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Epidemiological data demonstrate strong associations between psoriasis and metabolic comorbidities, including obesity, hypertension, diabetes mellitus, dyslipidemia, and non-alcoholic fatty liver disease. The presence of metabolic comorbidities significantly influences the selection and effectiveness of pharmacological treatments. Some drugs should be prescribed with caution in patients with metabolic comorbidities because of an increased risk of adverse events, while others could have a reduced effectiveness. The aim of this narrative review is to highlight the challenges that healthcare professionals may face regarding the management of psoriasis in patients with metabolic comorbidities. In the first part of the article, the epidemiological association between psoriasis and metabolic comorbidities and their pathogenetic mechanisms is summarized. The second part describes the efficacy and safety profile of conventional and biologic drugs in patients with selected metabolic comorbidities including obesity, non-alcoholic fatty liver disease/hepatic steatosis, and diabetes. Finally, the role of pharmacological and non-pharmacological interventions, such as diet, alcohol abstinence, physical activity, and smoking avoidance is discussed. In conclusion, the choice of the best approach to manage patients with psoriasis with metabolic comorbidities should encompass both tailored pharmacological and individualized non-pharmacological interventions. [ABSTRACT FROM AUTHOR]

Introduction: The introduction of biological therapies has revolutionized the treatment of moderate-to-severe plaque psoriasis. In particular, ixekizumab, an inhibitor of interleukin-17A, has shown great results in terms of efficacy and safety in both clinical trials and real-world experiences. However, there is a lack of long-term real-world data available for ixekizumab. Methods: We conducted a multicenter real-life study to evaluate the effectiveness and safety of ixekizumab in patients with moderate-to-severe plaque psoriasis. Psoriasis Area and Severity Index score (PASI) was collected at baseline and after 1, 2, 3, 4, and 5 years. The occurrence of any adverse events was recorded at each time point. Results: We enrolled 1096 patients treated with ixekizumab for at least 1 year. At week 52, the percentages of PASI 90 and PASI 100 were 85.04% and 69.07%, respectively. After 5 years of treatment with ixekizumab, out of 145 patients, a PASI 90 response was achieved by 86.90% of patients, while complete skin clearance was reached by 68.28% of patients. We did not observe any new significant safety findings throughout the study period. Conclusion: This study supports the long-term effectiveness and safety of ixekizumab in a real-world setting. [ABSTRACT FROM AUTHOR]

Introduction: Psoriasis is a chronic inflammatory disease occurring worldwide. It is currently considered a multisystem disease, which is associated with several comorbidities. Aim: To deeply understand the clinical characteristics of psoriasis comorbidities and explore the relationship between psoriasis comorbidities, different subtypes and related influencing factors. Material and methods: This retrospective study analysed data from the electronic inpatient medical record system of dermatology and non-dermatology departments at a tertiary hospital in China. We collected relevant demographic data and clinical features of all patients diagnosed with psoriasis from January 2013 to September 2023. Results: This study ultimately included a total of 1097 patients with psoriasis. Psoriasis vulgaris was the most common among the subtypes of psoriasis, with 957 (87.2%) cases. The sample consisted of 65.6% of males and 34.4% of females, with an average age of 53.5 ±15.2 years. Common comorbidities of psoriasis included hypertension (38.2%), hyperlipidaemia (29.4%), type 2 diabetes mellitus (24.6%), fatty liver disease (21.4%), coronary heart disease (21.0%), tumours (15.5%), gastroduodenal disease (14.4%), osteoarthropathy (11.8%), and cerebrovascular disease (10.8%). The incidence of hypertension (p = 0.015), hyperuricemia (p < 0.001), osteoarthropathy (p < 0.001), and autoimmune disease (p = 0.003) among different subtypes of psoriasis showed statistically significant differences. In addition, gender, smoking and alcohol consumption all have significant impacts on the distribution of comorbidities. Conclusions: The distribution of psoriasis comorbidities and complications varies among different subtypes of psoriasis. Lifestyles such as smoking and alcohol abuse, as well as gender, are also associated with the occurrence of psoriasis comorbidities. [ABSTRACT FROM AUTHOR]

Psoriasis has a clear and strong connection with smoking in both its pathogenesis and clinical course. Smoking can cause a serious worsening of both the disease itself and the systemic complications such as cardiovascular events, psoriatic arthritis (PsA), cancer and depression. Smoking also seems to alter the gut microbiota and thus promote psoriasis itself. The aim of our article is to review all the most interesting discoveries on its role and thus provide a good picture of the current state of knowledge. Furthermore, we provide some alternative and healthier coping mechanisms for stress and depression related to the disease such as exercise, meditation, balneotherapy and acupuncture. [ABSTRACT FROM AUTHOR]

Introduction: It is well known that biological medications acting on selected elements of the immune response are highly effective in psoriasis treatment. It is a common perception that psoriasis is a seasonal disorder with improvement in warmer months, however it has not been unequivocally confirmed. It is not known whether the time of year of starting systematic therapy for psoriasis influences treatment outcomes. Material and methods: Changes in psoriasis severity scores during treatment with biologics were investigated. The scores were recorded for 62 patients with moderate to severe psoriasis at the beginning, after 1, 4 and 7 months of the therapy. Patients were divided into two groups: those beginning the treatment in the cold period of the year (November-March) and in the warm period (May-September). The seasonal groups were also divided into subgroups according to the type of biologics used: interleukin inhibitors and tumor necrosis factor α (TNF-α) inhibitors. Results of the treatment were analysed using standard statistical tests of differences between samples. Results: After 1 and 4 months of the therapy, better efficacy of interleukin inhibitors was found in patients starting treatment in summer. The course of psoriasis improvement in patients taking TNF-α inhibitors resulted in consistent improvement regardless of the season. The outcome of the treatment after 7 months was similar for both seasonal groups and types of biologics used. Conclusions: Our understanding of the effectiveness of the treatments depending on the time of the year combined with the type of biologics used, may further improve results of the therapy. [ABSTRACT FROM AUTHOR]

Psoriasis is a chronic‐inflammatory, immune‐mediated disease leading to a state of increased systemic inflammation. Mental comorbidities often occur in the patients and may additionally affect the therapy outcome. Currently, it is unknown whether the disease severity, psychosocial stress or health‐related quality of life determines the manifestation of anxiety/depression, or vice versa, in psoriasis. The interplay between these variables during the dermatological treatment of psoriasis remains to be elucidated in order to initiate appropriate psychological interventions and to identify patients at risk for comorbid anxiety/depression. In a prospective cohort study, the impact of disease severity, health‐related quality of life and psychosocial stress on anxiety/depression were examined during the dermatological treatment in patients with moderate to severe psoriasis (patients with psoriasis = PSO). Patients were examined before (T1) and about 3 months after (T2) the beginning of a new treatment episode, in most cases by means of systemic therapy. Data were analysed, exploratory, using Bivariate Latent Change Score Models and mediator analyses. Assessments included patient‐reported outcomes (Hospital Anxiety and Depression Scale/HADS, Perceived Stress Scale/PSS, Childhood Trauma Questionnaire/CTQ, Dermatology Life Quality Index‐DLQI, Body Surface Area‐BSA), at both T1 and T2. 83 PSO patients (37.3% women, median age 53.7, IQR 37.8–62.5, median BSA 18.0, IQR 9.0–40.0) with complete data of HADS and DLQI were included. In the total group, a higher anxiety/depression at T1 was associated with a lower improvement in psoriasis severity in the course of the dermatological treatment (γBSA = 0.50, p < 0.001). In subgroups of PSO with low/high CTQ scores, anxiety/depression at T1 had no impact on the change in psoriasis severity. Only by tendency, in CTQ subgroups, a higher psoriasis severity at T1 was linked with a higher improvement in anxiety/depression at T2 (low/high CTQ, γHADS = −0.16/−0.15, p = 0.08). An improvement in the health‐related quality of life was positively associated with an improvement in anxiety/depression (Pearson's r = 0.49, p = 0.02). Here, the reduction of acute psychosocial stress seems to be a decisive factor, mediating this association (β = 0.20, t [2,60] = 1.87; p = 0.07, 95% CI −0.01, 0.41). The results allude, that the initial severity of anxiety/depression may presumably have an impact on the treatment outcome in the total group. In contrast, analysing subgroups of patients with high/low childhood trauma, the impact of the initial disease severity on the course of anxiety/depression after a switch to a new dermatological treatment could not be conclusively ruled out. The latter results from the latent change score modelling should be treated cautiously because of the small sample size. A common aetiopathological mechanism for psoriasis and anxiety/depression might be assumed with impact of dermatological treatment on both. The change in perceived stress seems to play an important role in the manifestation of anxiety/depression, substantiating the need for adequate stress management in patients with increased psychosocial stress during their dermatological treatment. [ABSTRACT FROM AUTHOR]

