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This cross-sectional study aimed to determine the detectability of a panel of 92 inflammatory biomarkers in tape strips from the skin of patients with inflammatory skin diseases, and whether this depended on the number of tape strips taken. Furthermore, the biomarker levels in the patients were compared with those in healthy controls. Eight consecutive uniform tape strips (each 3.8 cm²) were obtained from 2 adjacent skin sites from 8 atopic dermatitis, contact dermatitis, and psoriasis patients, respectively, and 5 controls. Three separate analyses were carried out using the Olink® Target Inflammation panel: (i) all 8 tape strips (1-8) from 1 skin site and from the other skin site, (ii) the first 4 tape strips (1-4), and (iii) the next 4 tape strips (5-8). Biomarkers were above the detection limit for 65.7% of atopic dermatitis, 70.2% of psoriasis, and 45.1% of contact dermatitis samples. There were no significant differences in biomarker levels between the use of 4 or 8 tape strips, or between the first and last 4 tape strips. In general, atopic dermatitis and psoriasis patients were distinguishable from controls, whereas contact dermatitis patients were not. Based on the overall data quality, analysing protein signatures in tape strips with the targeted inflammatory panel is feasible.Weiterlesen

Photosensitive presentations of psoriasis are often under-recognized and may closely mimic other photodistributed dermatoses. We report the case of a 39-year-old male patient with no history of other photodermatoses who developed a progressive, non-pruritic rash, localized in sun-exposed skin areas, with marked exacerbation after phototherapy. Pronounced photosensitivity and atypical lesion distribution, involving the malar and nasal regions, complicated the initial differential diagnosis between photosensitive plaque psoriasis and cutaneous lupus erythematosus (CLE). Only further clinical evaluation, alongside histopathological analysis and immunological testing, helped to confirm the final diagnosis of photosensitive plaque psoriasis. Treatment with systemic and topical corticosteroids, vitamin D analogues, and calcineurin inhibitors resulted in gradual clinical improvement. This case report highlights photosensitive psoriasis as an important cause of photodistributed eruptions and a rare but significant mimic of CLE.Weiterlesen

ObjectiveTo evaluate the long-term efficacy of interleukin (IL)-17A inhibition with secukinumab on structural bone changes and clinical outcomes in psoriatic arthritis (PsA).MethodsWe conducted a phase-IV non-interventional study on adult patients with active PsA using high-resolution peripheral quantitative CT (HR-pQCT) and MRI of the hand over 48 months. All participants received secukinumab treatment and were followed up according to clinical practice, with repeated HR-pQCT and MRI. Number and volume of erosions, bone density, cortical and trabecular microarchitecture and bone biomechanical properties were assessed based on HR-pQCT scans. MRI synovitis, tenosynovitis, osteitis, periarticular inflammation, erosions and osteoproliferation were quantified by Psoriatic Arthritis MRI Score (PsAMRIS)-Outcome Measures in Rheumatology (OMERACT) score. Study outcomes included drug survival and changes from baseline in disease activity, functional status and imaging-detected inflammation and damage.Results32 patients with PsA (40.6% female, mean age 56±7.5 years) were enrolled. Drug survival rate was 68.8% at 48 months. Secukinumab was highly effective in all PsA disease domains, with significant improvements in Disease Activity Score 28 (p<0.001), Leeds Enthesitis Index (p=0.027), Psoriasis Area and Severity Index (p=0.001), C reactive protein (p=0.09), Psoriatic Arthritis Impact of Disease (p<0.001) and pain (p<0.001). Functional status measured by the Health Assessment Questionnaire remained stable. On HR-pQCT, bone density, microarchitecture and biomechanics were preserved. There was no progression of bone erosions (all changes were not significant). On MRI, PsAMRIS erosion and osteoproliferation subitems increased marginally (+1.4 and +0.8, respectively), while inflammatory changes remained stably low. No major safety signals emerged.ConclusionMultimodal imaging with HR-pQCT and MRI showed no relevant progression of structural bone damage over 48 months in patients with PsA treated with secukinumab, suggesting that anti-IL-17A therapy induces sustained osteoprotective effects in PsA.Weiterlesen

