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Candida infections in patients with psoriasis and psoriatic arthritis treated with interleukin-17 inhibitors and their practical management. G Ital Dermatol Venereol 2020. https://doi.org/10.23736/S0392-0488.20.06580-3 3 Saunte DM, Mrowietz U, Puig L, Zachariae C. Candida infections in patients with psoriasis and psoriatic arthritis treated with interleukin-17 inhibitors and their practical management. An integrated safety analysis of treatment-emergent fungal infections in patients with psoriasis treated with ixekizumab from 16 clinical studies. [Extracted from the article]

Background: Drug survival rates in patients with psoriasis had been described extensively. Different survival rates of TNF‐α inhibitors (TNFIs), ustekinumab and secukinumab were reported. Objectives: To investigate drug survival rates of TNFIs, ustekinumab and secukinumab, with particular emphasis on the difference between ustekinumab and secukinumab. Methods: Survival analysis was performed in patients with moderate‐to‐severe psoriasis who received adalimumab, infliximab, etanercept, ustekinumab and secukinumab treatment in 2002–2018, using the Clalit Health Services database. Stratified analysis was performed according to biologic treatment lines. Multivariate analysis was performed adjusting for demographic variables, calendar year, metabolic syndrome, psoriatic arthritis, biologic treatment line, biologic naivety, co‐administration of oral treatments and previous oral systemic treatment exposure. Results: Among 1459 patients treated with 3070 biologic medication courses, ustekinumab had a significantly higher crude survival as compared with TNFIs and secukinumab. The mean drug survival of ustekinumab, adalimumab, etanercept, infliximab and secukinumab was 43.5 (CI: 39.7–47.2), 38.2 (CI: 34.8–41), 33.9 (CI: 30.8–37.1), 28.2 (CI: 22.5–33.8) and 17.1 (CI: 15.6–18.6) months, respectively, with significant statistical differences for all comparisons (P < 0.001). The differences between ustekinumab and secukinumab were not significant following adjustment to factors that included treatment line (hazard rate 1.16, CI: 0.93–1.43). Conclusion: Different drug survival rates between ustekinumab and secukinumab are determined by the treatment line and calendar year, reflecting the availability of biologic medications, and not only by the biologic attributes of each medication. [ABSTRACT FROM AUTHOR]

Background: Hidradenitis suppurativa (HS) is a chronic, debilitating, dermatological disease that causes substantial psychosocial impediments with increased suicidal risk. Yet data on psychiatric comorbidity in HS have not been sufficiently elucidated in population‐based studies. The current study sought to investigate the association between HS and schizophrenia, a major psychiatric disease, in a nationwide population‐based study in Israel. Methods: Data mining was performed on the database of Clalit Health Services (CHS), the largest managed healthcare company in Israel. Patients diagnosed with HS (n = 4191) were examined and compared to age‐ and sex‐matched controls (n = 20 941). The association between HS and schizophrenia was assessed via multivariate binary logistic regression, adjusting for demographic factors and smoking status. Results: The analysis revealed a tenfold increase in the prevalence of schizophrenia in HS patients compared to controls (1.4% and 0.4%, respectively, P < 0.001). In multivariate analysis, HS was found to be associated with schizophrenia (OR 1.44, 95% CI 1.01–2.07, P < 0.05). Conclusions: Hidradenitis suppurativa is associated with schizophrenia. Screening for severe mental illness during the assessment of patients with HS is of great importance, as comorbid psychiatric disorders may affect treatment outcomes. Linked Commentary: F. Poot. J Eur Acad Dermatol Venereol 2020; 34: 442–443. https://doi.org/10.1111/jdv.16260. [ABSTRACT FROM AUTHOR]

