Redaktion

**Tildrakizumab im echten Leben wirksam** Ein neues Medikament gegen Schuppenflechte heißt Tildrakizumab[1]. Es wurde in vier deutschen Studien mit über 1500 Patienten getestet[1]. Die Forscher wollten prüfen, wie das Mittel im alltäglichen Behandlungsalltag wirkt[1]. Das Wichtigste: Das Medikament wirkt Originaltitel: Tildrakizumab Real-World Experience (T-REX) in Plaque Psoriasis: Meta-Analysis of Four Non-interventional Studies. Link zur Quelle

**LAG-3: Wenn ein Protein zwei Seiten hat** Wissenschaftler erforschen gerade ein Protein namens LAG-3. Es sitzt auf Abwehrzellen und steuert deren Arbeit. Diese speziellen Zellen heißen Tregs und bremsen normalerweise Entzündungen. Das Besondere: LAG-3 arbeitet je nach Krankheit ganz unterschiedlich. Bei Schuppenflechte und Lupus schwächt LAG-3 die Schutz-Zellen. Sie fangen dann an, Entzündungen zu fördern statt zu bremsen. Bei Rheuma oder Multipler Sklerose sieht es anders aus. Dort hilft LAG-3 den Tregs, gut zu funktionieren. Sie hemmen dann Entzündungen richtig. Das Wichtige: Eine Therapie darf nicht alle Patienten gleich behandeln. Die Forschung sollte LAG-3 gezielt für jede Krankheit unterschiedlich steuern. So könnte man Schuppenflechte-Patienten besser helfen als mit simplen Blockade-Mitteln. Originaltitel: LAG-3 at the crossroads: A context-dependent regulator of Tregs and autoimmunity inflammatory disorders. Link zur Quelle

# Volume Versus Intensity: Which Matters More for Your Health? Recent research shows conflicting but complementary findings on whether the *amount* (volume) or *intensity* of physical activity matters most for preventing chronic diseases. ## The Key Finding: Intensity Takes Priority **Intensity appears to be the stronger predictor of reduced mortality risk**, particularly for cardiovascular disease.[2] Research indicates that spending more time at higher intensity levels and accumulating vigorous activity in continuous bouts provides greater protection than simply doing more total activity.[2] The benefits plateau at certain thresholds, meaning there's a point beyond which doing even more activity yields diminishing returns.[2] ## But Volume Still Counts The picture becomes more nuanced when looking at specific outcomes. Total physical activity volume is significantly associated with lower all-cause mortality risk[1] and helps prevent 19 different chronic conditions, including cardiovascular disease, cancer, respiratory disease, and diabetes.[6] However, one analysis found that volume's mortality benefits may largely stem from including higher-intensity activities within that volume.[2] ## What the Guidelines Tell Us Meeting current recommendations—**150 minutes of moderate-intensity or 75 minutes of vigorous-intensity activity per week**[7]—reduces cardiovascular disease mortality by 22% to 31%.[3] Those who exceed these guidelines by 2 to 4 times experience 21% to 33% lower cardiovascular mortality risk.[3] The evidence suggests that integrating *any* intensity of activity into daily life helps, with added benefits when that activity is performed more vigorously.[1] The practical takeaway: consistent activity matters, but prioritizing higher-intensity efforts within your routine maximizes health protection. Originaltitel: Volume vs intensity of physical activity and risk of cardiovascular and non-cardiovascular chronic diseases | European Heart Journal | Oxford Academic Link zur Quelle