Background: Psoriasis is a chronic systemic inflammatory disease with established extra-cutaneous manifestations. While the association between uveitis and spondyloarthritis (SpA)-related disorders is well recognized, the incident risk of uveitis among broader psoriasis populations remains inadequately defined due to methodological limitations and inconsistent findings across previous studies. We aimed to estimate the incidence of uveitis in a large, nationwide population-based cohort and identify specific clinical and treatment-related predictors of ocular inflammation. Methods: This retrospective cohort study utilised electronic health records from Clalit Health Services, Israel's largest health maintenance organization (2002-2024). We identified 157,360 patients with dermatologist-confirmed psoriasis and 156,927 age- and sex-matched controls. The primary outcome was incident uveitis, with risk estimated using Cox proportional hazards models. Within the psoriasis cohort, multivariable logistic regression was employed to identify predictors of uveitis, ensuring appropriate temporal sequencing between psoriasis treatment exposure and outcome. Results: Over a median follow-up of 12.6 years, psoriasis was associated with a significantly higher risk of incident uveitis (adjusted Hazard Ratio [aHR] 1.80; 95% CI, 1.50-2.15). Stratified analysis revealed a graded risk pattern: mild psoriasis showed no increased risk (aHR 1.01; 95% CI, 0.91-1.13), whereas severe disease (aHR 1.59; 95% CI, 1.25-2.03) and concomitant SpA (aHR 2.21; 95% CI, 1.87-2.61) demonstrated markedly elevated risks. Within the psoriasis cohort, independent predictors included SpA, diabetes mellitus, systemic lupus erythematosus, and sarcoidosis. Exposure to biologics, particularly etanercept (OR 3.37; 95% CI, 2.42-4.54), was associated with higher odds of uveitis, potentially reflecting higher disease severity. Conclusions: Incident uveitis risk in psoriasis is primarily driven by the magnitude of systemic inflammatory burden, with the highest risk observed in severe disease and those with concomitant SpA. Clinicians should maintain heightened vigilance for ocular symptoms in these high-risk subgroups to ensure timely intervention.Weiterlesen

No abstract supplied.Weiterlesen

Psoriasis is a chronic, inflammatory skin disease occurring worldwide that significantly affects patients' quality of life. This common skin condition is characterized by abnormal hyperplasia of keratinocytes, which leads to the formation of raised, scaly plaques, typically located on the head, elbows, knees, and lumbar region. Psoriasis usually requires long-term drug therapy, which aims not only to combat skin symptoms but also to improve quality of life. Although topical treatments, systemic treatments (methotrexate, cyclosporine, acitretin), and phototherapy play a role, biologic agents have improved the efficacy of treatment of moderate-to-severe psoriasis. The purpose of this article is to comprehensively review the clinical trial data and evaluate and compare the key features of the currently approved biologic drugs for the treatment of psoriasis.Weiterlesen

Originaltitel: Antagonizing IL-17A Reduces Vascular Inflammation and Attenuates Oxidative Stress Formation but Does Not Significantly Improve Vascular Dysfunction Induced by One Week of Angiotensin II Treatment. Link zur Quelle

# Secukinumab schützt die Knochen bei Psoriasis-Arthritis Eine neue Studie zeigt: Das Medikament Secukinumab hält die Knochen bei Psoriasis-Arthritis stabil und verhindert Schäden langfristig. Forscher untersuchten dafür 32 Patienten über vier Jahre hinweg. Die Patienten bekamen regelmäßig spezielle Aufnahmen ihrer Hände gemacht. Diese zeigten sehr deutlich, wie es ihren Knochen geht. Das Ergebnis ist ermutigend: Die Knochendichte blieb erhalten. Es bildeten sich kaum neue Erosionen, also keine Löcher und Unebenheiten in den Knochen. Gleichzeitig verbesserte sich der Zustand der Patienten deutlich. Die Entzündungen gingen zurück. Die Schmerzen sanken. Die Patienten konnten ihre Hände besser bewegen. Zwei Drittel der Patienten setzten das Medikament über die ganze Zeit fort. Die Studie zeigt: Secukinumab wirkt nicht nur gegen Schmerzen und Entzündungen. Es schützt auch die Knochenstruktur. Das ist wichtig, weil Psoriasis-Arthritis die Knochen langfristig zerstören kann. Mit dem richtigen Medikament lässt sich diese Zerstörung verhindern. Originaltitel: Long-term osteoprotective effects of IL-17A blockade with secukinumab in psoriatic arthritis: data from the PSARTROS-II study Link zur Quelle

