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Background: Psoriasis is a prevalent, chronic skin disease with a potential impact on work productivity, medical consumption costs, and quality of life. The influence of the extent of skin lesions on these outcomes is not well known. Objective: We determined associations of self-reported skin lesions with self-reported work productivity, medical consumption costs, and health-related quality of life in respondents with psoriasis. Methods: In this cross-sectional study, we included respondents with self-reported psoriasis in the Netherlands in an online questionnaire. We assessed the self-reported percentage body surface area (BSA) of psoriasis lesions. We used validated instruments to assess work productivity (WPAI-PsO), medical consumption costs (iMCQ), and health-related quality of life (EQ-5D-5L and the DLQI). We used ordinal logistic regression to associate BSA categories >1% versus 0-1% with outcomes adjusted for multiple confounders. Results: We included 501 respondents with a mean age of 43±12years; 64% were men. Median BSA was 2% (interquartile range 1–5%). A higher BSA was associated with higher overall work impairment due to psoriasis (common odds ratio [cOR] 2.44, 95% confidence interval [CI] 1.40–4.29; n=205), higher medical consumption costs (cOR 2.06, 95% CI 1.45–2.94) and lower health-related quality of life. Associations were strongest with a BSA cutoff of 0% or 1% compared to 2% or higher categories. Discussion: In our study, having few to no lesions in psoriasis was associated with lower overall work impairment due to psoriasis, lower medical consumption costs, and higher health-related quality of life. [ABSTRACT FROM AUTHOR]

Background/Objectives: Itch is one of the hallmarks of atopic dermatitis (AD), which has a significant impact on the quality of life of pediatric patients with AD and their caregivers. We aimed to conduct a systematic review and meta‐analysis to evaluate the antipruritic effects of systemic AD treatments in pediatric patients with AD. Methods: PubMed, EMBASE, Cochrane, and Web of Science databases were searched, including studies providing original data on the effects of systemic treatment on pruritus in pediatric patients (<18 years) with AD. Placebo‐controlled trials reporting a Peak Pruritus Numerical Rating Scale 4 (PP‐NRS4) response were included in a meta‐analysis. Results: A total of 30 studies were included, with most evidence available for dupilumab. Overall, marked improvements of pruritus (50% or greater reduction in pruritus outcome measurements) were found for treatment with cyclosporin A (2–16 years), dupilumab (6 months–17 years), abrocitinib, and upadacitinib (both 12 and 17 years). Nemolizumab (12–17 years) may be promising in reducing pruritus in pediatric patients; however, data are limited. Only five randomized controlled trials could be included in our meta‐analysis, in which dupilumab, abrocitinib, and upadacitinib showed a significantly higher probability of achieving a PP‐NRS4 response compared with placebo. Our study was limited by a lack of homogeneity of included studies. Conclusions: Cyclosporin A, dupilumab, abrocitinib, and upadacitinib are all effective in decreasing pruritus and, therefore, in improving the quality of life in children with AD. As more systemic treatments for AD become available, it will be imperative to incorporate patient‐oriented treatment goals such as reduction of pruritus into therapeutic decision‐making. [ABSTRACT FROM AUTHOR]

This article provides an update to the 2017 European Dermatology Forum Guidelines on scleroderma, focusing on the diagnosis and treatment of sclerosing skin diseases. The consensus addresses characteristic clinical and histopathological features, diagnostic scores, and serum autoantibodies for differential diagnosis. Part 1 of the consensus covers localized scleroderma and systemic sclerosis, while Part 2 covers scleromyxoedema and scleroedema. The article emphasizes the importance of timely diagnosis and accurate treatment to prevent irreversible damage. Collaboration with other specialists may be necessary depending on the subtype of sclerosing disease. The authors provide clear recommendations and a helpful flow chart for treating physicians. The article also highlights the need for more randomized controlled trials to identify optimal treatment regimens. There is some promising evidence for the efficacy of certain tyrosine kinase inhibitors in immune-mediated sclerosing skin diseases. The author declares no conflict of interest. [Extracted from the article]