**Warum erinnert sich unsere Haut an Psoriasis-Schübe** Eure Haut speichert Informationen über frühere Entzündungen — so wie ein biologisches Gedächtnis.[1][3] Forscher haben bei Mäusen gezeigt: Epidermale Stammzellen bewahren epigenetische Erinnerungen an psoriasisähnliche Schübe über Jahre.[1] Das bedeutet, dass bestimmte DNA-Bereiche nach einem Schub offengeblieben und leicht zugänglich für Entzündungen bleiben.[1] **Was das für Euch praktisch bedeutet** Dieses Gedächtnis erklärt möglicherweise, warum Psoriasis immer wieder an gleichen Stellen aufflammt.[1] Die Haut ist dort sensibilisiert und reagiert schneller auf neue Reize.[1] Etwa 10% dieser epigenetischen Veränderungen bleiben dauerhaft bestehen.[1] **Perspektive für neue Behandlungen** Wenn Forscher verstehen, wie diese molekularen Erinnerungen entstehen und funktionieren, könnten zukünftige Therapien gezielt eingreifen — um Rückfälle zu verhindern oder zu verzögern. Die Studie zeigt: Es geht nicht nur um die aktuelle Entzündung, sondern um ihre langfristigen Spuren in eurer Haut. Originaltitel: Distinctive DNA sequence features define epigenetic longevity of inflammatory memory Link zur Quelle

Background and objectivesAtopic dermatitis and psoriasis are chronic inflammatory skin diseases often linked to psychological stress. Integrative care models are lacking. This randomized pilot study aimed to develop and test a psychoeducational intervention for dermatology patients.Patients and methodsPatients with a PHQ-2 score ≥ 3 at an outpatient inflammation center were randomized into an intervention or control group. The intervention group received three standardized educational sessions focusing on maladaptive schemas, coping strategies, psychoeducation, and emotion-focused techniques (e.g. chair-dialogues, imaginary rescripting).Results19 patients received the intervention; 13 were in the control group. Post-intervention, significant improvements were observed in dermatological quality of life (DLQI), subjective well-being (WHO-5), and depressive symptoms (PHQ-9, BDI-II). Psychological benefits were largely independent of disease severity (PASI, EASI). Qualitative feedback highlighted usability, learning specific techniques, and a trusting therapeutic relationship.ConclusionsA brief psychoeducational intervention significantly reduced psychological stress in dermatology outpatients. Further studies are needed to evaluate long-term effects and broader implementation.Weiterlesen

No abstract supplied.Weiterlesen

BackgroundPsoriasis is one of the chronic inflammatory skin conditions, affecting about 2-3% of the world population. Steroidal treatment are only best choice of treatments, but it is often associated with side effects due to higher lipophilicity.ObjectivesIn this work, a nanoparticle-loaded transdermal film was developed to maintain nanoparticle integrity in the skin.MethodsFluticasone propionate loaded chitosan nanoparticles (NPs) were developed, and their particle size, zeta potential, drug loading, entrapment efficiency and scanning electron microscope (SEM) images were determined. The NPs-loaded film was further characterized for appearance, thickness and Fourier Transform Infrared (FTIR) spectra, and an in vitro and in vivo permeation study was conducted.ResultsThe particle size of FSNPs was found to be 250nm with +32.4 ±1.5 mV zeta potential, great entrapment efficiency and spherical in shape. In vivo dermato-kinetic studies showed long-term, confined drug release from the NP-formulated film in the epidermal layers, compared with the film containing free drug.ConclusionThe study demonstrated that the FSNPs-loaded film showed higher skin permeation, which is effective for managing psoriasis and warrants further evaluation.Weiterlesen