**Secukinumab schützt Knochen bei Psoriasis-Arthritis langfristig** Das Medikament Secukinumab hemmt einen Botenstoff namens IL-17A und schützt die Knochen von Menschen mit Psoriasis-Arthritis dauerhaft. Das zeigt die PSARTROS-II-Studie über vier Jahre hinweg. Die Ärzte beobachteten 32 Patienten und stellten mit speziellen Kameras fest: Die Knochen wurden nicht angegriffen. Sie blieben stabil und dicht. Die gefürchteten Knochenerosionen (kleine Löcher im Knochen) schritten nicht voran. Auch Entzündungen blieben dauerhaft niedrig. Das Wichtigste: Den Patienten ging es deutlich besser. Ihre Gelenkschmerzen sanken. Sie konnten besser laufen und arbeiten. Bei etwa 69 Prozent der Patienten wirkte das Mittel nach vier Jahren immer noch. Diese Ergebnisse sind ermutigend. Denn Knochenabbau ist bei Psoriasis-Arthritis ein großes Problem. Er führt zu Behinderungen. Wenn Secukinumab das verhindert, können Menschen mit dieser Erkrankung länger aktiv und mobil bleiben. Originaltitel: Long-term osteoprotective effects of IL-17A blockade with secukinumab in psoriatic arthritis: data from the PSARTROS-II study. Link zur Quelle

No abstract supplied.Weiterlesen

BackgroundPsoriasis is a persistent, chronic autoimmune skin disease that affects around 2% of the global population. Conventional therapies often exhibit limited efficacy, systemic side effects, and poor patient compliance due to long-term treatment needs.Materials & methodsThis study focused to develop and optimize a sulfasalazine-loaded microemulsion (SSZ-ME) for topical delivery to enhance skin penetration and therapeutic efficacy in psoriasis. Pseudo-ternary phase diagrams were prepared to identify the optimal surfactant mixture, with Tween 80 and Polyethylene Glycol 400 selected in a 2:1 ratio. A 23 factorial design was used to optimize formulation parameters, focusing on oil and surfactant mixture effects on globule size and viscosity.Results and conclusionsThe resulting microemulsions showed globule sizes between 60 ± 0.42 to 349 ± 0.13 nm, with optimal viscosity. In vitro release studies confirmed sustained drug release over 24 hours, following first-order kinetics. Skin permeation studies demonstrated enhanced drug penetration with SSZ-ME, while histopathological analysis revealed significant improvements in psoriatic symptoms in mice treated with 4% SSZ-ME compared to 2% SSZ-ME and marketed formulation. Blood analysis confirmed minimal systemic absorption and localized action. These results suggest that SSZ-ME offers a promising, patient-compliant, and effective topical therapy for psoriasis with improved therapeutic outcomes and minimal systemic exposure.Weiterlesen

# Model-informed Precision Dosing: Medikamente endlich richtig dosieren Lange Zeit bekamen alle Psoriasis-Patienten die gleiche Medikamentenmenge. Das ist aber nicht ideal, denn jeder Körper baut Medikamente unterschiedlich ab.[1] Ein neuer Ansatz könnte das ändern: Model-informed Precision Dosing, kurz MIPD. Mit MIPD können Ärzte vorhersagen, wie dein Körper ein Medikament verarbeitet.[1] Sie nutzen dafür Blutuntersuchungen und mathematische Modelle. So erkennen sie, welche Dosierung bei dir persönlich am besten passt. Die Vorteile sind überzeugend. Besserer Behandlungserfolg. Weniger Nebenwirkungen. Und die Medikamente wirken länger gut.[1] Eine Studie mit Psoriasis-Patienten zeigte: Etwa 35 Prozent bräuchten eine höhere Dosis als üblich. 26 Prozent könnten mit weniger auskommen.[2] Das spart Kosten und schont den Körper. Für dich als Patient bedeutet das neue Chancen. Bald könnten Behandlungen viel genauer auf deine Bedürfnisse abgestimmt sein. [1][2] Originaltitel: Bridging theory and practice in model-informed precision dosing of medication in inflammatory skin diseases Link zur Quelle