Background: Current treatment paradigms in anti‐p200 pemphigoid rely on low levels of evidence, primarily originating from case reports and case series. Objective: To systematically review the utilized treatment modalities for anti‐p200 pemphigoid and to synthesize the available clinical outcomes of treated patients. Methods: We conducted a systematic review of the literature using Ovid‐Medline (1946–2018), Embase (1947–2018) and Web of Science (1900–2018) databases with a broad and inclusive search strategy along with a subsequent search of retrieved articles. All case reports and case series of patients with anti‐p200 pemphigoid were included. Results: Sixty‐eight eligible studies comprising 113 anti‐p200 pemphigoid patients with a mean age of 65.5 years were included in the qualitative synthesis. The clinical outcome of patients following treatment was reported for 91 (80.5%) patients, of whom 83 (91.2%) had achieved complete remission at least once. Complete remission on‐therapy was observed in 51 (56.0%) and complete remission off‐therapy in 12 (13.2%) patients. Thirty‐six (39.6%) patients had experienced at least one flare during the duration of follow‐up. A combination of systemic corticosteroids and adjuvant immunomodulatory agents was the leading therapeutic approach (63.0%) required for disease control. Systemic and topical corticosteroids as monotherapy were sufficient to control the disease in 19.6% and 13.0% of cases, respectively. Dapsone was the most commonly used (41.3%) adjuvant agent. The highest rates of complete remission were achieved in patients managed by systemic corticosteroids as monotherapy (100%) and in those managed by systemic corticosteroids with adjuvant agents (90.7%). Conversely, 45.5% of patients treated only by topical corticosteroids experienced at least one relapse during follow‐up. Conclusion: The vast majority of patients had reached a complete remission during the course of the disease, whereas a considerable proportion of patients experienced at least one relapse. A combination of systemic corticosteroids and adjuvant immunomodulatory agents was the most frequently utilized therapeutic approach. [ABSTRACT FROM AUTHOR]

The relationship between HS and OSA and nSD weakened in multivariate models, suggesting that other risk factors do contribute to OSA and nSD. HS is believed to induce a systemic pro-inflammatory state.4 We propose that OSA and nSD, which are also accompanied by systemic inflammatory states, may be triggered by the cytokine milieu of HS in susceptible individuals. A previous retrospective cohort study of 19 945 individuals with HS and 296 170 matched controls in the United States interrogated the incidence of OSA in HS patients and controls. [Extracted from the article]

Background: Psoriasis is a common chronic inflammatory skin disease associated with a heavy burden of morbidity, disability and cost. The occurrence of the disease in Israel has not been previously investigated. Objectives: To provide standardized estimates of trends in psoriasis incidence, prevalence and mortality among patients in Israel between 2011 and 2017. Methods: Using electronic health records from Clalit Health Services, the largest nationwide public health provider in Israel, we conducted a population‐based study investigating trends in the annual incidence and prevalence of psoriasis between the years 2011 and 2017. We report age‐ and sex‐adjusted rates, using the standard European population as a reference. Results: We identified 71 094 incident psoriasis cases. The mean (SD) age of onset was 42.4 (21.0) years with a bimodal distribution, peaking in the early '30s and early '60s. Late‐onset psoriasis, occurring after 40 years of age, accounted for 51.1% of incident cases. The annual psoriasis incidence rate was constant throughout the study period (280/100 000 person‐years). Psoriasis prevalence rose from 2.5% in 2011 to 3.8% in 2017. Conclusions: Psoriasis prevalence is increasing in Israel, although its incidence is stable. Clinicians and policymakers should plan to address the growing demands in the clinical, economic and societal burden of psoriasis. [ABSTRACT FROM AUTHOR]

Background: Data regarding the association between atopic dermatitis (AD) and the metabolic syndrome are controversial. Objective: To evaluate the prevalence of the metabolic syndrome and its components in a large group of patients with AD compared to a matched reference group. Methods: A cross‐sectional study of AD patients diagnosed by a dermatologist between 1998 and 2016, and a matched comparison group was performed. We analysed the association between AD and metabolic syndrome, its components and possible complications for the entire study population, adults (age > 18) and adults with moderate‐to‐severe AD. Results: The study included 116 816 patients with AD and 116 812 comparison enrollees. AD in the entire group of patients and in the adult patients was associated with a higher prevalence of dyslipidaemia and a lower prevalence of diabetes and metabolic syndrome. Moderate and severe AD were associated, respectively, with higher prevalence rates of the metabolic syndrome (17.0% vs. 9.4%), its components (obesity: 22.2% vs. 18.6%; diabetes: 15.9% vs. 9.2%; hypertension 27.9% vs. 15.3%; dyslipidaemia 47.1% vs. 28.5%, all P values < 0.001) and cardiovascular morbidity (all P values < 0.001). Multivariate analysis demonstrated a significant overrepresentation of the metabolic syndrome in moderate‐to‐severe AD (P = 0.04). Conclusions: Severely affected patients with AD may have one or more undiagnosed components of metabolic syndrome. Linked Commentary: C. Vestergaard. J Eur Acad Dermatol Venereol 2019; 33: 1629. https://doi.org/10.1111/jdv.15831. [ABSTRACT FROM AUTHOR]