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Psoriasis is a chronic inflammatory skin disease in which the IL-23/Th17/IL-17 axis plays a central pathogenic role while also contributing to antifungal defence. IL-17-targeting biologics such as secukinumab and ixekizumab are increasingly used in its management. This study aimed to characterize changes in the diversity and composition of oral fungal and bacterial communities in psoriasis patients before and after treatment with IL-17 inhibitors. Oral swabs were collected from psoriasis patients at baseline and after 3 months of IL-17 inhibitor therapy, as well as from healthy controls. Direct microscopy and fungal culture were performed. Microbial DNA was extracted and subjected to amplicon sequencing of the fungal ITS1 region and the bacterial 16S rRNA V3-V4 region using the Illumina HiSeq platform. A total of 36 patients and 38 healthy controls were enrolled in this study. Fungal microbiome analysis revealed significantly increased alpha diversity after treatment compared with baseline (p < 0.05), accompanied by markedly elevated beta diversity (p < 0.001). The dominant fungal genera were Blumeria, Pichia and Aspergillus. The relative abundance of Candida was significantly higher in psoriasis patients at baseline than in controls (16.00% vs. 6.43%, p < 0.05) and decreased significantly after therapy (6.12%, p < 0.05). In the bacterial microbiome, beta diversity decreased significantly following treatment (p < 0.001), whereas alpha diversity increased (p < 0.05). The predominant bacterial genera were Streptococcus, Neisseria and Rothia. After treatment, the relative abundance of Haemophilus was significantly lower than at baseline (9.18% vs. 10.14%, p < 0.05). Streptococcus showed a higher trend in patients versus controls (29.74% vs. 16.48%) and declined post-treatment (23.71%). In conclusion, IL-17 inhibitor therapy in psoriasis alters the oral fungal and bacterial microbiota, with notable shifts in Candida, Haemophilus and Streptococcus. These findings provide new insights into the oral microbial changes associated with biologic therapy and may inform clinical monitoring of mucocutaneous microbial imbalance during treatment.Weiterlesen

BackgroundData on the prevalence of sensitive skin in patients with chronic inflammatory skin diseases are lacking. The aim of this study was to address this gap.MethodsThis observational study included patients with psoriasis, atopic dermatitis or chronic hand eczema who attended the Unit of Dermatology of Ferrara and Messina, Italy, between June and December 2023. All participants completed a 10-item questionnaire for the diagnosis of sensitive skin (score range: 0-10). Participants were classified as having sensitive skin if they scored ≥4.ResultsA total of 188 subjects were included, of whom 82 had psoriasis (mean Psoriasis Area and Severity Index [PASI] 4.2±5.1), 59 had atopic dermatitis (Eczema Area and Severity Index [EASI] 3.5±6.7) and 47 had hand eczema (Hand Eczema Severity Index [HECSI] 39.3±3.26). The mean questionnaire scores were 2.6±2.4 for psoriasis, 4.7±2.9 for atopic dermatitis, and 3.0±2.1 for hand eczema, with significant differences observed between atopic dermatitis and both psoriasis (P<0.001) and hand eczema (P<0.001). The prevalence of sensitive skin was higher among atopic dermatitis patients compared to those with psoriasis (P<0.001) and hand eczema (P<0.01).ConclusionsIn the present study, which should be regarded as a pilot due to the relatively small number of cases included, sensitive skin was both more prevalent and more severe in patients with atopic dermatitis compared to those with psoriasis and hand eczema. Atopic dermatitis appears to promote skin sensitivity, independently of its clinical severity.Weiterlesen

BackgroundPsoriasis is a chronic immune-mediated skin disease influenced by genetic, environmental, and lifestyle factors, with increasing burden among working-age adults.ObjectiveTo examine global trends in psoriasis prevalence among working-age adults, evaluate associations with lifestyle factors using a simplified Life's Essential 4 (LE4) index, and explore potential dietary causal relationships through Mendelian randomization (MR).MethodsGlobal prevalence trends from 1990 to 2021 were analyzed using GBD 2021 data, calculating age-standardized rates (ASR) and estimated annual percentage changes (EAPC), with projections to 2031. Regional variations across SDI levels were also assessed. The LE4 index, derived from core lifestyle components of the Life's Essential 8 framework using NHANES data, was evaluated via survey-weighted logistic regression and restricted cubic spline analysis. Two-sample MR analyses were conducted using the inverse-variance weighted (IVW) method to assess dietary traits.ResultsThe global prevalence of psoriasis among working-age adults increased from 555.7 to 600.6 per 100,000 (EAPC: 0.22%), with projections reaching 631.6 by 2031; Notably, upward trends were consistently observed across all SDI regions. Higher LE4 scores (≥81.2) were associated with lower odds of psoriasis (OR: 0.518, P=0.040). MR analyses suggested that genetically predicted fizzy drink consumption increased risk (OR: 1.57, P=0.0215), whereas salad vegetable intake showed a protective association (OR: 0.85, P=0.0224).ConclusionThe burden of psoriasis among working-age adults shows a modest global increase with regional heterogeneity. Healthier lifestyle patterns and favorable dietary factors were associated with reduced risk, highlighting the importance of modifiable behaviors in prevention strategies.Weiterlesen