The aggregate index of systemic inflammation (AISI), calculated from monocyte, neutrophil, lymphocyte, and platelet counts, is a blood-count-derived composite marker of systemic inflammation. This cross-sectional study aimed to examine the association between AISI and the prevalence of psoriasis among U.S. adults. The dataset was obtained from the National Health and Nutrition Examination Survey (NHANES) database from 2003 to 2006 and from 2009 to 2014. The relevant covariates were adjusted during the analysis. We employed restricted cubic spline (RCS) regression and logistic regression frameworks to statistically assess the correlation between the AISI standard and psoriasis. The study also included subgroup analyses to determine whether the effectiveness of AISI varied among different categories. Compared with individuals without psoriasis, participants with psoriasis had higher AISI values. A total of 17 776 participants were included in the analysis. In multivariable logistic regression analyses, higher AISI levels were independently associated with higher odds of prevalent psoriasis after adjustment for potential confounders (p for trend < 0.001). Restricted cubic spline analyses demonstrated an approximately linear positive association between ln-transformed AISI and psoriasis prevalence (p for non-linearity > 0.05). Subgroup analyses showed no statistically significant interactions across most strata, suggesting overall consistency of the association. Receiver operating characteristic analysis indicated that AISI had limited discriminatory ability for prevalent psoriasis, with an AUC (95% CI) of 0.58 (0.55-0.60). In this large, population-based cross-sectional study, higher AISI levels were associated with the prevalence of psoriasis among U.S. adults. Given the cross-sectional design and the modest discriminatory ability (AUC = 0.58), AISI is best interpreted as a correlate of systemic inflammation rather than as a marker with predictive or causal utility for psoriasis.Weiterlesen

Psoriasis is a chronic inflammatory skin disease, and previous studies among Western populations have suggested an increased risk of cardiovascular events in patients with psoriasis. However, evidence from Asian populations remains limited. We evaluated the risk of major adverse cardiovascular events (MACE) in patients with psoriasis compared with patients who have atopic dermatitis (AD) using a large-scale administrative claims database from Shizuoka, Japan. We conducted a cohort study using the Shizuoka Kokuho Database, including patients aged ≥ 40 years who were newly diagnosed with psoriasis or AD between April 2012 and September 2022. Propensity score matching was used to balance age, sex, and baseline cardiovascular risk factors. The primary outcome was hospitalization for MACE, defined as myocardial infarction (MI) or stroke. Survival analyses were conducted, treating death as a competing risk. After 1:1 propensity score matching (n = 2208 per group), the mean age was 70 years. During a follow-up period (median 4.5 years for psoriasis and 4.4 years for AD), the incidence of MACE was 2.7% in both groups (hazard ratio 0.96, 95% confidence interval 0.67-1.38; p = 0.84). When analyzed separately, the risks of MI and stroke did not differ significantly between groups. Results were consistent across subgroups by psoriasis severity and in two sensitivity analyses. We observed no excess risk of MACE in Japanese patients with psoriasis compared with those with AD over a median follow-up of approximately 4.5 years. These findings suggest that the cardiovascular risk specifically attributable to psoriasis may be limited in the Japanese population.Weiterlesen

BackgroundBiologic therapies have transformed psoriasis management, and their incorporation into Brazil's public healthcare system (SUS) in 2019 expanded access nationwide. However, real-world utilization and perceptions remain incompletely understood.ObjectivesTo evaluate perceptions, barriers, and prescription patterns regarding biologic therapy among Brazilian dermatologists and patients five years after universal incorporation, while quantifying the prevalence of undertreatment.MethodsWe conducted two independent cross-sectional online surveys throughout 2024 among dermatologists (n = 225) and patients with psoriasis or psoriatic arthritis (n = 1,001). Data on demographics, clinical characteristics, and perceived barriers were analyzed.ResultsOverall, 64.9% of dermatologists prescribed biologics, with higher prescribing rates among younger physicians (p = 0.022), those with fewer years of practice (p = 0.013), higher patient volumes (p < 0.001), and practice in tertiary centers (p = 0.001). Only 25.5% of patients were receiving biologics, strongly associated with psoriatic arthritis (p < 0.001), with no difference between public and private care. Key barriers included perceptions that conventional therapies are sufficient (59.5%), insufficient training (38.0%), and administrative burden (45.5%), while patients mainly reported safety (45.7%) and cost (30.9%) concerns. Undertreatment was prevalent, affecting over 50% of patients with moderate-to-severe disease. While 71.3% of non-users were willing to start biologics, only 28.0% had received a medical recommendation.ConclusionsPersistent educational and structural barriers continue to limit optimal biologic use despite formal availability, highlighting the need for targeted education, streamlined care pathways, and improved physician-patient communication to achieve equitable outcomes.Weiterlesen