Background: Numerous studies have indicated that comorbid anxiety and depression are associated with a more severe course of illness. Yet generally, the study of the effect of psoriasis on patients' mental health has considered anxiety and depression to be separate states. Objective: To measure the association between psoriasis and anxiety, depression and anxiety–depression co‐occurrence among patients according to their socioeconomic statuses (SES). Methods: A nationwide population‐based study of psoriasis patients and age and gender frequency‐matched controls (n = 255 862) was designed. Diagnostic data were obtained from Clalit Health Services, the largest managed care organization in Israel. This database was established using continuous real‐time input from healthcare providers, pharmacies, medical care facilities and administrative computerized operating systems. Results: After controlling for demographic and clinical variables, psoriasis was associated with anxiety (OR 1.11, 95% CI 1.01–1.23, P < 0.05), depression (OR 1.17, 95% CI 1.08–1.26, P < 0.001), and anxiety and depression co‐occurrence (OR 1.32, 95% CI 1.21–1.45, P < 0.001) among patients with low SES, yet was associated only with anxiety (OR 1.15 95% CI 1.04–1.27, P < 0.001) but not depression or comorbid anxiety–depression among patients with high SES. Survival analyses indicated that between the ages of 40 and 60, the cumulative probability of psoriasis patients with low SES to suffer from anxiety, depression and their co‐occurrence inclined more sharply with age as compared to psoriasis patients with high SES. Conclusions: As psoriasis patients with low SES are prone to suffer from more severe courses of anxiety and depression, the choice of treatment of psoriasis should address the SES as well as the underlying psychiatric disease. [ABSTRACT FROM AUTHOR]

Summary: Background: Chronic urticaria (CU) carries many risk factors for osteoporosis, but data on the relationships between CU and osteoporosis are lacking. Objectives: To evaluate the association between CU and osteoporosis in a large community‐based study. Methods: A nationwide observational longitudinal cohort study was conducted. CU was defined as four pairs of urticaria diagnoses; each pair was recorded within a period of 6 weeks and was registered by physicians in a primary‐care setting. Patients with CU and their age‐ and sex‐ matched controls were followed for the incidence of osteoporosis and other laboratory data between 2002 and 2017. Data regarding systemic steroid exposure and other relevant risk factors for osteoporosis were obtained. Analyses of risk for osteoporosis were performed in Cox regression models adjusted for age, sex, exposure to systemic corticosteroids, obesity, smoking and hyper‐ and hypothyroid disease. Results: The study included 11 944 patients with CU and 59 829 controls. During the study's observation period, 1035 (8·7%) patients with CU were diagnosed with osteoporosis, compared with 4046 (6·8%) controls. The adjusted multivariate analysis demonstrated that CU was significantly associated with a higher risk for osteoporosis (hazard ratio 1·23, 95% confidence interval 1·10–1·37, P < 0·001). Conclusions: CU may impose a risk for osteoporosis. Appropriate targeted screening should be considered. What's already known about this topic? Chronic urticaria (CU) is associated with the chronic inflammatory process. What does this study add? In this nationwide cohort study, we determined that patients with CU had an increased risk for osteoporosis compared with the general population in Israel. Linked Comment: Egeberg. Br J Dermatol 2019; 180:979. Plain language summary available online Respond to this article [ABSTRACT FROM AUTHOR]