ObjectiveTo disentangle tobacco constituents in psoriasis, we contrasted nicotine exposure-proxied by the nicotine metabolite ratio (NMR)-with smoking intensity (cigarettes per day, CPD) and evaluated cross-ancestry effects.MethodsThis study applied multivariable Mendelian randomization (MR) jointly modeling genetically proxied NMR (instrumented using variants from a European-ancestry GWAS) and CPD to estimate their independent effects on liability to psoriasis and psoriatic arthritis (PsA). Chronic obstructive pulmonary disease (COPD) served as a positive control. Cross-ancestry generalizability was tested using a trans-ethnic MR (TEMR) framework under conditional likelihood with Nelder-Mead optimization. Sensitivity analyses assessed pleiotropy, heterogeneity, directionality (Steiger), MRLap, RadialMR, and multiple testing (Benjamini-Hochberg).ResultsNMR showed an independent association with higher PsA risk irrespective of CPD (OR = 1.104, 95% CI: 1.039-1.174). CPD retained an independent effect on overall psoriasis after conditioning on NMR (OR = 1.305, 95% CI: 1.082-1.573), while the NMR effect on psoriasis attenuated (P > 0.05). In univariable MR, genetically predicted NMR increased psoriasis risk in Europeans (EUR; OR = 1.032, 95% CI: 1.013-1.051). CPD associated with psoriasis in EUR (OR = 1.130, 95% CI: 1.031-1.239) and strongly in Hispanics (HIS; OR = 1.448, 95% CI: 1.434-1.463), with suggestive evidence in East Asians. Reverse-direction MR indicated psoriasis liability correlated with lower CPD across EUR, EAS, AFR, and HIS (β < 0, Padj < 0.05).ConclusionThis study supports ancestry-specific differences and suggests distinct roles of nicotine-related versus non-nicotine tobacco smoke constituents in psoriasis and its subtypes, while the underlying biological mechanisms remain to be clarified.Weiterlesen

BackgroundB-cell depleting therapies (BCDT), including ocrelizumab, ofatumumab, and ublituximab, are highly effective disease-modifying therapies for multiple sclerosis (MS). Several case reports have raised concerns about new-onset or exacerbation of psoriasis under BCDT.ObjectivesThis article aims to analyze clinical characteristics, treatment courses, and outcomes of MS patients who developed or experienced worsening of psoriasis during BCDT.DesignThis retrospective, multicenter analysis included patients from four German university hospitals (Düsseldorf, Hannover, Bochum, Giessen).MethodsWe retrospectively screened 3228 MS patients under BCDT between 2020 and 2024 for development of psoriasis or an exacerbation of a known psoriasis. Clinical data, including Expanded Disability Status Scale, Psoriasis Area and Severity Index scores, treatment regimens, and comorbidities, were analyzed.ResultsAmong 3228 patients treated with BCDT, 7 developed new-onset psoriasis and 10 showed exacerbation of preexisting psoriasis. The median time to psoriasis onset or worsening was 13 months (3-83 months) under continuous treatment with BCDT. Topical therapies were effective in most cases, but a change of MS treatment or initiation of psoriasis-specific immunotherapies, including the interleukin-17A-antibody secukinumab, was required in four patients.ConclusionPsoriasis onset or worsening during BCDT is rare. While most cases are manageable with standard psoriasis treatments, severe cases may necessitate therapy adjustments. The potential immunological interplay between MS and psoriasis treatment warrants further investigation.Weiterlesen

