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Introduction: Psoriasis is a chronic inflammatory skin disorder that affects approximately 2-3% of the population worldwide. Translational medicine, which focuses on treating and analyzing diseases caused by translational factors, is becoming increasingly relevant in the field of psoriasis research. This review aims to display the current literature on the role of translational medicine in the treatment and understanding of psoriasis. We found that translational factors such as protein kinases and cytokines play a key role in the development and progression of psoriasis. Additionally, current treatments for psoriasis, such as biologics, target these translational factors to reduce inflammation and improve skin condition. Furthermore, studies have shown that genetic variations in translational-related genes can also contribute to the development of psoriasis. This highlights the importance of translational medicine in understanding the underlying mechanisms of psoriasis and developing increasingly effective treatments for this debilitating disease.

Background: Biological therapies are widely used for moderate to severe chronic plaque psoriasis owing to their high efficacy and safety profile. However, skin and soft tissue infections (SSTIs) have been reported in association with biological treatment in psoriasis., Methods: We report a case of necrotizing fasciitis in an 18-year-old psoriasis patient with a history of severe combined immunodeficiency treated with secukinumab and conducted a systematic literature review of SSTIs associated with biological therapy for psoriasis. The literature review related to biological therapies for psoriasis between the years 1990 and 2020: Medline (PubMed), Embase, and CENTRAL (Cochrane Central Register of Controlled Trials) were searched for psoriasis, biological treatment, and skin and soft tissue infections., Results: Over 1,300 titles were found, 24 of which met the inclusion criteria for our study: nine retrospective studies, nine randomized controlled trials, and six prospective studies. The data covered 10 biological treatments. More than 40,000 patients receiving biological treatment were included, and nearly 1,000 cases of SSTIs were documented., Conclusions: We present the available records regarding SSTIs among chronic plaque psoriasis patients given biological treatment. Most reported SSTIs were related to psoriasis patients treated with TNF-α inhibitors. In view of the presented data, biological treatment appears to be a safe mode of therapy for this aspect of psoriasis., (© 2021 the International Society of Dermatology.)