Summary: Background: Cancer risk following long‐term exposure to systemic immunomodulatory therapies in patients with psoriasis is possible. Objectives: To assess a dose–response relationship between cumulative length of exposure to biological therapy and risk of cancer. Methods: Four national studies (a healthcare database from Israel, and prospective cohorts form Italy, Spain and the U.K. and Republic of Ireland) collaborating through Psonet (European Registry of Psoriasis) participated in these nested case–control studies, including nearly 60 000 person‐years of observation. 'Cases' were patients who developed an incident cancer. Patients with previous cancers and benign or in situ tumours were excluded. Four cancer‐free controls were matched to each case on year of birth, sex, geographic area and registration year. Follow‐up for controls was censored at the date of cancer diagnosis for the matched case. Conditional logistic regression was performed by each registry. Results were pooled using random‐effects meta‐analysis. Results: A total of 728 cases and 2671 controls were identified. After matching, differences between cases and controls were present for the Charlson Comorbidity Index in all three registries, and in the prevalence of previous exposure to psoralen–ultraviolet A and smoking (the British Association of Dermatologists Biologic Interventions Register only). The risk of first cancers was not significantly associated with cumulative exposure to biologics (adjusted odds ratio per year of exposure 1·02, 95% confidence interval 0·92–1·13). Results were similar if squamous and basal cell carcinomas were included in the outcome. Conclusions: Cumulative length of exposure to biological therapies in patients with psoriasis in real‐world clinical practice does not appear to be linked to a higher risk of cancer after several years of use. What's already known about this topic? Systemic therapies, including biologics, are widely prescribed for patients with moderate‐to‐severe psoriasis.As a result of the immunomodulatory mechanism of biological therapies for psoriasis it is hypothesized that long‐term exposure to them may increase the risk of developing cancer. What does this study add? This study suggests that, in current clinical practice, the treatment of patients with psoriasis with biologics is not associated with an increased risk of cancer in the medium term, after a few years of use and latency.Given the heterogeneity of the data sources and methodological limitations, it remains unclear if use of biologics may be associated with an increased (albeit small) risk of certain cancer subtypes. Linked Editorial: Egeberg. Br J Dermatol 2018; 179:809–810. Plain language summary available online Respond to this article [ABSTRACT FROM AUTHOR]

Biosimilars, sometimes called 'generic biologics', are no longer a vision for the future but a present-day reality. Drug manufacturers and regulatory authorities are charged with ensuring that these products are safe and effective. Because biologically produced medications are large, complex proteins, many factors affect the quality of the end product, including glycosylation and presence of impurities, and thus many factors need to be compared between an emerging biosimilar and its originator biologic. Indeed, preclinical analytical assessments to determine similarity to an originator biologic are critical and are considered to be the foundation for regulatory approval of biosimilars. Here, the science behind the preclinical development of biosimilars is discussed by members of the International Psoriasis Council, and suggestions are put forth to try to ensure that future biosimilars are produced in a high quality and standardized manner. [ABSTRACT FROM AUTHOR]

The article discusses the study on the association between pemphigus and smoking. The protective effect of smoking on pemphigus is also discussed. The cohort study used big data for adjusting multiple confounding factors as well as used sensitivity analysis, and multivariate logistic regression analysis to calculate inverse association of smoking and pemphigus.

Hidradenitis suppurativa (HS) is a chronic, inflammatory, debilitating skin disease. The aim of the study was to systematically review the literature and critically answer the question: In patients with HS, do cardiovascular risk factors appear at a significantly higher rate compared with controls? The main search was conducted in Medline, Embase and the Cochrane Central Register. Studies eligible for inclusion were of case-control, cross-sectional and cohort design, and included comparison of any cardiovascular risk factor(s) in patients with HS with those of control groups. An I² value > 50% was considered to show substantial heterogeneity. In this case, DerSimonian and Laird random-effect models were considered to compute pooled odds ratios (OR). Otherwise, a fixed-effects model was suitable. Nine studies, with 6174 patients with HS and 24 993 controls, were included. Significant association of HS with obesity [OR 3.45, 95% confidence interval (CI) 2.20-5.38, P < 0.001], central obesity (OR 2.97, 95% CI 1.41-6.25, P = 0.004), active smoking (OR 4.34, 95% CI 2.48-7.60, P < 0.001), history of smoking (OR 6.34, 95% CI 2.41- 16.68, P < 0.001), hypertriglyceridemia (OR 1.67, 95% CI 1.14-2.47, P = 0.009), low high-density lipoprotein (HDL) (OR 2.48, 95% CI 1.49- 4.16, P < 0.001), diabetes (OR 2.85, 95% CI 1.34-6.08, P = 0.007) and metabolic syndrome (OR 2.22, 95% CI 1.62-3.06, P < 0.001) was detected. Associations were significant both in population and hospital patients with HS, with hospital HS groups having uniformly higher ORs than the population HS groups. Causality could not be assessed. Heterogeneity was substantial in all analyses. This systematic review indicated that cardiovascular risk factors appear at a significantly higher rate in patients with HS compared with controls. The need for screening of patients with HS for modifiable cardiovascular risks is emphasized. [ABSTRACT FROM AUTHOR]

