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Background: The product of Physician Global Assessment and Body Surface Area (PGA × BSA) is a new outcome measure for psoriasis severity and response to therapy. The objective of this study was to evaluate PGA × BSA as an alternative to Psoriasis Area and Severity Index (PASI) for psoriasis assessments. Methods: The relationship between PASI and PGA × BSA was assessed in a post hoc analysis of pooled data from the PRISTINE (NCT00663052) and PRESTA (NCT00245960) trials in patients with moderate-to-severe psoriasis who received etanercept 50 mg/week. Data were analyzed using Spearman and intra-class correlation coefficients, effect sizes, scatterplots, Bland–Altman plots, and Kappa statistics. Results: Spearman correlations at baseline, week 12, and week 24 were strong for PGA × BSA versus PASI (r=0.78, 0.87, and 0.90, respectively; all P [ABSTRACT FROM AUTHOR]

Abstract: Background: Psoriasis is a chronic inflammatory skin disease, which requires long‐term, safe and effective treatment. Apremilast, a small‐molecule PDE4 inhibitor, has been introduced as psoriasis (and psoriatic arthritis) treatment in Europe in 2015. Objective: We analysed and report the efficacy and safety of apremilast in the first 51 patients with psoriasis that have undergone treatment with this novel small molecule in our outpatient clinic. Method: Our primary endpoint was the evaluation of clinical response to apremilast according to the percentage of Psoriasis Area Severity Index (PASI) reduction (ΔPASI) at 16 weeks after treatment initiation. Secondary endpoints were the evaluation at week 16 of (i) PASI; (ii) Dermatology Life Quality Index (DLQI); (iii) Physician Global Assessment (PGA); (iv) Psoriasis Scalp Severity Index (PSSI); and (v) the percentage of patients who achieved ΔPASI50, ΔPASI75, ΔPASI90 and ΔPASI100; (vi) adverse events (AE); (vii) reasons for drug discontinuation; and (viii) drug survival. Results: About 59.3% of the patients who remained on apremilast achieved at least ΔPASI75 at week 16, while 11.1% achieved combined 50% ≤ PASI < 75% and DLQI ≤ 5 (satisfactory response) adequate enough to maintain treatment. Five patients (18.5%) also achieved ΔPASI100. Patients discontinued apremilast (28%), mostly during the first 4 weeks due to adverse events (12%) with gastrointestinal symptoms being the most common, and later due to lack of efficacy (16%). A statistically significant improvement of PASI, DLQI, PGA and PSSI scores was observed after 4 and 16 weeks of treatment relative to pretreatment measurements. Conclusion: Apremilast is a safe and efficacious treatment for psoriasis patients as it produces ΔPASI75 and ΔPASI50 responses combined with DLQI ≤ 5 in 16 weeks in 70.4% of the patients. These results, from a real‐world setting, confirm the efficacy and safety of apremilast which has been demonstrated in large phase III clinical trials. [ABSTRACT FROM AUTHOR]

Abstract: The effects of tofacitinib in treating moderate‐to‐severe plaque psoriasis were unclear. We aimed to assess the effects of tofacitinib in treating moderate‐to‐severe plaque psoriasis. We searched PubMed, Cochrane Central Register of Controlled Trials and EMBASE for relevant randomized controlled trials (RCTs) and conducted a systematic review and meta‐analysis. Four RCTs with 2724 participants were included. Compared to placebo, tofacitinib significantly improved psoriasis {≥75% reduction in the Psoriasis Area and Severity Index score: 5 mg BID: risk difference (RD) 0.32 [95% confidence interval (CI) 0.28–0.35], 10 mg BID: RD 0.51 (95% CI 0.43–0.58); ≥90% reduction in the Psoriasis Area and Severity Index score: 5 mg BID: RD 0.19 (95% CI 0.17–0.22), 10 mg BID: RD 0.36 (95% CI 0.31–0.42); Physician's Global Assessment 0/1: 5 mg BID: RD 0.31 (95% CI 0.27–0.35), 10 mg BID: RD 0.48 (95% CI 0.44–0.53)} and participants’ life quality [Dermatology Life Quality Index 0/1: 5 mg BID: RD 0.24 (95% CI 0.20–0.2), 10 mg BID: RD 0.36 (95% CI 0.33–0.40)]. Tofacitinib was associated with an increase in minor adverse events [upper respiratory tract infection: 5 mg BID: RD 0.02 (95% CI 0.00–0.03), 10 mg BID: RD 0.02 (95% CI 0.00–0.04); hypercholesterolaemia: 5 mg BID: RD 0.02 (95% CI 0.01–0.04), 10 mg BID: RD 0.02 (95% CI 0.01–0.04)]. In conclusion, tofacitinib may be a treatment option for moderate‐to‐severe plaque psoriasis that is unresponsive to other therapies and patients who are intolerable to other therapies or prefer oral medications. [ABSTRACT FROM AUTHOR]

In vivo reflectance confocal microscopy (RCM) is a modern, non-invasive imaging technique, which allows for real-time examination of the upper layers of the skin at a resolution similar to that of classic microscopy. In addition, it has the advantage of real-time evaluation of blood flow and dynamic monitoring of cutaneous changes while preserving tissue integrity. The present study reported on the in vivo RCM technique as an objective method for the noninvasive assessment of psoriasis vulgaris that is potentially applicable in clinical studies and in monitoring the evolution of lesions under treatment. In psoriasis lesions, RCM virtual horizontal sections at the level of the dermo-epidermal junction featured numerous and prominent dermal papillae that were not surrounded by bright rings of basal cells. Micromorphological examination of the lesions using this technique revealed that mean values of the section area, the perimeter and the Feret's diameter of the dermal papillae were significantly higher in psoriatic lesions than in normal skin. An increased number of capillary vessels per lesional dermal papilla as compared to healthy skin was observed. Furthermore, micromorphological parameters of dermal capillaries were increased in psoriatic skin. These observations point to the utility of in vivo RCM as a promising technique for the non-invasive diagnosis of psoriasis vulgaris, for monitoring the evolution of lesions at a micromorphological level under various treatments and for gaining a better understanding of the pathophysiological processes that occur in the evolution of this disease. [ABSTRACT FROM AUTHOR]