The evidence on treating older patients with psoriasis with modern biologics is scarce. This study compared the efficacy and safety of tildrakizumab among younger and older patients with psoriasis (<65/≥65 years) in a post hoc analysis of 2 phase III trials (reSURFACE1/2, n=1,862). Tildrakizumab 100 mg/200 mg was administered at weeks 0/4/every 12 weeks thereafter. At week 28, patients with ≥75% improvement in baseline Psoriasis Area and Severity Index (PASI75) in reSURFACE1 were re-randomized to the same tildrakizumab dose or placebo; in reSURFACE2, PASI75 responders to 200 mg were re-randomized to tildrakizumab 100 mg or 200 mg; PASI75 responders to 100 mg maintained their dose. At weeks 64/52 (reSURFACE1/2), PASI50 responders entered an extension period (weeks 256/244). Outcomes were proportion of patients with PASI<3, Dermatology Life Quality Index (DLQI) 0/1, comorbidities, comedication, and side-effects. The proportion of patients with a PASI<3 was similar and maintained (tildrakizumab 100 mg and 200 mg, week 244: 83.3% and 84.1%/92.3% and 100.0%); DLQI 0/1 proportions at week 52 were 66.8% and 72.0%/68.3% and 81.3%. Comorbidity and comedication were more common in older patients. The safety profile of tildrakizumab appeared favourable in both groups. Tildrakizumab in patients ≥65 years appears effective and safe in longterm psoriasis management. These findings might assist treatment selection and overcome treatment reluctance. [ABSTRACT FROM AUTHOR]

Patients with psoriasis are at risk of developing psoriatic arthritis, which can lead to joint damage. While screening questionnaires have been developed, their performance varies. The objective of this study was to develop a referral tool for dermatologists to identify psoriasis patients with concomitant psoriatic arthritis for rheumatological referral. This study used data from the DAPPER study, in which psoriasis patients were screened by a rheumatologist for the presence of concomitant psoriatic arthritis. Multivariable regression analysis was used to identify predictive variables for the presence of concomitant psoriatic arthritis: treatment history with conventional systemic drugs (odds ratio (OR) 2.97, 95% confidence interval (95% CI) 1.01–8.74, p=0.04), treatment history with biologicals/small molecule inhibitors (OR 2.90, 95% CI 1.52– 5.53, p=0.01), patient-reported history of joint pain not caused by trauma (OR 4.23, 95% CI 1.21–14.79, p=0.01), patient-reported history of swollen joints (OR 4.25, 95% CI 2.17–8.32, p<0.001), and patientreported history of sausage-like swollen digits (OR 2.38, 95% CI 1.25–4.55, p=0.01). Based on these variables, a referral tool was created with an area under the curve of 0.82. This referral tool could be used to aid dermatologists to identify psoriasis patients with concomitant psoriatic arthritis, who may benefit from rheumatological referral. [ABSTRACT FROM AUTHOR]

Treatment needs of young psoriasis patients and parents are not widely studied and could advance patient-centered care. To explore treatment goals and preferences of pediatric psoriasis patients, young adults, and parents. A web-based survey among Dutch psoriasis patients aged ≥6 to ≤30 years and parents included multiple-choice, open-ended, and 4-point Likert scale questions. Treatment goals and characteristic preferences of pediatric patients (≤17 years) were compared to young adults (≥18 years) and parents. 195 young patients (20.2 ± 6.3 years) and 45 parents were included. The most important treatment goals were 'preventing lesions', 'reducing lesions', 'no itch', and 'no lesions'. Regarding treatment characteristics, 'long-term safety', 'high effectiveness', and 'short-term safety' were most important. We found differences by age, gender, and current treatment. Pediatric patients rated 'not sticky', 'quick results', and 'no/few blood samples needed' higher than parents and/or young adults. Young adults rated 'feeling more confident' and 'better quality of sleep' higher than pediatric patients. Parents considered safety most important. Psychosocial goals were more important for women and patients on biologics. Young psoriasis patients and parents mainly strive to clear lesions and itch with effective and safe treatment. However, revealed differences underline the relevance of addressing individual needs. [ABSTRACT FROM AUTHOR]