BackgroundThe clinical definition of moderate psoriasis is debated, affecting treatment eligibility and patient outcomes.ObjectiveA panel of Italian dermatologists aimed to propose practical criteria to define moderate psoriasis, based on a comprehensive literature review and clinical experience.MethodsThe panel reviewed publications between 2016 and 2024 focusing on key severity scores, including the Psoriasis Area and Severity Index (PASI), Body Surface Area (BSA), Dermatology Life Quality Index (DLQI), and Physician's Global Assessment (PGA), along with special area involvement and patient-reported outcomes.ResultsDespite variability among studies, and the lack of universally accepted thresholds, the panel defined moderate psoriasis as a BSA of 5%-10%, DLQI of 5-10, a PGA score of 3, and involvement of at least two special areas (e.g. scalp, face, genitals, nails, hands, or feet). Distressing itch and psychosocial impact were also recognized as critical elements influencing perceived disease burden. A composite PGA-based approach, integrating objective measures with patient-centered criteria, is proposed for identifying patients with moderate psoriasis who may benefit from systemic therapy.ConclusionThis pragmatic approach may help bridge the gap between guidelines and real-world clinical practice, ensuring more accurate treatment allocation and reducing undertreatment of psoriasis.Weiterlesen

No abstract supplied.Weiterlesen

ObjectiveTo compare on-label persistence among adults with psoriasis who switched from other advanced therapies to guselkumab versus subcutaneous tumor necrosis factor inhibitors (SC TNFi), subcutaneous interleukin-17 inhibitors (SC IL-17i), or apremilast.Materials and methodsThis retrospective cohort study used U.S. claims data from the IQVIA PharMetrics® Plus database (2016- 2023). Overlap propensity score weights were used to balance cohorts on baseline characteristics. On-label persistence was defined as the absence of drug discontinuation (event) and any dose change relative to the U.S. label (censoring). Survival analyses were used to assess on-label persistence from the start of the maintenance phase.ResultsAt 12, 18, and 24 months after the start of the maintenance phase, respectively, on-label persistence was 190%, 180%, and 179% more likely on guselkumab versus SC TNFi; 78%, 87%, and 91% more likely on guselkumab versus SC IL-17i; and 187%, 199%, and 193% more likely on guselkumab versus apremilast (all p < 0.001).ConclusionsPatients experiencing suboptimal outcomes with other psoriasis-indicated advanced therapies achieved higher on-label persistence after switching to guselkumab, raising the potential for improved disease control relative to other treatment options.Weiterlesen

BackgroundTo the best of our knowledge, no validated scoring instrument currently exists that comprehensively evaluates both cutaneous manifestations and systemic comorbidities of psoriasis. This multicenter study aimed to develop and validate a novel multidimensional scoring system addressing this clinical gap.MethodsUnder the guidance of the Shenzhen Psoriasis Academy, we conducted seven expert meetings to analyze existing evidence from PubMed, Wanfang, and CNKI databases. Through iterative Delphi consensus processes involving 26 specialists across 10 disciplines, we established the Psoriasis Disease Assessment Index (PSODAI). This 60-point composite instrument evaluates cutaneous involvement and nine key organ/system comorbidities. An accompanying online calculator (http://www.psodai.com.cn/) was developed for clinical implementation. Validation involved 254 psoriasis patients from six tertiary centers, with comparative analyses against PASI and DLQI metrics.ResultsThe PSODAI framework stratifies disease severity as mild (0-20), moderate (21-40), and severe (41-60). Comparative analysis revealed comparable proportions of moderate-to-severe cases between PSODAI and conventional tools (PASI/DLQI) (p>0.05). Notably, 11 patients (4.3%) classified as severe by PASI were re-categorized as mild through PSODAI's systemic evaluation, primarily due to limited extracutaneous manifestations.ConclusionAs the first comorbidity-integrated assessment tool, PSODAI enables cross-specialty collaboration for holistic patient management. Its clinical adoption may facilitate timely comorbidity detection and preventive interventions. Further multicenter validation is warranted to confirm these preliminary findings.Weiterlesen