Introduction: Tumor necrosis factor (TNF)-α inhibitors are widely used for the treatment of inflammatory diseases. One of the side effects of TNF-inhibitors is the development of a psoriatiform eruption, also known as paradoxical psoriasis. In this case report, we describe a patient with this side effect after treatment with adalimumab and etanercept. Case Report: A 45-year-old female was treated with adalimumab 40 mg once every 2 weeks for pustulosis palmoplantaris and psoriatic arthritis. After 2 injections, the patient developed a psoriatiform eruption on her body, which improved after discontinuation of adalimumab but worsened after treatment with etanercept 50 mg twice weekly. Eventually, the patient was treated with topical corticosteroids and ustekinumab 45 mg once every 3 months with a complete remission of the psoriatiform eruption. Discussion: Several case reports and reviews have been published in recent years which describe patients with a psoriatiform eruption after treatment with TNF-α inhibitors. The pathogenesis that causes this psoriatic eruption is unclear. In conclusion, we describe a patient with a psoriatiform eruption after treatment with adalimumab and etanercept. This patient had to discontinue the treatment and eventually had a complete response after treatment with topical corticosteroids and treatment with ustekinumab. [ABSTRACT FROM AUTHOR]

Psoriasis is a chronic, relapsing, immune-mediated disease that can have a profound negative impact on patients' quality of life. Five different types of psoriasis have been characterised according to their clinical features. A working group sanctioned by the Dermatology Society of South Africa engaged in discussions which resulted in the development of guidelines for the diagnosis and management of psoriasis in the South African context. Healthcare professionals can use these recommended guidelines to promote a strategic evidence-based approach when treating patients with psoriasis to ensure optimal treatment outcomes. Topical agents are the mainstay of treatment in mild psoriasis, and phototherapy and systemic agents should be considered if the treatment is ineffective or the severity of the psoriasis heightened. [ABSTRACT FROM AUTHOR]

Introduction: Psoriasis is a chronic, inflammatory papulosquamous disease clinically characterized by erythematous, sharply demarcated, indurated papules and rounded plaques covered by silvery, micaceous scales. Psoriasis is characterized by hyperproliferation and abnormal differentiation of epidermal keratinocytes, infiltration of mostly T lymphocytes and various endothelial vascular changes in the dermal layer, such as angiogenesis, dilatation and high endothelial venule (HEV) formation. Material and Methods: The study was conducted on 70 patients of psoriasis attending the outpatient department. Patients who fulfilled the selection criterion were alternately assigned into two groups, 35 patients in each group. The assessment of effectiveness was done with the help of PASI. Follow up of patients were done after 1st, 2nd, 4th and 6th week of initiation of treatment. Results: We observed 70 patients and both the group showed statistically significant reduction in the disease severity. Conclusion: The calcipotriol and mometasone furoate ointment were found to be equally effective in clearance of the disease. [ABSTRACT FROM AUTHOR]

The article discusses the case of a psoriasis patient who became pregnant while undergoing treatment with ustekinumab. Topics discussed include the discontinuation of ustekinumab treatment during the patient's first pregnancy, the re-start of ustekinumab after pregnancy which resulted to the remission of psoriasis and impetigo herpetiformis, and unintended second pregnancy following the third injection of ustekinumab.

The author discusses various approved systemic treatments for psoriasis, a chronic skin condition that causes skin cells to grow quickly. Topic discussed include theoretical risk of malignancy and infection for using oral tofacitinib, association between psoriasis and cardiovascular comorbidities, and use of several medication such as ustekinumab and methotrexate in psoriasis.

The article presents the findings of a medical research study into the use of advanced glycation end products (RAGE) as a biomarker for determining the severity of Psoriasis in patients. Topics include the objective of the conducted medical study along with the methods used and the results of the medical study.

The article describes the case of a 44-year-old male patient with a history of psoriasis vulgaris and who developed generalized pustular psoriasis (GPP) which was treated with secukinumab. The patient previously took other medications such as cyclosporine, prednisolone, etanercept, anakinra and ustekinumab that exacerbated his condition. A discussion on the possibility of using secukinumab in other neutrophilic dermatosis is offered.

The article discusses the cases of patients with severe psoriasis who underwent treatment with biosimilar infliximab (Remsima). Topics discussed include the treatment of the patients via biosimilar infliximab monotherapy and in combination with methotrexate or leflunomide, remissions achieved by the patients, and the effectiveness and safety of the biosimilar.

The article discusses the development of biosimilars for the treatment for psoriasis. Topics discussed include the European Medicines Agency's (EMA) approval of CT-P13 biosimilar monoclonal antibody for psoriasis, the clinical trials of biosimilars of etanercept and adalimumab, and the role of dermatologists in the prescription of biosimilar substitutions for psoriasis.

The article discusses a research about the role of p16 protein in psoriasis and chronic spongiotic dermatisis. Topics discussed include the histopathological criteria for psoriasis, differential diagnosis of chronic spongiotic dermatitis, focal expression of p16 protein and the overexpression of p16 in psoriatic lesions as not a consistent finding and can never be used in the assessment of psoriasiform dermatitis.