Background Hidradenitis suppurativa ( HS) is a chronic relapsing inflammatory skin disease. Objectives To evaluate the association between HS and metabolic syndrome and its component morbidities in a large, community-based cohort of patients with HS, using the database of Clalit Health Services, the largest public healthcare provider in Israel. Methods A cross-sectional study was performed. Metabolic syndrome was defined as the presence of at least three of the following conditions: diabetes, hyperlipidaemia, hypertension and obesity. The association between HS and metabolic syndrome was assessed by a multivariate logistic regression model, adjusting for age, sex, diabetes, hypertension, hyperlipidaemia, obesity and smoking status. Results The study included 3207 patients with HS (general frequency of 0·07%) diagnosed by a dermatologist in primary-care centres, and 6412 age- and sex-matched control patients without HS. HS was significantly associated with metabolic syndrome [odds ratio ( OR) 1·61, 95% confidence interval ( CI) 1·36-1·89], diabetes ( OR 1·41, 95% CI 1·19-1·66), obesity ( OR 1·71, 95% CI 1·53-1·91), hyperlipidaemia ( OR 1·14, 95% CI 1·02-1·28) and hypertension ( OR 1·19, 95% CI 1·03-1·38). Conclusions We found an association between HS and diabetes, hyperlipidaemia, obesity, hypertension and metabolic syndrome among a large community-based cohort of patients with HS. Clinicians should take into account that patients with HS may have one or more undiagnosed components of metabolic syndrome despite their young age. Thus, appropriate targeted screening is advised. [ABSTRACT FROM AUTHOR]

Background It is generally accepted that the risk of cardiovascular disease ( CVD) in women is significantly increased after the menopause. Hormonal changes associated with the menopausal transition may also alter the course of autoimmune diseases. It has been reported that menopause may exacerbate the symptoms of rheumatoid arthritis, systemic sclerosis and giant cell arteritis, but attenuate the course of systemic lupus erythemathosus. There is a growing body of literature indicating that the course of psoriasis may be altered by menopausal hormone changes. Considering the fact that both psoriasis and menopause are independent risk factors for CVD, and that menopause may exacerbate the course of psoriasis, a possible additive effect between these two conditions may be crucial for proper monitoring and treatment of peri- and post-menopausal psoriatic patients. Objective The aim of this study is to analyse potential relationship between psoriasis, menopausal status and risk of CVD. Materials and methods A retrospective analysis of the Clalit Health Services database was performed in an attempt to provide new data and the available literature concerning these issues was reviewed. Data on cardiovascular events in 10 872 female psoriatic patients and 19 471 controls were extracted and compared. Results In both psoriatic and control patients the association of CVD increased with age. The association of CVD was significantly greater in psoriatic patients, but no significant differences were found between any of age groups. Conclusions The association of psoriasis and CVD in women increases with age but there is insufficient evidence to confirm that menopause increases the risk of psoriasis. Further studies directly addressing this issue are needed. [ABSTRACT FROM AUTHOR]

