased global prevalence and the limitations of synthetic therapies, developing of natural product-originated agents with fewer side effects and high therapeutic efficacy is of serious concern. Therefore, this work aimed to evaluate the potential effect of enzymatically-modified isoquercitrin (EMIQ, 50 and 100 mg/kg body weight "b.wt", administered orally for 8 days), in comparison with methotrexate (MTX, a synthetic drug), against imiquimod (IMQ)-induced psoriatic lesions in female BALB/c mice. Furthermore, the protective effect of EMIQ against the skin associated-vascular permeability response was investigated by using IMQ-induced Evans blue extravasation mouse model. The results showed that EMIQ (particularly at the higher dose) attenuated significantly (P < 0.05-0.001) all complications shown in psoriatic mice like MTX. These effects included reduction in the psoriasis area and severity index, prevention of b.wt loss, and alleviation of histopathological alterations and oxidative stress. Importantly, EMIQ reduced the elevated expression of interleukin (IL)-23 and IL-17A (the key cytokines involved in psoriasis pathogenesis), inhibited phosphorylation of nuclear factor-κBp65, and down-regulated tumor necrosis factor-α, IL-1β, and cyclooxygenase-2 levels in mice skin tissues. Moreover, oral administration of EMIQ prevented significantly (P < 0.001) the vascular permeability associated with augmented Evans blue leakage and dermal accumulation of degranulated mast cells, suggesting a reduction in inflammation and edema. Taken together, our study demonstrated that EMIQ can alleviate psoriasis and may be considered as a promising strategy for psoriasis treatment via targeting IL-23/IL-17A axis and mast cell degranulation.Weiterlesen

To develop a unified diagnostic algorithm for axial psoriatic arthritis (axPsA). MATERIALS AND METHODS. : A total of 122 patients with psoriatic arthritis (PsA), duration less than 10 years, were included in the study according to CASPAR criteria, provided that they also had axial involvement. Axial involvement was detected in case of radiographic sacroiliitis [(rSI); bilateral grade ≥2 or unilateral grade ≥ 3] or active MRI SI (MRI-SI), or ≥ 1 syndesmophyte(s) of the cervical and/or lumbar spine (CS/LS), or facet joints ankyloses of the CS. Patients were evaluated for the presence of inflammatory back pain (IBP) by ASAS criteria. Back pain lasting over 3 months, that did not meet ASAS criteria was considered chronic back pain (chrBP). HLA-B27 antigen status was observed. Results and discussion. IBP was identified in 87 (71.3%), chrBP-in 35 (28.7%) patients, 49 (40.2%) patients had older age (>40 years) at back pain onset; 120 (98.4%) patients had peripheral arthritis, 75 (61.5%)-dactylitis, 69 (56.6%)-enthesitis, 122 (100%)-psoriasis, 90 (73.8%)-nail psoriasis. Isolated axial disease without peripheral arthritis was found in 2 (1.6%) patients. rSI was detected in 85 (69.7%) patients, in 28 of 85 (32.9%) patients rSI developed without IBP. Spinal lesions of the LS and CS were found in 100 (82.0%) patients, chunky "non-marginal" syndesmophytes-in 60 (49.2%), asymmetrical syndesmophytes of the LS-in 22 of 72 (30.6%), paravertebral ossification-in 5 (4.1%) patients. Isolated spinal lesions without rSI were found in 37 (30.3%), isolated spinal lesions without rSI or MRI-SI-in 21 (17.2%) patients. HLA-B27 was observed in 27 of 86 (31.4%) examined patients. Diagnostic algorithm for axPsA was developed. All PsA patients, regardless whether they experienced IBP/chrBP or not, must undergo diagnostic imaging: pelvis, LS and CS X-ray. In patients without rSI, MRI of the sacroiliac joints should be performed. AxPsA diagnosis must be confirmed by imaging. Axial involvement is detected in case of rSI or MRI-SI, or ≥1 syndesmophyte(s) of the CS/LS, or facet joints ankyloses of the CS.Weiterlesen