Background: Drug survival is defined as the time period of treatment with a certain drug until its cessation. The role of previous exposure to traditional systemic treatments in biologic survival is still unknown., Objective: To investigate the drug survival rates of biologic treatments in patients with psoriasis and to identify predictor factors., Methods: Survival analysis was performed on patients with severe psoriasis who received adalimumab, infliximab, etanercept, and ustekinumab for treatment of psoriasis, drawn from the Clalit Health Services database. Multivariate analysis was performed adjusting for demographic variables; metabolic syndrome and its components; psoriatic arthritis; biologic naivety; coadministration of methotrexate, acitretin, or cyclosporine; and previous standard systemic treatment exposure., Results: Among 907 patients treated with 1575 biologic treatments, ustekinumab had a significantly higher survival rate than tumor necrosis factor inhibitors. Biologic naivety and concomitant methotrexate intake were positive predictors for drug survival, whereas the female sex and the duration of previous systemic treatments were negative predictors., Limitations: Data regarding disease severity or duration could not be drawn from the Clalit Health Services database., Conclusion: Ustekinumab had better retention rates in comparison with other investigated biologics in patients with severe psoriasis, most of whom used it as a third line therapy., (Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Background: Secukinumab demonstrated superior efficacy to ustekinumab at week 4 and week 16 of the CLEAR study, with comparable safety, in subjects with moderate-to-severe plaque psoriasis., Objective: To compare the efficacy and safety of secukinumab and ustekinumab use over 52 weeks., Methods: Analysis of 52-week data from CLEAR, a randomized, double-blind, phase 3b study., Results: Among 676 randomized subjects, secukinumab demonstrated superiority to ustekinumab at week 52 in the proportion of subjects with ≥90% improvement in Psoriasis Area and Severity Index (PASI 90) (76% vs 61% [P < .0001]); PASI 100 responses were 46% versus 36% (P = .0103) and Investigator's Global Assessment responses of clear/almost clear skin were 80% versus 65% (P < .0001). Subjects on secukinumab reported greater reductions in psoriasis-related pain, itching, and scaling, and greater improvement across all quality-of-life measures evaluated (Dermatology Life Quality Index [DLQI], EuroQoL 5-Dimension Health Questionnaire, Work Productivity and Activity Impairment Questionnaire-Psoriasis, and Health Assessment Questionnaire-Disability Index). At week 52, 72% of subjects on secukinumab versus 59% on ustekinumab (P = .0008) reported no impact of skin disease on their lives (DLQI 0/1 response). Safety and tolerability was comparable., Limitations: There was no placebo arm., Conclusion: In this head-to-head, double-blind study, secukinumab demonstrated sustained superior efficacy in comparison with ustekinumab in clearing skin through week 52, greater improvement in quality of life, and a favorable and comparable safety profile., (Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Background: Secukinumab, a fully human anti-interleukin-17A monoclonal antibody, has shown superior efficacy to etanercept with similar safety in moderate to severe plaque psoriasis (FIXTURE study)., Objective: We sought to directly compare efficacy and safety of secukinumab versus ustekinumab., Methods: In this 52-week, double-blind study (NCT02074982), 676 subjects were randomized 1:1 to subcutaneous injection of secukinumab 300 mg or ustekinumab per label. Primary end point was 90% or more improvement from baseline Psoriasis Area and Severity Index (PASI) score (PASI 90) at week 16., Results: Secukinumab (79.0%) was superior to ustekinumab (57.6%) as assessed by PASI 90 response at week 16 (P < .0001). The 100% improvement from baseline PASI score at week 16 was also significantly greater with secukinumab (44.3%) than ustekinumab (28.4%) (P < .0001). The 75% or more improvement from baseline PASI score at week 4 was superior for secukinumab (50.0%) versus ustekinumab (20.6%) (P < .0001). Percentage of subjects with the Dermatology Life Quality Index score 0/1 (week 16) was significantly higher with secukinumab (71.9%) than ustekinumab (57.4%) (P < .0001). The safety profile of secukinumab was comparable with ustekinumab and consistent with pivotal phase III secukinumab studies., Limitations: The study was not placebo-controlled and of short-term duration., Conclusions: Secukinumab is superior to ustekinumab in clearing skin of subjects with moderate to severe psoriasis and improving health-related quality of life with a comparable safety profile over 16 weeks., (Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Combination therapy has become important in treating psoriasis, using synergism between different mechanisms to maximize efficacy and minimize toxicity. Little has been published on the combination of cyclosporine and anti-tumor necrosis factor (TNF) α agents. In this study, a retrospective chart review was made of the effects of this combination therapy in 10 patients with recalcitrant psoriasis. Treatment included a conditioning phase with cyclosporine, 3.14 ± 0.37 mg/kg for 4.6 ± 2 weeks, and a combination phase during which etanercept/adalimumab were initiated and cyclosporine was tapered over 10.2 ± 3.7 weeks. Treatment success, evaluated after each phase, was classified as complete recovery (CR, more than 75% improvement), partial response (PR, 25-75% improvement), and no response (NR, less than 25% improvement). All patients reached CR at the end of the combination therapy. Two were still on combination therapy after 12 and 20 weeks. Adverse event occurred in three cases, all in the conditioning phase. We conclude that combination therapy with cyclosporine and anti-TNF α appears to offer an effective and safe approach to treatment of psoriasis., (© 2015 Wiley Periodicals, Inc.)

Introduction: Psoriasis is a chronic papulosquamous cutaneous disease. The etiology is unknown. Several biochemical and immunological processes, which appear in patients with genetic predisposition, lead to enhanced proliferation of epidermal cells, and inflammation of the dermis. Thyroid gland hormones cause an increase of epidermal growth factor level, which has an important role in keratinocyte proliferation, which may be involved in psoriasis disease., Methods: In this study, we have prospectively examined the function of thyroid gland hormones--TSH, T3, T4, anti-TPO and antithyroglobulin--in 100 psoriatic patients. This database was compared with a control group of 54 patients, without known thyroid gland abnormalities, who were randomly chosen from the endocrinology clinic's medical records., Results: In the psoriatic patients, an increase in the anti-TPO levels was demonstrated in 9 psoriatic patients (9%), compared to 3 patients in the control group (5.6%). An increase of anti-TG was demonstrated in 3 psoriatic patients (3%) compared to one patient (1.8%) in the control group. An increase of TSH levels was demonstrated in 5 psoriatic patients (5%) compared to 3 patients (5.6%) in the control group. T3 levels were abnormal in 3 psoriatic patients, and T4 levels were abnormal in 2 psoriatic patients, while the T3 and T4 levels in the control group patients were normal., Conclusions: In our study we didn't observe a statistical difference in the thyroid gland functions between the psoriatic and the control patients. We have observed that in patients with severe psoriasis, there were increased TSH levels and positive auto-antibodies titer compared to patients with mild psoriasis., Summary: The clinical characteristics of the psoriatic patients were connected to the function of the thyroid gland. Nonetheless, the number of patients was low, and more studies are needed to confirm this relationship.