Background: Narrowband UVB (NBUVB) has recently been used in Vietnam for the treatment of psoriasis. However, there are no data on Vietnamese patients to adopt a uniform national protocol. Objectives: This study aimed to establish an optimal NBUVB therapy for the treatment of psoriasis in Vietnamese patients. Materials and Methods: One hundred and twenty-two patients with psoriasis vulgaris were included. They were randomly allocated to two groups: the percentage dose (group 1, 62 patients) and the fixed dose (group 2, 60 patients). In group 1, the starting dose was 50% of the minimal erythema dose (MED) and the 10% increment dose adjusted in the next sessions. In group 2, the starting dose was based on Fitzpatrick skin types (fixed dose). Psoriasis area and severity index (PASI) was used to evaluate efficacy. Results: More than 68% of the patients get PASI75 at session 36. Group 2 had significantly fewer sessions (20 ± 5 vs 25 ± 7, P- value = 0.0004) and lower cumulative dose than group 1 (14.1 ± 4.3 J/cm² vs 18.0 ± 8.0 J/cm², P- value = 0.0075) to achieve PASI75. Adverse effects were more common in group 2 than group 1, including burning sensation/erythema (43.33% vs 14.52%, P- value = 0.0009) and pruritus (75.00% vs 22.58%, P- value <0.0001). Conclusion: NBUVB therapy was safe and effective for Vietnamese psoriasis patients. Fixed doses produced a quicker clinical response with fewer sessions and lower cumulative doses. Adverse effects were mild in both groups and less noted for the MED-based dose. For the recommendation, a fixed dose should be applied for patients who have less concern about side effects, while a MED-based dose can be suitable for patients having conditions related to light sensitivity. [ABSTRACT FROM AUTHOR]

Generalized pustular psoriasis (GPP) is a rare but severe skin inflammatory disorder characterized by the eruption of widespread sterile neutrophilic pustules, often accompanied by systemic inflammation. Given its life-threatening potential, GPP requires prompt accurate diagnosis and effective treatment, but its rarity and relapsing-remitting nature pose challenges in performing large-scale randomized controlled clinical trials. Established international guidelines are currently lacking and management guidance often follows that for plaque psoriasis. However, while it can co-exist with plaque psoriasis and has traditionally been classified as a most severe form of psoriasis, GPP is now recognized as a distinct entity, with its own clinicopathological, autoinflammatory, immunologic and genetic features. Research conducted over the past decade revealed that an imbalance of interleukin (IL)-36 signaling favoring the proinflammatory activity is the central driver of the pathogenesis of GPP, thereby laying the groundwork for the development of targeted therapies for the disease. This article reviews the evidence thus far on spesolimab, a selective humanized antibody against the IL-36 receptor that was recently licensed in Europe and the United States for the treatment of GPP flares in adults. In phase II, randomized controlled clinical trials, spesolimab led to rapid and effective skin clearance in patients experiencing a GPP flare and demonstrated superiority to placebo in preventing flares for up to 48 weeks with maintenance treatment, with reassuring safety and tolerability profiles. Spesolimab is considered to be a first-in-class medication establishing itself as the standard of care for the treatment of GPP flares, thus changing the paradigm of the management of GPP to a new era of scientifically- and evidence-based targeted therapy for this distinctive disease. [ABSTRACT FROM AUTHOR]

The use of remote consultations via telephone or video can contribute to the management of people with psoriasis and has allowed continuity of patient care throughout the SARS-CoV-2 pandemic, though little is known about the patient experience. The present study aimed to provide insights into the views and experiences of people with psoriasis and psoriatic arthritis on their remote consultations during the SARS-CoV-2 pandemic and develop guidance for patients and healthcare professionals on how to optimise future remote consultations. We conducted a cross-sectional, on-line survey of people with psoriasis and psoriatic arthritis. Data were analysed using descriptive statistics and Thematic Analysis. Overall, 126 people reported experiences of telephone (92%) or video (8%) consultations. Most participants were satisfied with (78%), and were happy for, remote consultations to continue (21%); few were not (5%). Others did not always want remote consultations (39%) and preferred alternating with face-to-face consultations (18%). Some wanted remote care during the pandemic only (17%). Five themes were identified: (1) Advantages of Remote Consultations; (2) Disadvantages of Remote Consultations plus sub-themes (2.1) Practical Issues and (2.2) the Absence of Non-Verbal Cues and Emotions; (3) Serving a Purpose; and (4) A 'Good' Remote Consultation; and (5) Advice to Other Patients. Remote consultations form an important part of psoriatic disease management, mainly for routine follow-up appointments in patients with stable disease, and in addition to face-to-face consultations. Additional skills training for clinicians could improve the quality of remote consultations. [ABSTRACT FROM AUTHOR]

Introduction: Introduction of novel biologic treatments for plaque psoriasis has revolutionized treatment approach and improved outcomes in patients with moderate-to-severe disease. New groups of biologics are even more effective and better tolerated compared to their predecessors. However, none of the currently available biologic drugs is associated with complete skin clearance in all treated patients. Moreover, the requirement to stop therapy in accordance with previous therapeutic program guidelines in Poland may have contributed to a gradual loss of efficacy of biologic drugs. Betamethasone dipropionate (BD) and calcipotriol (CAL) foam is the most widely studied topical drug in the therapy of mild forms of psoriasis. Numerous clinical trials have demonstrated its excellent efficacy not only in reactive therapy but also in preventing recurrences through the implementation of proactive therapeutic regimens. Case reports: We present two cases of patients with severe psoriasis and psoriatic arthritis who were treated with biologic drugs with incomplete remission of skin lesions. Topical therapy with BD/CAL foam was introduced to treat refractory psoriatic lesions, leading to excellent outcomes. Conclusions: The reported cases show that therapy with BD/CAL foam may be an effective adjuvant treatment of psoriasis in cases of incomplete and unsatisfactory response to systemic therapies, including biologics. [ABSTRACT FROM AUTHOR]

Introduction: Metformin has potential in treating patients with psoriasis, and this meta-analysis aims to explore the impact of metformin supplementation on treatment efficacy for psoriasis. Material and methods: The PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched, and we included randomized controlled trials (RCTs) assessing the effect of metformin on treatment efficacy for patients with psoriasis. Results: Three RCTs were included in the meta-analysis. Overall, compared with control intervention for psoriasis, metformin intervention resulted in significantly increased psoriasis area severity index (PASI) 75% reduction (odds ratio (OR) = 22.02; 95% confidence interval (CI): 2.12 to 228.49; p = 0.01), and erythema, scaling and induration (ESI) 75% reduction (OR = 9.12; 95% CI: 2.13 to 39.02; p = 0.003), and was associated with substantially decreased fasting plasma glucose (FPG, standard mean difference (SMD) = --0.59; 95% CI: -0.92 to -0.26; p = 0.0005), triglycerides (SMD = -0.92; 95% CI: -1.38 to -0.47; p < 0.0001), total cholesterol (SMD = -0.77; 95% CI: -1.22 to -0.32; p = 0.00008), and low-density lipoprotein (LDL, SMD = -0.67; 95% CI: -1.12 to --.23; p = 0.003). Conclusions: Metformin supplementation effectively improves treatment efficacy and metabolic syndrome in psoriasis patients. [ABSTRACT FROM AUTHOR]