Originaltitel: Immunomodulatory Effects of a Tick Salivary Serpin on Psoriasis-like Inflammation Link zur Quelle

Originaltitel: A Study on Lifestyle and Dietary Factors in Psoriasis: Global Prevalence Trends in Working-Age Populations, Association with LE4 Lifestyle Factors, and Mendelian Randomization Analysis of Dietary Causal Effects. Link zur Quelle

# Axial Involvement bei Psoriasis-Arthritis: Was die AXIS-Studie zeigt Die **AXIS-Studie** untersuchte 409 Psoriasis-Arthritis-Patienten weltweit. Das Ergebnis: Bei etwa 27 Prozent der Patienten ist die Wirbelsäule oder das Kreuzbein entzündet. Das nennt man axiale Beteiligung. Wer ist besonders betroffen? Patienten mit axialer Beteiligung sind typischerweise jünger. Sie sind häufiger männlich und haben mehr Rückenschmerzen. Ein bestimmter genetischer Marker namens HLA-B*27 kommt bei ihnen öfter vor. Auch erhöhte Entzündungswerte im Blut sind ein typisches Zeichen. Die Forscher machten Röntgen- und MRT-Aufnahmen der Wirbelsäule. Diese Bilder zeigten deutlich, wer eine axiale Beteiligung hat. Die genaue Bildgebung war wichtig. Denn anfangs dachten die Ärzte, dass 37 Prozent der Patienten betroffen sind. Nach genauerer Auswertung sank diese Zahl auf 27 Prozent. **Das ist wichtig für dich:** Wenn du unter Rückenschmerzen und Psoriasis-Arthritis leidest, solltest du deinen Arzt fragen. Möglicherweise brauchst du spezielle Bildgebung. Dann kann dein Arzt die richtige Behandlung für dich finden. Originaltitel: Frequency and characteristics of axial involvement in psoriatic arthritis: results from the International Multicentre AXIS Study. Link zur Quelle

Originaltitel: Vitiligo secondary to immunosuppressants: a pharmacovigilance study of the FDA Adverse Event Reporting System Link zur Quelle

# Achsenbeteiligung bei Psoriasis arthritis: Was die Forschung zeigt **Die Häufigkeit ist höher als früher gedacht** Bei etwa einem Viertel bis zur Hälfte der Patienten mit Psoriasis arthritis betrifft die Erkrankung auch die Wirbelsäule und das Kreuzbein-Darmbein-Gelenk.[1][2][4] Die genauen Zahlen unterscheiden sich je nachdem, wie Ärzte die Achsenbeteiligung definieren und nachweisen – ob durch Röntgen, MRT oder Symptome. **Das ist für euch im Alltag wichtig** Patienten mit Achsenbeteiligung berichten von stärkeren Schmerzen, mehr Müdigkeit und einer schlechteren Lebensqualität.[2] Die Entzündung im Rücken verursacht typischen Rückenschmerz: Er verbessert sich durch Bewegung, verschlimmert sich nachts und morgens ist die Steifheit länger als 30 Minuten.[1] Auch Frauen sind häufiger betroffen als Männer – das könnte mit Hormonen zusammenhängen.[1] **Welche Warnsignale solltet ihr kennen** Bestimmte Merkmale deuten auf ein höheres Risiko hin: Das Gen HLA-B27, erhöhte Entzündungswerte im Blut (CRP, BSG) und Nagelbeteiligung der Psoriasis.[1][2] Falls ihr diese Zeichen habt, sollte euer Arzt gezielt die Wirbelsäule untersuchen. **Was das für die Behandlung bedeutet** Eine frühzeitige Diagnose ist wichtig. Biologika werden bei Achsenbeteiligung häufiger eingesetzt.[2] Eine gezielte Therapie kann Folgeschäden verhindern. Originaltitel: Frequency and characteristics of axial involvement in psoriatic arthritis: results from the International Multicentre AXIS Study - PubMed Link zur Quelle