Background/Objectives: Psoriasis and periodontitis share inflammatory pathways. Current evidence suggests a bidirectional non-causal relation. However, the evidence on the effects of periodontal treatment on psoriasis outcomes (severity, inflammatory markers, quality of life) is limited. This study aims to synthetize the available clinical and preclinical evidence of periodontal treatment effects on psoriasis outcomes, in patients with comorbid psoriasis and periodontitis (CRD420261298145). Methods: Several databases (PubMed, WebOfScience, ScienceDirect, ProQuest and GoogleScholar) were searched for relevant articles, without language or time restrictions. We included randomised and non-randomised clinical studies on humans, and controlled animal experiments. Interventions included periodontal treatment (surgical and non-surgical). Outcomes were the Psoriasis Area and Severity Index and dermatology-specific quality of life scores; secondary outcomes included inflammatory biomarkers and periodontal parameters. Studies were screened in duplicate, data extracted independently and risk of bias was assessed using Cochrane RoB 2, ROBINS I, NOS and SYRCLE. Results: A total of five studies were included in this systematic review (four clinical studies and one preclinical studies). Three studies directly assessed post-treatment psoriasis outcomes, with two studies investigating inflammation mediators as secondary outcomes. Two studies directly assessed PASI (Psoriasis Area and Severity Index) modifications, both studies confirming PASI scores decreasing post-periodontal treatment; one study also reported DLQI (Dermatology Life Quality Index). Typical follow-up durations ranged from 8 to 10 weeks for interventional studies, to 5 years for one cohort study. Conclusions: Although momentarily limited by the small number of available studies, the results of this review suggest that periodontal treatment may be associated with improvements in psoriasis outcomes. Further studies on larger samples, with longer follow-up periods would be necessary to confirm and possibly strengthen the existing results.Weiterlesen

No abstract supplied.Weiterlesen

BackgroundUp to one-third of people living with psoriasis develop psoriatic arthritis (PsA), and the majority have active psoriasis prior to the development of arthritis. Clinical risk factors, such as nail involvement, in conjunction with novel blood biomarkers, could improve PsA risk monitoring and early diagnosis.ObjectivesThe aim of the HIPPOCRATES Prospective Observational Study (HPOS-www.hpos.study) is to follow a cohort living with psoriasis and identify risk factors for the development of PsA.DesignHPOS is a patient-driven online prospective European observational cohort.MethodsAdult participants with psoriasis but with no prior diagnosis of PsA are eligible. Participants are invited to provide consent and join the study online. They complete a semi-structured questionnaire to collect data on demographics, psoriasis, comorbidities, risk factors for PsA, and the Psoriasis Epidemiology Screening Tool screening questionnaire. Follow-up is conducted through a questionnaire every 6 months. The primary outcome is the new onset of PsA confirmed by a diagnosis from their doctor. The study will also collect peripheral blood samples from a subset of participants for biomarker identification.EthicsThis study follows the principles of the Declaration of Helsinki. To date, ethical approval has been granted by independent ethical committees in 10 countries.DiscussionStudying a cohort of individuals with psoriasis will allow us to identify risk factors for arthritis development and to develop a risk calculator. This can support focused efforts on screening, patient education, and even studies looking to delay or prevent the onset of arthritis. This study, run via remote online data collection, provides an efficient way to recruit a large cohort (25,000) across multiple countries. However, challenges have had to be addressed with some key changes in study design, ethical review, and recruitment strategies required for each individual country.Trial registrationHPOS, Clinicaltrials.gov ID: NCT05858528, IRAS number 325080; https://clinicaltrials.gov/study/NCT05858528?locStr=United%20Kingdom&country=United%20Kingdom&cond=Psoriasis&term=HPOS&aggFilters=status%3Anot%20rec&rank=1.Weiterlesen