Background • Despite there being advanced treatment options, psoriasis remains an incurable and recurring disease. Noteworthy scholars of Unani (Greco-Arab) medicine have proposed many drugs and formulations for psoriasis but the scientific evidence on the same is scarce. Hence, trial formulations were selected for the study. Primary Study Objectives • This study was designed to evaluate the efficacy and safety of two herbal Unani formulations, Ma΄jūn Mundī and Qairūtī Karnab, in the management of chronic plaque psoriasis (CPP). Methods/Design • This open-label, single-arm clinical trial was conducted on 33 participants, of whom 30 completed the 12-week treatment course. Setting • This study was conducted at the Central Research Institute of Unani Medicine (CRIUM), Hyderabad, Telangana, India, from 01 August 2018 to 25 May 2019. Participants • Participants of any gender aged 18 to 65 years with clinically diagnosed CPP and psoriasis area severity index (PASI) ≥ 10% were included in the trial. Interventions • The participants received 5 g of Ma΄jūn Mundī (a semisolid preparation) orally, twice daily with water, followed by the topical application of Qairūtī Karnab (a homogenous paste) to cover the lesions over 12 weeks. Outcome Measures • The primary outcome measure was the change in PASI determined pre- and post-trial in terms of mean and percentage reduction. Secondary outcome measures were changes in patient global assessment (PGA) on a 100 mm visual analog scale, investigator global assessment (IGA) on a 6-point scale, and subjective parameters including erythema, induration, scaling, and itchiness. Results • The analysis revealed a significant reduction in the PASI score, with 12 subjects (40%) achieving PASI 75 and 3 subjects (10%) achieving PASI 90. Significant improvements were also observed in secondary outcome measures with no adverse events. Conclusion • The findings of the study indicate that the trial formulations exhibit a notable anti-psoriatic effect without any adverse effects. The formulations are worthy of further evaluation as an alternative treatment for CPP [ABSTRACT FROM AUTHOR]

Genital psoriasis affects 3-33% of patients with psoriasis during the course of the disease, usually leading to a severe reduction in the patient’s quality of life. This study aims to retrospectively assess the effectiveness of interleukin (IL)-23 and IL-17 inhibitors in a real-life population affected by moderate-to-severe plaque psoriasis with genital involvement coming from our dermatology department. A total of 86 patients with a diagnosis of moderate-tosevere plaque psoriasis with severe genital involvement were enrolled. Patient characteristics, psoriasis area and severity index (PASI), and static physician global assessment of genitalia (sPGAG) at each visit were recorded. During the treatment, the mean PASI decreased from 12.8 to 0.63 at week 52; a PGA of 0/1 was reached by 97.40% at week 52 and by 100% of patients (37/37) at week 104. No significant differences between IL-23 and IL-17 inhibitors were observed; indeed, the bio-naïve group of patients demonstrated a superior response compared to the group of bioexperienced patients.Our findings confirmed that IL-23 and IL-17 inhibitors are safe and effective therapeutic options for the treatment of genital psoriasis. [ABSTRACT FROM AUTHOR]

Introduction • Psoriasis is a chronic inflammatory dermatological condition characterized by welldemarcated erythematous scaly plaques. It affects the immune system of the body causing inflammation and hyper-proliferation of the skin, where a key role is played by immune dysfunction and psychological stress. Psoriasis is a relapsing and remitting disease which shows its affections primarily for skin. This makes it more difficult to treat as there often is a mental maintaining cause associated in the background. Homoeopathy is an ideal system of medicine for the treatment of such diseases which show affections for both physical and mental sphere. Whilst treating such diseases, the homoeopathic physician often faces challenges when the most indicated remedy stops acting after an initial amelioration. This demands the usage of an intercurrent remedy which removes the obstacles in the path of cure and brings about recovery in the patient. Case Summary • A 28-year-old female presented with thick, coppery red eruptions on ear pinnae, scalp, extensor surface of left hand, back and ankles laterally. Based on the totality of symptoms, she was prescribed Staphysagria 1M which initially provided relief to the patient. The case was stood still for several months during which both placebo and Staphysagria 10M were prescribed. Still there was no progress whatsoever, the case was retaken, but the totality and the remedy were same. This was a clear call for prescribing an anti-miasmatic remedy to remove the miasmatic block. The patient was prescribed Psorinum 1M as an intercurrent anti-miasmatic remedy with remarkable physically and mental recovery. Staphysagria 10 M was repeated which later removed all the lesions and restored the patient mentally too. [ABSTRACT FROM AUTHOR]

Aim: Psoriasis is a disease characterized by chronic inflammation of the skin and small joints that causes serious deterioration in quality of life. Inflammation, angiogenesis and fibrosis plays a significant role in the disease pathogenesis. Fibroblast growth factor 2 (FGF2) is a vigorous mitogenic agent and a molecule associated with pathways that are effective in the pathogenesis of psoriasis. The purpose of this study is to determine the level of patients with FGF2 in the serum of psoriasis and to determine the change in the level of this molecule according to the severity of the disease. Materials and Methods: 96 patients with psoriasis and 100 healthful were included in this study. The level of FGF2 was measured by ELISA method from serum samples obtained from blood samples taken from those included in the study. The results were compared with the healthful control group. Patients with psoriasis were grouped as mild, moderate, severe and very severe. FGF2 levels were compared in patients grouped according to disease severity. Results: Serum FGF2 levels were found to be higher in psoriasis patients compared to the healthful control group (p<0.0001). When psoriasis patients were checked against the healthy control group according to the severity of the disease, serum FGF2 levels were found to increase in the moderate, severe and very severe patient groups (p<0.001). Conclusion: Elevated serum FGF2 level in psoriasis patients was revealed for the first time. As the severity of the disease increases, the increase in the serum FGF2 level shows that this molecule may be effective in the pathogenesis of psoriasis and may be the target molecule in treatment. [ABSTRACT FROM AUTHOR]

Psoriasis is a common immune-mediated, chronic inflammatory disease, causing adverse effects on patients' quality of life and disease burden. In psychodermatology, psoriasis is included both in the group of dermatological diseases, in which the psychophysiological background plays a key role, and in dermatoses being a potential source of emotional disturbances or being a trigger for the development of secondary mental disorders. A comprehensive view of the patient with psoriasis, not only from the point of view of skin disease, but also as a result of a wide impact of stress, including low self-esteem and inappropriate social perception may have a key influence on improvement of quality of life of these patients. [ABSTRACT FROM AUTHOR]

Psoriasis is a chronic inflammatory dermatosis with periods of exacerbation and remission. Prevalence of psoriasis is estimated at 1-3% of the population of Europe and the United States of America. The disease process may affect the skin, nails and joints. Perception of psoriasis as not only a skin disease, but a systemic inflammatory disease that affects the functioning of the entire body has changed over the years. Patients suffering from psoriasis more often than the general population suffer from many comorbidities. Little data is available on the comorbidity of psoriasis and pancreatic diseases. The relationship between the coexistence of psoriasis and chronic pancreatitis seems to the most interesting and worth further studies. [ABSTRACT FROM AUTHOR]

Aim: Psoriasis is a chronic systemic inflammatory disease. A generally accepted laboratory marker for monitoring the treatment response of psoriasis is not yet available. The aim of this study was to evaluate the effects of biologic therapy on the novel inflammatory biomarkers neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), mean platelet volume (MPV), and plateletcrit (PCT) in psoriasis. Methods: Fifty-five patients with psoriasis who received biologic therapy including tumor necrosis factor-alpha, interleukin (IL)-17, IL- 12/23, and IL-23 inhibitors for at least three months were retrospectively evaluated. Psoriasis area severity index scores, hemogram data, and C-reactive protein (CRP) levels were analyzed before and after three months of therapy. Results: The CRP, neutrophil count, platelet count, NLR, PLR, and PCT values revealed a significant decrease after three months of therapy, irrespective of the type of biologics used (p=0.008, 0.012, 0.017, 0.001, 0.011, and 0.009, respectively). After treatment, NLR and PLR decreased promptly in parallel with a decrease in CRP, in which NLR has a low-moderate (p=0.025, r=0.303), and PLR has a moderate correlation (p=0.000, r=0.525). Conclusion: Neutrophil-lymphocyte ratio, PCT and particularly PLR parameters derived from hemogram data can be used to assess the effect of biological therapy on systemic inflammation among psoriasis patients. [ABSTRACT FROM AUTHOR]

The article provides information on psoriasis, a chronic, immune-mediated dermatological condition, and its implications for nursing care. Topics discussed include risk factors and aetiology of the disease, pathophysiology and clinical classification of psoriasis which includes inverse psoriasis, guttate psoriasis and pustular psoriasis, and diagnosis and treatment for the disease.