Your skin cells have a memory. Scientists discovered that when inflammation like psoriasis flares happens, your skin stores this experience in your DNA[1]. This memory sticks around for the entire life of the organism and even survives when skin cells divide and multiply[1]. The key to how long this memory lasts lies in special DNA sequences called **CpGs**[2]. Think of them as a timer. DNA regions with high CpG density hold onto inflammation memories much longer than regions with low CpG density[2]. Once inflammation activates certain genes, these DNA sequences keep them primed and ready[1]. This is why your skin becomes extra sensitive to future flares[1]. Here's what makes this discovery important for psoriasis: Your skin doesn't just forget a flare and return to normal. Instead, it stays on alert. The next time inflammation hits, your skin responds faster and stronger because it remembers the previous attack[1]. This helps explain why people with psoriasis experience repeated flares. Understanding how DNA stores these inflammatory memories could eventually help doctors develop better treatments[1]. Instead of just reducing symptoms during a flare, doctors might target Originaltitel: Distinctive DNA sequence features define epigenetic longevity of inflammatory memory. Link zur Quelle

Originaltitel: Psoriasis under B-cell depleting therapies in multiple sclerosis: a retrospective multicenter analysis. Link zur Quelle

**Frühe Behandlung hilft langfristig** Die STEPIn-Studie zeigt, dass eine frühe Therapie mit dem Medikament Secukinumab bei neu diagnostizierter Schuppenflechte wirksam ist.[1] Dabei wurden Patienten untersucht, die maximal ein Jahr lang krank waren. 91 Prozent der Patienten zeigten nach 52 Wochen Secukinumab eine starke Hautverbesserung.[1] Das war deutlich besser als die traditionelle UV-B-Therapie mit nur 42 Prozent Erfolg.[1] Das Besondere: Auch nach dem Absetzen des Medikaments blieb die Haut bei manchen Patienten lange klar. Ein Jahr später hatten noch über 20 Prozent der Patienten eine gute Hautverbesserung, obwohl sie kein Medikament mehr nahmen. Die Forscher schließen daraus: Eine frühe intensive Behandlung bei neu diagnostizierter Psoriasis kann die Krankheit langfristig kontrollieren.[1] Das gibt vielen Patienten Hoffnung auf weniger Schübe in Zukunft. Originaltitel: Impact of early treatment of psoriasis on disease recurrence - Results from the STEPIn study. Link zur Quelle

# Biologika bei Kindern mit Psoriasis: Was wir wissen und was nicht Biologika könnten für Kinder mit mittlerer bis schwerer Psoriasis eine echte Hoffnung sein. Tatsächlich zeigen die bisherigen Studien, dass diese Medikamente sehr wirksam sind und gut vertragen werden[5]. Fünf Biologika sind derzeit für Kinder ab sechs Jahren zugelassen: unter anderem Secukinumab, Ixekizumab und Ustekinumab[1]. Doch es gibt ein Problem: Bei Kindern wissen wir deutlich weniger als bei Erwachsenen[6]. Viele Ärzte nutzen Biologika deshalb einfach "off-label", also nicht offiziell zugelassen, weil die Datenlage dafür spricht. Die meisten Erfahrungen stammen aus Fallberichten und echten Behandlungen im Alltag – nicht aus großen Studien[6]. Biologika sind zudem teuer und erfordern weniger Kontrollen als ältere Mittel. Das macht sie attraktiv, besonders wenn traditionelle Therapien nicht wirken[1]. Doch Langzeitfolgen bei Kindern sind noch nicht ausreichend erforscht. Diese Lücke im Wissen schließen sich nur langsam – eine Herausforderung für Eltern und Ärzte. Originaltitel: Paediatric psoriasis and biologics: An evidence gap in plain sight Link zur Quelle