# Neue Studie: Autoimmunerkrankungen und Herzrhythmusstörungen **Forscher der Universität Gießen haben untersucht, ob Autoimmunerkrankungen das Risiko für Vorhofflimmern erhöhen.**[2] Diese Studie basiert auf echten Patientendaten von deutschen Arztpraxen. Das ist wichtig für dich zu wissen: Menschen mit Autoimmunerkrankungen wie Psoriasis-Arthritis leben mit einer überaktiven Körperabwehr. Diese dauerhafte Entzündung kann nicht nur die Gelenke treffen, sondern auch das Herz beeinflussen. Vorhofflimmern ist eine Herzrhythmusstörung, bei der das Herz unregelmäßig schlägt.[4] Das erhöht die Schlaganfallgefahr. Andere Studien zeigen bereits: Patienten mit rheumatoider Arthritis haben ein etwa 1,5-fach höheres Risiko für Vorhofflimmern.[3] Die neue deutsche Studie schaut sich an, wie häufig diese Verbindung in der Praxis vorkommt und ob Männer und Frauen unterschiedlich betroffen sind.[2] Solche Erkenntnisse helfen Ärzte dabei, Menschen mit Autoimmunerkrankungen besser zu überwachen. Falls du mit Psoriasis-Arthritis lebst, ist es sinnvoll, dein Herz regelmäßig kontrollieren zu lassen. Das solltest du mit deinem Arzt besprechen. Originaltitel: Association between autoimmune diseases and atrial fibrillation: a real-world analysis from German outpatient data. Link zur Quelle

Originaltitel: Northwestern European Ancestry Predominates in Idiopathic Subglottic Stenosis: Results From an English-Speaking Cohort. Link zur Quelle

Originaltitel: The IL-36 cytokine family: From barrier immunity to therapeutic target in inflammatory diseases. Link zur Quelle

Originaltitel: Oncostatin M upregulates CD73 via the MAPK pathway in keratinocytes to promote an adenosine-dependent anti-inflammatory response in psoriasis. Link zur Quelle

Originaltitel: Air Pollution and Skin Diseases: A Systematic Review of Epidemiological Evidence. Link zur Quelle

Trial number: 2023-507415-35-00 Overall trial status: Ongoing, recruitment ended Trial title: A Phase III, Randomized, Double-Blind, Placebo-Controlled Study to Demonstrate the Efficacy and Safety of Tildrakizumab in Anti-TNF Experienced Subjects with Active Psoriatic Arthritis I (INSPIRE 1) Medical conditions: Psoriatic Arthritis Status in each country: Czechia:Ended, Germany:Ended, Estonia:Ended, Spain:Ended, Slovakia:Ongoing, recruitment ended, Italy:Ended, Poland:Ended Trial phase: Therapeutic confirmatory (Phase III) Therapeutic Areas: Diseases [C] - Skin and Connective Tissue Diseases [C17] Primary end point: The proportion of subjects who achieve ACR20 at Week 24 Secondary end point: N/A Age of participants: 18-64 years, 65+ years Gender of participants: Female, Male Trial region: In both EEA and non-EEA Planned number of participants: 204 Sponsor: Sun Pharmaceutical Industries Limited Sponsor type: Pharmaceutical company Trial product: Ilumetri 100 mg solution for injection in pre-filled syringe, tildrakizumab placebo solution for injection in pre-filled syringe Results posted: No Overall decision date: 31/05/2024 Countries decision date: PL: 21/06/2024, ES: 04/06/2024, IT: 01/07/2024, DE: 31/05/2024, CZ: 04/06/2024, SK: 31/05/2024, EE: 31/05/2024 Last updated date: 10/04/2025Den kompletten Artikel zeigen