Objective: As with every chronic disease, YouTube is increasingly heavily accessed to get information for psoriasis. It contains quality videos containing medical information; however, some content is of low quality, unscientific, misleading, and potentially harmful. We aimed to conduct this study to reveal this situation, understand the rate of non-physician practice, and develop solutions. Material and Methods: Between May 1-31, 2022, we searched the YouTube search engine by typing “psoriasis treatment” in Turkish. The number of views of the video, the number of subscribers, time of publication, duration of the video, gender and occupation of the presenter, type of YouTube channel on which the video was posted, were recorded. In the analysis of analytical statistics, the Quade test was used to eliminate the severity of the difference in the number of views and the extreme difference of skewness. Levene’s test was used for homogeneity analysis. Results: The majority of the videos consisted of education-information about psoriasis treatment methods (41.6%) and specific treatment recommendations (35%). 46.2% of the video narrators were physicians (21.7% dermatologist, 24.5% non-dermatologist) 25.8% were non-physicians, and herbalists (15.4%) were the leading ones. The rate of evidence-based treatment recommendations was 24.5%, while the rate of non-evidence-based treatments was 65.7%. Conclusion: We have identified videos created by herbalists who recommend supplements containing plant extracts, which are not based on substantial evidence. There should be more videos on YouTube about psoriasis and its treatment by dermatologists who are experts in the subject. [ABSTRACT FROM AUTHOR]

Dimethyl fumarate (DMF) was recently approved by the European Medicines Agency for systemic treatment of moderateto-severe chronic plaque psoriasis. Appropriate management of DMF treatment is required to achieve optimal clinical benefits. 7 dermatology experts gathered online for 3 meetings to identify consensus on the use of DMF in patient selection, drug dosage/titration, side effects management, and follow-up, with the aim to provide guidance on the use of DMF for psoriasis in clinical dermatological practice based on literature data and expert opinion. 20 statements were discussed and voted on using a facilitator-mediated modified Delphi methodology. Strong consensus was reached for all statements (agreement level of 100%). DMF treatment is characterized by dosage flexibility, sustained efficacy, high rates of drug survival, and low potential for drug-drug interactions. It can be used in a broad range of patients, including the elderly or those with comorbidities. Side effects (mainly gastrointestinal disorders, flushing, and lymphopenia) are frequently reported but are generally mild and transient and can be minimized by dosage adjustments and a slow titration schedule. Hematologic monitoring throughout the treatment course is required to reduce the risk of lymphopenia. This consensus document provides clinical dermatologists with answers on the optimal use of DMF to treat psoriasis. [ABSTRACT FROM AUTHOR]

Purpose of the article: Interleukin-23 inhibitors, such as tildrakizumab, have emerged as safe and effective options for the management of psoriasis. Yet their efficacy in elderly patients (aged 65years or more), particularly in those with difficult-to-treat areas involvement, remains insufficiently explored. We conducted this real-life retrospective multicentric observational study to assess the effectiveness of tildrakizumab in elderly patients with moderate-to-severe psoriasis, with involvement of difficult-totreat areas. Materials and methods: We enrolled forty-nine patients aged 65years old or more (mean age 73.1±6.0), all treated with tildrakizumab for at least 28weeks. The effectiveness of tildrakizumab was assessed by Static Physician’s Global Assessment of Genitalia (sPGA-G), fingernail-PGA (f-PGA), palmoplantar PGA (pp-PGA), scalp-specific PGA (sc-PGA), and Psoriasis Area and Severity Index (PASI) scores. Results: Significant improvements in PASI scores were observed within 28weeks of treatment, with 77.5%, 60%, and 45.2% of patients achieving PASI75, PASI90, and PASI100, respectively. The mean PASI decreased significantly from baseline (13.6±9.9) to 1.3±1.7 at week 28. More than 90% of patients had clear sPGA-G and pp-PGA scores and over 70% had clear f-PGA and sc-PGA scores after 28weeks. Conclusions: Our findings suggest that tildrakizumab could be a valuable option for the treatment of elderly patients, including those with difficult-to-treat areas involvement. [ABSTRACT FROM AUTHOR]

Background: The recent introduction of biological drugs specifically targeting the interleukins involved in psoriasis pathogenesis revolutionized the therapeutic scenario of moderate to severe forms of psoriasis. Among these, risankizumab, an anti-IL-23, was shown to be effective both in clinical trials and real-life experiences. However, data on its use on very severe forms of psoriasis, defined by a Psoriasis Area Severity Index (PASI) of at least 30, are scant. In this context, our study aimed to investigate the outcomes of patients with very severe psoriasis, and the involvement of difficult-to-treat areas treated with risankizumab for up to 2 years. Methods: A retrospective, observational study enrolled patients with very severe plaque psoriasis and the involvement of difficult-to-treat areas undergoing treatment with risankizumab. Clinical and demographic data were collected at baseline. Moreover, at baseline and each dermatological examination (16, 28, 40 and 104 weeks), clinical improvement was measured using the percentage of patients achieving PASI 75/90/100 response, site-specific Psoriasis Global Assessment and Dermatology Life Quality Index. Results: At baseline, the mean PASI was 35.1 ± 5.1. A significant reduction was observed since week 16 and maintained up to week 104. Moreover, the Psoriasis Global Assessment and Dermatology Life Quality Index improved as well. Conclusions: Risankizumab showed to be effective and safe in patients affected by very severe forms of psoriasis with the involvement of difficult-to-treat areas. [ABSTRACT FROM AUTHOR]

Purpose: Tildrakizumab is a selective inhibitor of IL-23 approved for the treatment of moderate-tosevere plaque psoriasis in two dosages. We conducted a 16-week multicenter retrospective study to compare the effectiveness and safety of tildrakizumab 200mg versus tildrakizumab 100mg in patients with a high disease burden or high body weight. Materials and methods: Our retrospective study included 134 patients treated with tildrakizumab 200mg and 364 patients treated with tildrakizumab 100mg from 28 Italian Dermatology Units affected by moderate-to-severe plaque psoriasis. The patients had a body weight above 90kg or a high disease burden (Psoriasis Area and Severity Index [PASI]≥16 or the involvement of difficult-to-treat areas). We evaluated the effectiveness of tildrakizumab at the week-16 visit in terms of PASI90, PASI100 and absolute PASI ≤ 2. Results: After 16weeks of treatment with tildrakizumab 200mg, PASI90 was reached by 57.5% of patients and PASI100 by 39.6% of patients. At the same time point, 34.3% and 24.2% of patients treated with tildrakizumab 100mg achieved PASI90 and PASI100, respectively. Conclusions: Our data suggest that tildrakizumab 200mg has better effectiveness than tildrakizumab 100mg in patients with a body weight ≥ 90kg and a high disease burden. [ABSTRACT FROM AUTHOR]

Axial symptoms (i.e., back pain) are common in the general population. At the same time 25–70% of patients with psoriatic arthritis (PsA) exhibit signs of inflammatory axial involvement (axial PsA). The presence of unexplained chronic (duration ≥ 3 months) back pain in a patient with psoriasis or PsA should trigger evaluation of the presence of axial involvement. Evaluation of axial involvement normally involves imaging of the axial skeleton (sacroiliac joints and/or spine) in addition to clinical and laboratory evaluation. Symptomatic patients with confirmed axial PsA are treated with a combination of non-pharmacologic and pharmacologic methods including the use of non-steroidal anti-inflammatory drugs, tumour necrosis factor, interleukin 17, and Janus kinase inhibitors. Interleukin 23 blockade might also be effective in the axial domain of PsA; a dedicated clinical study is ongoing at present. Safety considerations, patient preference, as well as the presence of other disease manifestations (especially of extra-musculoskeletal manifestations—clinically relevant psoriasis, acute anterior uveitis, inflammatory bowel disease), define the choice of a specific drug or drug class. [ABSTRACT FROM AUTHOR]

Introduction: Psoriasis is an immune-mediated, chronic, inflammatory, systemic disease that primarily affects the skin and joints. Despite advances in the comprehension of the disease, there is still a lack of biomarkers available for clinical use. Objective: To evaluate neutrophil-lymphocyte ratio (NLR) as a marker of systemic inflammatory status in patients with moderate to severe plaque psoriasis vulgaris, compared with controls. Methods: Observational case-control study, conducted in a public hospital unit, focused on skin disease. A total of 165 patients with psoriasis and 187 healthy subjects seen between August and December 2020 were studied. Results: The group of cases showed a greater median of NLR compared with controls (medium = 1.96, p = 0.032). When stratified by age, the median NLR was higher in individuals between 31 and 60 years, with statistical significance. No differences were identified in gender, presence of arthritis or comorbidities. Study limitations: Observational, retrospective, single-center study based on medical records review. Conclusion: NLR was higher in individuals with psoriasis when compared with controls. It is simple, inexpensive and available in all levels of care, based on an elementary laboratory test that is already part of the routine care of patients with psoriasis. Its use in evaluating systemic inflammation could contribute to better management of psoriatic disease. [ABSTRACT FROM AUTHOR]