Background Hidradenitis suppurativa ( HS) is a chronic recurrent inflammatory disease affecting skin that bears apocrine glands. Only anecdotal reports and a few small studies have demonstrated a possible association between HS and depression, but these studies were uncontrolled or were based on small sample sizes. To the best of our knowledge, the association between HS and other psychiatric disorders has never been investigated. Objectives To investigate the association between HS and psychiatric disorders: depression, anxiety, psychoses, schizophrenia and bipolar disorder. Methods A cross-sectional study was conducted utilizing the database of Clalit Health Services (over 4 100 000 patients). Case patients were defined as having HS when diagnosed by a dermatologist. Control patients without HS were age and gender matched in a 2 : 1 manner. The proportions of patients with psychiatric diseases were compared between patients with and without HS. The association between HS and psychiatric diseases was assessed in multivariate models using logistic regression analyses. Results The study included 3207 patients with HS and 6412 age- and gender-matched controls. Depression was diagnosed in 5.9% of patients with HS vs. 3.5% of patients without HS ( P < 0.001). Anxiety was diagnosed in 3.9% of patients with HS vs. 2.4% of patients without HS ( P < 0.001). These associations were significant after controlling for the confounders age and gender (Depression: OR = 1.7, 95% CI: 1.4-2.1; Anxiety: OR = 1.7, 95% CI: 1.3-2.1). Conclusions Hidradenitis suppurativa was associated with depression and anxiety. Dermatologists treating patients with HS should be aware of this important association. [ABSTRACT FROM AUTHOR]

Linked Article: Forbes et al. Br J Dermatol 2021; 184:1077–1084. [ABSTRACT FROM AUTHOR]

Background Seborrheic dermatitis (SD) is a chronic inflammatory skin disease that shares some features with psoriasis. Previous reports have demonstrated an association between hypertension and psoriasis. Chronic skin inflammation may plays a role in the aetiology of hypertension in both disorders. Objective To evaluate the association between SD and hypertension in an adult large population sample. Methods A cross-sectional study was carried out by utilizing the database of Clalit Health Services, a healthcare provider organization for over 4 million enrollees in Israel. All adult patients previously diagnosed with SD were compared with a sample of enrollees without SD regarding the prevalence of hypertension. Patients without SD were frequency matched to SD patients regarding age and sex. Data on other health-related lifestyles and comorbidities were collected. Results The study included all 9255 patients with SD and 9246 age- and sex-matched patients without SD. The prevalence of hypertension was significantly higher in patients with SD (27.1% vs. 24.7%, P < 0.001, OR = 1.13, 95% CI: 1.05-1.21). A multivariate logistic regression model demonstrated that SD was significantly associated with hypertension after controlling for confounders, including age, sex, socioeconomic status, smoking, diabetes and obesity (multivariate OR = 1.23, 95% CI: 1.12-1.35, P < 0.001). Conclusions In this study, an association between SD and hypertension was demonstrated in adults. Many factors can be advocated to explain this association. Genetic predisposition, psychological conditions, lipid abnormalities and chronic inflammation of the skin with a change in cytokine balance should be explored as potential mechanisms. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article on whether the high between-country variation of systemic psoriasis therapy is a sign of unwarranted variation.

Background Little is known about the risk of herpes zoster (HZ), among patients with psoriasis treated with biologic drugs. Objective To determine the incidence of HZ in patients with psoriasis and the association between HZ and use of biologic drugs in these patients. Methods The study was performed utilizing the medical database of Clalit Health Services in Israel. The incidence of HZ events was calculated among patients with psoriasis treated with phototherapy, traditional systemic medications and biologic drugs. Incidence rates of HZ events were calculated for each medication, as well as hazard ratios adjusted for age, sex and healthcare utilization burden. Results Among 22 330 psoriasis patients (215 656 person-years), 1321 HZ cases were diagnosed. The crude incidence rates per 1000 person-years were 6.0 for UVB phototherapy (95% confidence interval (CI), 0-12.8), 10.1 for PUVΑ (1.3-19.0), 5.4 for acitretin (2.2-8.7), 17.0 for methotrexate (10.6-23.4), 13.9 for etanercept (0.3-27.4), 19.3 for infliximab (0-45.8) and 4.6 for controls (CI, 4.3-5.0). No cases of HZ were seen among patients treated with alefacept, efalizumab or adalimumab. In a multivariate analysis, age, female sex, healthcare utilization pattern and corticosteroid treatment were associated with the time to HZ infection. The association of HZ with infliximab approached statistical significance (Hazard ratio: 1.77, 95% CI: 0.92-3.43), but none of the other biologic drugs were significantly associated with the risk of HZ. Conclusion Among patients with psoriasis, treatment with some biologic drugs was associated with a higher incidence of HZ compared with controls, though the difference was not statistically significant. [ABSTRACT FROM AUTHOR]