Background: Various diagnostic tools are used to assess cutaneous psoriasis, but most of it were subjective. Sympathetic skin response (SSR), skin PH and temperature objectively measure the skin barrier functions that could aid clinicians to evaluate accurately and predict skin disease incidence even before the onset of clinical symptoms. Aim and Objectives: The study's objective was to assess the utility of cutaneous parameters (skin temperature and pH) and SSRs influencing psoriatic patients' diagnosis management and treatment compared to controls. Materials and Methods: A total of 40 healthy participants and 40 psoriasis patients aged 18 to 65 years were recruited for this study. SSR, skin temperature and pH were assessed. The psoriasis disability index (PDI) was recorded from all the patients. Data analysis was carried out using SPSS version 20.0. Results: The results shows significantly increased skin temperature, prolonged SSR latency (bilaterally) and decreased SSR amplitude (bilaterally) among patients affected with psoriasis compared to control subjects. There is a positive correlation between SSR latency with PDI and a negative correlation between SSR amplitude and PDI in psoriasis patients. Conclusion: SSR reveals sympathetic sudomotor dysfunction and increased skin temperature in psoriasis. Furthermore, there is a link between increased SSR latency and PDI, which shows that local nervous system impairment significantly contributes to the inflammatory process in psoriasis. Thus, SSR can be used as a complementary tool for the early identification and assessment of epidermal barrier integrity in psoriasis patients, along with the clinician's standard protocols. [ABSTRACT FROM AUTHOR]

Psoriasis is a persistent and mysterious autoimmune skin condition that affects 2-3% of the world's population. Currently, topical therapies, light therapy, and systemic drugs are the three main forms of treatment used to lessen inflammation and skin irritation/itching. However, all these treatments are only used to manage the disease each time it surfaces. Therefore, the main target of this work is to search for a safer and more effective remedy for psoriasis from the reservoir of phytochemicals present in Carica papaya via in silico studies due to its anti-psoriatic and anti-inflammatory properties. Reported phytochemicals isolated from Carica papaya were subjected to computational simulations using the PyRx docking tool and were docked against Janus Kinase 1 (JAK1) and Tumor necrosis factor ff (TNFff) target receptors. The results obtained were visualized using PyMol, and Biovia 2019. Analysis of the results identified both Chlorogenic acid and Coumaroylquinic-acid with docking scores (-8.6 kcal/mol and -7.9 kcal/mol) respectively as potential inhibitors for the JAK1 receptor. The identified compounds also possessed excellent ADMET, drug-likeness, bioactivity, and activity spectra for substances (PASS) prediction properties. Their binding mode and the molecular interactions with the targets also affirmed their potency. In comparison with the standards (Methotrexate and Cyclosporine), Chlorogenic acid and Coumaroylquinic-acid have better ADMET properties, binding affinities, drug-likeness, PASS properties, bioactivities, oral bioavailability, binding mechanism, and interactions with the active site of the target receptor and are hereby recommended for further analysis towards the development of a new therapeutic agent for psoriasis treatment and management. [ABSTRACT FROM AUTHOR]

Psoriasis is a chronic, mild and common inflammatory skin condition. Still an ideal treatment for psoriasis, effective, safe, convenient, and economical is not available. In this scenario, the search for suitable alternative treatments with minimal side effects is necessary. Plants can be effective and alternative in this regard. Therefore, this article discusses the leaves of the plants Thespesia populnea (Malvaceae) that are traditionally used in the treatment of psoriasis. The present study aimed to assess anti-psoriatic activity. The dried leaves of the plants were subjected to soxhlation with 95% ethanol and phytochemical studies were performed. The anti-psoriatic activity was evaluated by the Mouse-Tail model. It is a relatively sensitive and reproducible morphometric method that allows quantitative evaluation of the effects of anti-psoriatics through epidermal differentiation. Extracts were applied topically at a dose of 500mg/kg over 14 days and at the end, the animals were sacrificed, longitudinal histological sections were made of the tail skin and the degree of orthokeratosis was determined. It was significantly (P <0.05) increased by the ethanolic extract of Thespesia populnea (52.86±2.86) compared to the control (17.30±4.09). In relative epidermal thickness, the ethanolic extract of Thespesia populnea (92.68±8.8) showed a significant difference (P <0.05) compared to the control (100±10.7). The data obtained suggest that the selected plant has anti-psoriatic activity and confirms its traditional use in the treatment of psoriasis. [ABSTRACT FROM AUTHOR]

Background: Among various nail disorders encountered in dermatology outpatient department, nail psoriasis is not uncommon. Around 80%–90% of patients with psoriasis present with nail involvement at some point in their life. In 1%–5% of patients, alterations compatible with nail psoriasis may also occur in the absence of cutaneous lesions. There is limited literature on nail psoriasis especially in Indian patients. Objective: The present study was undertaken to evaluate clinical, histopathological, and dermoscopic features in nail psoriasis and its impact on quality of life. Materials and Methods: All clinically suspected cases of nail psoriasis were included in the study. Clinical parameters and dermoscopic findings were observed and noted. Nail biopsy was performed to confirm the findings. Impact on quality of life was evaluated by correlating Nail Psoriasis Severity Index (NAPSI) score and nail psoriasis quality of life scale (NPQ10) score. Results: Of 50 patients with clinically suspected nail psoriasis, skin involvement was seen in 45 (90%), and 5 (10%) had only nail involvement. The mean NAPSI score was 34.34 in our study. The most common clinical nail finding was pitting (38 [76%]) followed by onycholysis (31 [62%]). The most common dermoscopic finding was pitting (39 [76%]) followed by onycholysis (32 [64%]). Histopathologically, the most common finding was parakeratosis (41 [82%]) followed by focal hypergranulosis (40 [80%]). The majority of the patients (21 [42%]) had NPQ10 (modified) score between 10 and 20, and moderate positive correlation between NAPSI score and NPQ10 scale score was observed. Limitations: Small sample size and no control group. Conclusion: Nail psoriasis does impact the quality of life of patients especially in females who feel embarrassed in social gatherings and workplace. Nail biopsy, though painful and difficult to perform, is the most efficient method to diagnose nail psoriasis. [ABSTRACT FROM AUTHOR]

SDZ-ADL is a biosimilar of reference adalimumab. Here, the safety and effectiveness data of SDZ-ADL from the British Association of Dermatologists Biologic and Immuno-modulators Register (BADBIR) are reported. In the safety set, data of SDZ-ADL were compared with conventional systemics data. In the effectiveness set, the effectiveness and quality-of-life of patients treated with SDZ-ADL as a first-time biologic, or who switched from a previous biologic to SDZ-ADL, were assessed using the Psoriasis Activity Severity Index (PASI) and Dermatology Life Quality Index (DLQI), respectively. A total of 565 (incidence rate (IR) per 1000 person-years 29.1, 95% CI 26.8–31.6) serious infections and 48 (IR 2.5, 95% CI 1.8–3.3) myocardial infarction events were reported in the conventional systemics cohort compared with four (IR 31.5, 95% CI 8.6–80.7) and one (IR 7.9, 95% CI 0.2–43.9) in the biologic cohort, respectively. One patient (0.7% (1/136)) reported injection-site pain in the biologic cohort. At 12 months, PASI ≤ 2 was achieved in 84.6% (11/13) and 76.9% (10/13) and DLQI 0/1 was achieved in 70% (7/10) and 75% (3/4) of patients in the biologic-naïve and biologic-switch cohorts, respectively. After one year of therapy, 82.7% (110/133) patients remained on SDZ-ADL. SDZ-ADL was well-tolerated and effective in patients with psoriasis. [ABSTRACT FROM AUTHOR]

Background: Drug survival, defined as the length of time from initiation to discontinuation of a given therapy, allows comparisons between drugs, helps to predict patient's likelihood of remaining on a specific treatment, and achieving the best decision for each patient in daily clinical practice. Objective: The aim of this study was to provide data on drug survival of secukinumab, ixekizumab, brodalumab, guselkumab, tildrakizumab, and risankizumab in a large international cohort, and to identify clinical predictors that might have an impact on the drug survival of these drugs. Methods: This was a retrospective, multicentric, multi-country study that provides data of adult patients with moderate to severe psoriasis who started treatment with an interleukin (IL)-17 or IL-23 inhibitor between 1 February 2015 and 31 October 2021. Data were collected from 19 distinct hospital and non-hospital-based dermatology centers from Canada, Czech Republic, Italy, Greece, Portugal, Spain, and Switzerland. Kaplan–Meier estimator and proportional hazard Cox regression models were used for drug survival analysis. Results: A total of 4866 treatment courses (4178 patients)—overall time of exposure of 9500 patient-years—were included in this study, with 3164 corresponding to an IL-17 inhibitor (secukinumab, ixekizumab, brodalumab) and 1702 corresponding to an IL-23 inhibitor (guselkumab, risankizumab, tildrakizumab). IL-23 inhibitors had the highest drug survival rates during the entire study period. After 24 months of treatment, the cumulative probabilities of drug survival were 0.92 (95% confidence interval [CI] 0.89–0.95) for risankizumab, 0.90 (95% CI 0.88–0.92) for guselkumab, 0.80 (95% CI 0.76–0.84) for brodalumab, 0.79 (95% CI 0.76–0.82) for ixekizumab, and 0.75 (95% CI 0.73–0.77) for secukinumab. At 36 months, only guselkumab [0.88 (95% CI 0.85–0.91)], ixekizumab [0.73 (95% CI 0.70–0.76)], and secukinumab [0.67 (95% CI 0.65–0.70)] had more than 40 patients at risk of drug discontinuation. Only two drugs had more than 40 patients at risk of drug discontinuation at 48 months, with ixekizumab demonstrating to have a higher cumulative probability of drug survival [0.71 (95% CI 0.68–0.75)] when compared with secukinumab [0.63 (95% CI 0.60–0.66)]. Secondary failure was the main cause for drug discontinuation. According to the final multivariable model, patients receiving risankizumab, guselkumab, and ixekizumab were significantly less likely to discontinue treatment than those receiving secukinumab. Previous exposure to biologic agents, absent family history of psoriasis, higher baseline body mass index (BMI), and higher baseline Psoriasis Area and Severity Index (PASI) were identified as predictors of drug discontinuation. Conclusion: The cumulative probability of drug survival of both IL-17 and IL-23 inhibitors was higher than 75% at 24 months, with risankizumab and guselkumab demonstrating to have overall cumulative probabilities ≥ 90%. Biological agent chosen, prior exposure to biologic agents, higher baseline BMI and PASI values, and absence of family history of psoriasis were identified as predictors for drug discontinuation. Risankizumab, guselkumab, and ixekizumab were less likely to be discontinued than secukinumab. [ABSTRACT FROM AUTHOR]

To maintain genomic integrity and avoid diseases, the DNA-damage response (DDR) not only detects and repairs DNA lesions, but also contributes to the resistance to DNA-damaging chemotherapeutics. Targeting the DDR plays a significant role in drug discovery using the principle of synthetic lethality. The incomplete current knowledge of the DDR encouraged us to develop new strategies to identify and study its components and pathways. Polycarcin V, belonging to the C-aryl glycoside natural products, is a light-activatable DNA-intercalating agent that causes DNA damage by forming a covalent [2+2] cycloadduct with thymine residue under 365–450 nm of light irradiation in a DNA-sequence-independent manner. Taking advantage of the light-activatable feature and temporal control of DDR, we designed and synthesized polycarcin V-based bifunctional chemical probes, including one that cross-links DNA to DNA-binding protein to explore the DDR induced by polycarcin V and uncover novel DNA–protein interactions. Utilizing this chemical probe and activity-based protein profiling-stable isotope labeling with amino acids in cell culture, we identified 311 DNA-binding protein candidates, including known DDR factors and additional proteins that may be of interest in discovering new biology. We validated our approach by showing that our probe could specifically cross-link proteins involved in nucleotide excision repair (NER) that repair bulky DNA adducts. Our studies showed that the [2+2] cycloadduct formed by polycarcin V could indeed be repaired by NER in vivo. As a DNA-damaging agent, polycarcin V or its drug-like derivative plus blue light showed promising properties for psoriasis treatment, suggesting that it may itself hold promise for clinic applications. [ABSTRACT FROM AUTHOR]

Background: Psoriasis is a chronic inflammatory skin disease affects 3 % of world population on average. Psoriasis can have disfiguring and disabling impacts on patients with increased global burden of the disease. According to WHO, there is continuous need for establishing new modalities for treatment of psoriasis with emphasis on treatment safety concerns of the patients.The aim of this study is to assess the efficacy and safety of turmeric extract based ointment in the treatment of mild to moderate psoriasis Methods: 10 patients with psoriasis vulgaris confirmed histopathologically were recruited at Dermatology Department outpatient clinic Zagazig University Hospitals. The disease severity was assessed clinically using PASI score and the histopathologic severity was assessed before and after 4 weeks of twice daily application of the turmeric extract based ointment. Results: Significant reduction in disease severity in all patients used treatment with PASI before treatment was 19.44 ± 10.7, and after was 10.5 ± 6.3 (P = 0.0007). There was 47% ± 12% improvement in disease severity, with 50% of patients already reached PASI 50 benchmark by 4th week of treatment. Conclusions: In this pilot study, the effectiveness and tolerability of turmeric extract-based ointment in the treatment of moderate psoriasis vulgaris was evaluated and proved on both clinical and histopathological levels. [ABSTRACT FROM AUTHOR]

Background: Psoriasis is a chronic inflammatory immune-mediated hyperproliferative skin disease. Angiogenesis has an important role in the pathogenesis of psoriasis, occurring even before plaque formation. Angiopoietins have an important role in angiogenesis so described as angiogenic factors, this study aimed to evaluate Angiopoietin-2 serum level in psoriasis Vulgaris patients and to evaluate if there is a relation between serum Angiopoietin-2 level and the disease activity. Patients and Methods: This is a case-control study that included 40participants, 20 are patients and other 20 are healthy subjects. Complete general, family, past history was documented, the dermatological examination was done to all patients included in the study. The study was approved by the research ethical committee of Faculty of Medicine Zagazig University.The work has been carried out in accordance with The Code of Ethics of the World Medical Association (Declaration of Helsinki) for studies involving humans. Results: There is a highly statistically significant difference between the studied groups regarding serum angiopoietin 2 level, higher in the psoriasis group. In the psoriasis group, there is a significant positive correlation between angiopoietin 2 serum level and psoriasis area severity index. There is a statistically significant difference in serum angiopoietin 2 level and disease course, higher in progressive type. Conclusions: Angiopoietin 2 is closely associated with the evolving of microvascular proliferation in psoriasis and its level increase with the severity of the disease. Based on our results, we suggest that serum Ang2 level act as a possible useful biomarker of Psoriasis Vulgaris. Also, the major role of Ang2 in systemic pathological processes in psoriasis. [ABSTRACT FROM AUTHOR]

Background: Galectin-3 is a one of the galectin family and produced by T-lymphocytes and has an important role in the inflammation process. Aim: the aim of this study was to determine the levels of serum galectin-3 in patients with psoriasis Vulgaris, a T-cell-mediated inflammatory disease, and investigate the correlation between these levels and activity of disease. Material and Method: this study included thirty-six patients with psoriasis Vulgaris and 30 healthy subjects. The psoriasis area and severity index (PASI) were calculated and recorded for every patient. The patients were divided into three groups: group I (mild), II (moderate) and III (Severe) according to the PASI scores. ELISA analysis was used to analyze the level of serum galectin 3. Results: level of serum galectin-3 in psoriasis Vulgaris patients was significantly lower than the control group (p=0.001). there was a negative correlation between level of serum galectin-3 and PASI scores (Spearman's rho=-0.749, P<0.001). Conclusion: the level of serum galectin-3 is considered an important factor in psoriasis Vulgaris etiopathogenesis and could be used as a reliable indicator for exacerbation during follow-up. [ABSTRACT FROM AUTHOR]