Background: Large disease registries are the preferred method to assess long-term treatment safety. If psoriasis registries collaborate in a network, their power to assess safety is increased. Objective: To identify heterogeneity in psoriasis registries and methodological challenges for synthesising the data they provide. Methods: We surveyed the registries in PSONET and identified and addressed the challenges to collaborative analysis for the network in several round table meetings. Results: Eight out of 10 registries had a prospective comparator cohort with similar disease characteristics but not on biologics. Registries differed in the coding and validation or follow-up of adverse events and in the way they sampled their population. Fifteen challenges to registries collaborating were identified in the areas of operational governance, structural conduct, bias and analysis. Conclusions: Participation in PSONET, a network of psoriasis registries, helps identify and solve common issues, enhancing the individual registries, and provides larger sets of more powerful safety data in a diverse population. Challenges to interpreting data collectively include heterogeneity in sampling, variable penetration of biologics and compatibility of different datasets. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

A letter to the editor in response to the article "Glycaemic control in patients with diabetes and concomitant psoriasis," that was published in a previous issue of the journal is presented.

Linked article: W. Rungapiromnan, et al. J Eur Acad Dermatol Venereol 2020; 34: 769–778. https://doi.org/10.1111/jdv.16018. [ABSTRACT FROM AUTHOR]

Systemic AL amyloidosis (AL) is a disorder in which light chains form fibrillar deposits, leading to organ dysfunction and death. Rarely, AL has been associated with non-Hodgkin's lymphoma (NHL), although this association has not been well characterized. We report a series of six patients with AL associated with NHL, primarily lymphoplasmacytic lymphoma. Organ involvement was variable, with frequent bulky lymphadenopathy and visceral cavity deposits, but no cardiac involvement. Positron emission tomography scans were negative. Bone marrow and lymph node biopsies showed a mixed population of CD20+ lymphoid and CD138+ plasma cells. Serum free light chains were elevated, and correlated with response to therapy. Immunoglobulin light chain variable region (Ig VL) germline gene use was typical for AL, reflecting previously observed correlations between germline gene use and organ tropism. Five patients received rituximab-based therapies with two responses. Two patients underwent autologous stem cell transplantation with one complete haematological response. Four patients survive at 10–132 months from diagnosis. AL with NHL has distinctive clinical features but employs the same Ig VL gene repertoire as AL with clonal plasma cell dyscrasias. Serial serum free light chain levels are useful for tracking response to therapy. Treatments aimed at both lymphoid and plasma cell components appear warranted. [ABSTRACT FROM AUTHOR]

Studies the incidence of hepatic veno-occlusive disease of gemtuzumab ozogamicin monotherapy and its efficacy for relaped acute myeloid leukaemia after hematopoietic stem cell transplant. Methodology; Results of the study; Discussion of findings.

Various Aloe vera extracts are widely used in a variety of overthe-counter skin products, but only a few studies have been conducted to provide support for the use of Aloe vera (A. barbadensis), one of the most commonly used species of Aloe vera, in the treatment of inflammatory skin conditions, Seborrheic dermatitis is a common inflammatory skin disorder for which available topical treatment may be helpful but; not curative. The objective of this study was to evaluate the effect of an emulsion formulated from a crude extract of Aloe vera (A. barbadensis) on seborrheic dermatitis. A double-blind, randomized, placebo-controlled prospective clinical trial was performed in 44 adult patients with seborrheic dermatitis, A comparison of symptom scores in the Aloe vera (A. barbadensis) and placebo groups, before and after treatment revealed a significant decrease in scaliness, pruritus and the number of sites involved in seborrheic dermatitis, but not in erythema, Global improvement rates in patients treated with Aloe vera (A. barbadensis) were significantly higher than in placebo-treated patients, as assessed by both dermatologists (58% and 15%, respectively; P=0.009) and patients (62% and 25%, respectively; P=0.03), The results of the present study indicate that Aloe vera (A. barbadensis) crude extract emulsion is effective in the therapy of patients with seborrheic dermatitis. [ABSTRACT FROM AUTHOR]