Real‐world secukinumab gastrointestinal‐related adverse events (GIRAE) data in psoriatic patients treated with secukinumab are lacking. A descriptive, retrospective study was performed by reviewing the medical records of patients who received secukinumab for plaque psoriasis for at least 1 year and who made a follow‐up visit to the dermatology clinic of "Ospedali Riuniti Umberto I" in Ancona between December 1, 2021, and March 31, 2022. The patients' medical history and clinical data were collected at T0, before treatment, and at T1, corresponding to the last follow‐up visit. Special attention was given to gastrointestinal adverse events (GIRAE). A total of 108 patients were included in the study. At baseline median PASI was 14.8 (range 2.2–27, SD 6.1), and median DLQI was 9.3 (5–16, SD 2.6). The median PASI for treated patients was 0.7 (0–3, SD 0.8; p < 0.00) 1and median DLQI was 0.3 (0–1, SD 0.5; p < 0.001). At T1 54/114 patients (50%) reached PASI100, of the other 54, 48 (88.9%) reached PASI 90 while the other six discontinued for secondary ineffectiveness. Only three patients reported a GIRAE (diarrhea), however, when screened, no IBD was found. Consistent with data in the literature, secukinumab is an effective and safe drug for the treatment of plaque psoriasis also in a real‐life experience context. There should be no concern in choosing the drug for fear of possible IBDs‐related GIRAE if there is no personal history or familiarity for IBDs. [ABSTRACT FROM AUTHOR]

Objectives. Psoriasis is a skin disease thought to be related to immune system dysfunction. Our study is aimed at analyzing the prevalence of psoriasis in China in multiple different categories and compared the prevalence at the global level, in order to bring insights to policymakers for treating this disease. Methods. We analyzed psoriasis trends from 1990 to 2019 in China as well as around the globe with data from the Global Burden of Disease 2019 study. Multiple metrics such as age-standardized prevalence rates, percent change in age-standardized prevalence rates, disability-adjusted life years (DALYs), and age and sex patterns were included. We also predicted the trends of psoriasis prevalence and DALYs in the following 30 years. Results. In China, the age-specific prevalence cases showed a right shift in 2019 compared to 1990 with a peak between the ages of 50 and 54 years and an obvious surpass in males between 40 and 69. Though China still had the largest number of psoriasis cases in 2019, the increase rate was below global level. A positive linear relationship between psoriasis prevalence and comorbidities was seen with rheumatoid arthritis, diabetes mellitus, multiple sclerosis, nonrheumatic valvular heart disease, cardiomyopathy and myocarditis, nonmelanoma skin cancer, non-Hodgkin lymphoma, and multiple myeloma in China within the male group in 2019. Discussion. The burden of psoriasis, as measured by the absolute number of DALYs, continues to increase around the world. The scarcity of modifiable risks for most psoriasis burdens suggests that new knowledge is needed to develop effective prevention and treatment strategies. [ABSTRACT FROM AUTHOR]

Psoralea corylifolia L. (Fabaceae) is a traditional medicinal herb used to treat various diseases, including kidney disease, asthma, psoriasis and vitiligo. To explore the antibacterial activity of Psoralea corylifolia L. and its bioactive components against Mycobacterium abscessus (M. abscessus). Ultra high performance liquid chromatography was utilized to analyze the bioactive fractions and compounds present in 30%, 60%, and 90% ethanol extracts of Psoralea corylifolia L.. The antibacterial effects of Psoralea corylifolia L. and potential active ingredients were determined by minimum inhibitory concentration (MIC). The bactericidal activity of the active ingredient isobavachalcone was evaluated and then scanning electron microscopy was used to explore the bactericidal mechanism of isobavachalcone. The 90% ethanol extracts of Psoralea corylifolia L. showed significant antibacterial activity against M. abscessus, with an MIC of 156 μg/mL. Isobavachalcone was identified as the bioactive ingredient, and testing of 118 clinical isolates of M. abscessus indicated their MICs ranged from 2 to 16 μg/mL, with an average MIC of 8 μg/mL. Furthermore, the minimum bactericidal concentration/MIC ratio and the time-kill test indicated rapid bactericidal activity of isobavachalcone against M. abscessus. Finally, we found that the bactericidal mechanism of isobavachalcone involved damage to the bacterial cell membrane, causing wrinkled and sunken cell surface and a noticeable reduction in bacterial length. Psoralea corylifolia L. ethanol extracts as well as its active component isobavachalcone show promising antimicrobial activity against M. abscessus. [Display omitted] • The 90% ethanol extracts of Psoralea corylifolia L. exhibits significant antibacterial activity against M. abscessus , with the MIC of 156 μg/mL. • Isobavachalcone, the active component of Psoralea corylifolia L., exhibits antibacterial activity on 118 clinical isolates of M. abscessus with an average MIC of 8 μg/mL. • The bactericidal mechanism of isobavachalcone involved damage to cell membrane causing wrinkled and sunken cell surface and a noticeable reduction in bacterial size. [ABSTRACT FROM AUTHOR]

Background. Psoriasis and cutaneous T-cell lymphoma (CTCL) expose patients to chronic inflammation as well as physical and psychological disabilities, but the impact of such alterations on cognitive function is unknown. Objective. This study is aimed at determining if CTCL and psoriasis impact cognitive functioning in relation to psychological and health-related quality of life (HR-QOL) status. Methods. A cross-sectional study was performed in an outpatient dermatology clinic of a university teaching hospital. Thirty-nine subjects with CTCL (N = 20) or psoriasis (N = 19) who met eligibility criteria were included. The cognitive domains of memory, attention and processing speed, and executive function were assessed with standard neuropsychological tests. Subjects were assessed for depression, anxiety, and HR-QOL (using the SKINDEX-29 questionnaire). Results. Study participants were CTCL and psoriasis subjects; cognitive impairment was found in the domain of memory in 17.9% subjects with CTCL or psoriasis. Lower scores on executive function tests were predicted by higher (worse HR-QOL) SKINDEX-29 functioning scores (p = 0.01). A higher estimated baseline intellectual functioning predicted lower scores (better HR-QOL) on the symptoms and functioning domains of SKINDEX-29 (p = 0.01 and 0.02, respectively) and a statistical trend (p = 0.07) for the emotion domain. Memory and acute anxiety were adversely impacted by shorter disease duration (p = 0.01 for both). Conclusions. Memory impairment may be associated comorbidity in CTCL and psoriasis. Subjects with stronger cognitive resources appear to cope better with health-related quality of life (HR-QOL) challenges. [ABSTRACT FROM AUTHOR]

Psoriasis is a common, chronic, immune-mediated, multisystem, inflammatory disorder. It affects all age groups, including infancy. In one-third of the cases, the onset of the disease is in the first and second decades of life. Childhood psoriasis significantly affects the quality of life of the child as well as that of the entire family. Pediatric psoriasis has distinct clinical presentations and evolves with time. Like in adults, chronic plaque psoriasis has been found to be the most common type of childhood psoriasis. Psoriatic plaques in children are less pruritic, smaller and thinner with less prominent scaling. In pigmented skin, the erythema is less prominent and plaques appear violaceous or hyperpigmented. Pediatric psoriasis can be associated with arthritis, metabolic syndrome, depression and anxiety. Hence all children should be screened routinely for associated comorbidities. Management of pediatric psoriasis is challenging owing to the limitation of approved therapies. 'Proactive therapy' is a recent approach in childhood-onset psoriasis that would help to prevent the severity of flare-ups, thus improving the quality of life. [ABSTRACT FROM AUTHOR]

Background and Design: This study aimed to investigate the effects of the comorbidities on disease severity and outcomes in pediatric psoriasis patients. Materials and Methods: A total of 366 patients enrolled to the study were ≤18 years old and were followed up between January 2013 and December 2017. Age, gender, family history, localization, clinical type, severity, treatments, duration of treatment/response, and comorbidities were retrieved retrospectively. Physician Global Assessment was used for psoriasis severity. All parameters were compared statistically in between groups that patients with or without comorbidities. Statistical significance was accepted p<0.05. Results: Of the 366 patients 62.6% were women, and 37.4% were men. At least one comorbidity was detected in 39.3% of the patients. The most common observed comorbidity was allergic rhinitis (8.1%), and obesity (7.1%) was the second most common. The duration of treatment was higher in patients with comorbidity than in patients without comorbidities, and the duration of the disease was statistically significant (p=0.043). Scalp, face, nail, and palmoplantar involvement was more common in patients with comorbidity than in patients without comorbidity (p>0.05). Those with comorbidity were generally higher in patients with moderate to severe psoriasis (p=0.165). In patients with epilepsy, asthma, allergic rhinitis, and valvular disorders, the clinical manifestation was mild. Biological agent use is statistically higher in comorbidity group (p=0.045). It was found that the rates of complete and partial remission rates were lower, and relapse was higher in the comorbidity group, but this was not statistically significant. Conclusion: In this study, a significant relationship was found between comorbidity and disease duration (p=0.043). Comorbidities in cases of moderate to severe psoriasis and accompanying cases. Our results are compatible with previous literature, which indicates that the key to managing pediatric psoriasis is investigation and recognition of comorbidities. [ABSTRACT FROM AUTHOR]

Diacerein belongs to the class of anthraquinone derivatives which has anti-inflammatory, analgesic, and antipyretic properties. The principal mechanism of action of diacerein is to inhibit the interleukin-1ß system and related downstream signaling. Several rheumatology societies such as the European League against Rheumatism (EULAR) and the Osteoarthritis Research Society International (OARSI) have introduced diacerein in their therapeutic guidelines as a treatment option in osteoarthritis. We hereby report the case of a 56-year-old man suffering from chronic plaque psoriasis who was prescribed diacerein by an orthopedician for bilateral knee osteoarthritis. We observed a dramatic improvement in the psoriatic skin lesions with the achievement of Psoriasis Area Severity Index 75 at 12 weeks, without objectively observed adverse drug event. This suggests a probable role of diacerein as an oral biological agent in the therapeutic armamentarium of chronic plaque psoriasis. [ABSTRACT FROM AUTHOR]

Prevalence of onychomycosis increases in patients with psoriasis and that psoriasis predisposes to onychomycosis. It was aimed to determine the frequency of onychomycosis and responsible pathogens in patients with psoriasis, to reveal their differences compared to the population without psoriasis, and to determine the factors in this study. The study included 81 patients with nail disorder diagnosed with psoriasis. Clinical findings, psoriasis area and severity index (PASI), nail psoriasis severity index (NAPSI) scores, body mass indexes (BMI) and laboratory characteristics were recorded. Mycological examination by direct microscopy and fungal culture was performed both on nails that were considered onychomycosis and on nails with any of the psoriatic nail findings. The prevalence of onychomycosis was 27.2% in psoriasis patients. Nail involvement of psoriasis was found in 31.3% of the patients using biologic agents, 5.9% of those receiving conventional treatment, and 31.3% of those receiving topical treatment and 68.8% of the patients who did not receive treatment at all. The difference between the patients who did not receive treatment and those who received conventional treatment was significant (p < 0.05). There was growth in the fungal culture in 23.5% of the patients with psoriasis. There was no statistically significant relationship between onychomycosis and PASI, NAPSI score, and BMI (p > 0.05). Since the prevalence of onychomycosis in psoriasis patients receiving conventional and anti‐TNF‐α therapy is higher than in patients not receiving treatment, nail changes in these patients should be evaluated in more detail for the presence of onychomycosis. In addition, since more than one fungal agent can grow and non‐dermatophyte molds are seen more frequently in patients with psoriasis, it should be taken into account that native and fungal culture examinations should be performed together. [ABSTRACT FROM AUTHOR]

Limited information is available regarding the risk of incident liver disease in patients with psoriasis receiving systemic therapies. To describe the liver safety findings of conventional and modern systemic therapies for moderate-to-severe psoriasis, and to compare the relative incidence rates of hepatic adverse events (AEs) for each drug. All the patients on the BIOBADADERM registry were included. Crude and adjusted incidence rate ratios (cIRR and aIRR, respectively) of hepatic AEs, using anti-TNF drugs as reference, were determined. Outcomes of interest were hypertransaminasemia, nonalcoholic fatty liver disease (NADFLD) and a group of other, less represented, hepatic AEs. Our study included 3,171 patients exposed to systemic drugs (6279 treatment cycles). Incident hypertransaminasemia was the most frequent hepatic AE (incidence rate of 21 per 1000 patients-years [CI 95% 18–23]), followed by NAFLD (8 cases per 1000 patients-years [95% CI 6–10]). Methotrexate (aIRR 3.06 [2.31–4.4]; p = 0.000) and cyclosporine (aIRR 2.37 [1.05–5.35]; p =.0378) were associated with an increased risk for hypertransaminasemia when compared to anti-TNF-α agents. No differences were observed between different groups of biologics. Conventional therapies were not associated with new incident NAFLD. Comparative information of the incidence of hepatic AEs could facilitate drug selection in moderate-to-severe psoriasis. [ABSTRACT FROM AUTHOR]

Background: Although dermatology is mostly an outpatient specialty, some patients with severe skin disease need hospital admission for management. There is a paucity of data regarding the profile of these dermatology in-patient admissions.Aims: We studied the profile of patients admitted to the dermatology ward of our tertiary care government hospital in North India.Methods: This was a retrospective analysis of discharge sheets of patients admitted in the dermatology ward from January 1, 2014 to December 31, 2017.Results: Discharge sheets of 2032 admissions for 1664 patients were analyzed. The most common diagnoses in the admitted patients were immunobullous disorders (576, 28%), connective tissue diseases (409, 20%), infections, including leprosy and sexually transmitted infections (179, 8.8%), psoriasis (153, 7.5%) and reactive arthritis (92, 4.5%). The mean duration of admission was 13.95±11.67 days (range 1-118 days). Two hundred and fifty-six patients (15.38%) were re-admitted, accounting for 368 (18.11%) re-admissions. Patients with immunobullous disorders (OR 1.72, 95% CI 1.29-2.28) and psoriasis (OR 1.62, 95% CI 1.02-2.55) were more likely to be re-admitted. Adult patients, those who were admitted for more than four weeks, those who had comorbidities, and those who developed a complication during the hospital stay also had a greater likelihood of being re-admitted.Limitations: The retrospective design of the study, and the non-availability of data regarding transfers to other specialties or intensive care units and deaths were the main limitations of this study.Conclusion: This study describes the profile of patients admitted in a dermatology ward of a tertiary care centre center in North India. The patient profile and admission characteristics associated with a higher probability of re-admission were identified. [ABSTRACT FROM AUTHOR]

Psoriasis is a genetic chronic disease mediated by the immune system with systemic and cutaneous manifestations that can significantly deteriorate patients' quality of life. Two-three percent of the population worldwide suffer from psoriasis and it imposes a substantial economic burden on patients. The aetiology is mainly related with genes and environmental factors. The pathophysiology of psoriasis is characterized by T cells and dendritic cells, antimicrobial peptides, genetic predispositions, lipoprotein-2, galactosin-3, fractalkine, vaspin, and human neutrophilic peptides, etc. in the progression of psoriasis. For patients with psoriasis, the traditional treatments include corticosteroids, vitamin D3 analogues, calcineurin inhibitors, methotrexate, cyclosporine, acitretin, phototherapy, and biological agents, etc. Nanodermatology is an emerging, multidisciplinary science that is gaining increasing recognition in the treatment of psoriasis. This review provides a summary of the pathophysiology, epidemiology, clinical diagnosis, and classical pharmacotherapy of psoriasis. The review also summarizes different nanotechnology therapies for effective treatment of psoriasis. [ABSTRACT FROM AUTHOR]

This study aimed to elicit preferences for psoriasis treatment features and to test for preference heterogeneity across groups of respondents. A discrete-choice experiment was employed to elicit preferences of patients with plaque psoriasis in multiple countries. The survey instrument included a series of choice questions between three hypothetical treatments, each characterized by varying levels of six attributes (namely, lesion reduction, risk of impairing side effects, time to reach results, mode and frequency of administration, itching reduction, and side effects). Random parameters logit was used to model the data. Results were compared across a total of 18 subgroup sets. The data analysis from 1,123 respondents showed that, on average, respondents receive more utility gain from higher levels of lesion reduction and lower risks of impairing side effects than changes in other attributes included in the study. Systematic differences were detected for 13 sets; the most pronounced differences were observed based on disease severity, nail psoriasis, biologic experience, and quality-of-life scores. These many sources of preference heterogeneity identified by our analysis suggest that to improve patient satisfaction and, probably, adherence and persistence, clinicians should discuss options with patients when prescribing their treatment. [ABSTRACT FROM AUTHOR]