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Psoriasis, a chronic inflammatory skin disease, affects millions of people worldwide. It imposes a significant burden on patients' quality of life and healthcare systems, creating an urgent need for optimized diagnosis, treatment, and management. In recent years, image-based artificial intelligence (AI) applications have emerged as promising tools to assist physicians by offering improved accuracy and efficiency. In this review, we provide an overview of the current landscape of image-based AI applications in psoriasis. Emphasis is placed on machine learning (ML) algorithms, a key subset of AI, which enable automated pattern recognition for various tasks. Key AI applications in psoriasis include lesion detection and segmentation, differentiation from other skin conditions, subtype identification, automated area involvement, and severity scoring, as well as personalized treatment selection and response prediction. Furthermore, we discuss two commercially available systems that utilize standardized photo documentation, automated segmentation, and semi-automated Psoriasis Area and Severity Index (PASI) calculation for patient assessment and follow-up. Despite the promise of AI in this field, many challenges remain. These include the validation of current models, integration into clinical workflows, the current lack of diversity in training-set data, and the need for standardized imaging protocols. Addressing these issues is crucial for the successful implementation of AI technologies in clinical practice. Overall, we underscore the potential of AI to revolutionize psoriasis management, highlighting both the advancements and the hurdles that need to be overcome. As technology continues to evolve, AI is expected to significantly improve the accuracy, efficiency, and personalization of psoriasis treatment. [ABSTRACT FROM AUTHOR]

Psoriasis, an inflammatory disease, is largely mediated by T-helper 17 cytokines. We have previously identified the immune system-released activating agent (Israa) as a novel gene that connects the nervous and immune systems. This research aims to investigate the role of the Israa gene in psoriasis in vivo using the imiquimod-induced psoriasis model. We established the model in C57BL/6 wildtype mice, which were then treated with 200 pg/mouse, 400 pg/mouse, or 800 pg/mouse of recombinant ISRAA compared to methotrexate. Subsequently, we also induced psoriasis in Israa-knockout mice to confirm the effect of Israa. Results consistently showed improvement in psoriasis in all groups receiving recombinant ISRAA. The 200 pg/mouse dose eliminated the disease, reduced the cutaneous release of IL-17 to one-third and TNF-α to one-sixth, increased IL-10 release to over 500 pg, completely resolved parakeratosis, decreased epidermal thickness to one-half, and reduced the expression of CD4 and neutrophil elastase in the skin (all p < 0.05). Israa-knockout mice exhibited less severe psoriasis in all scoring, biochemical, and histological parameters compared to wild-type mice (p < 0.05). This study highlights Israa as a crucial molecule in psoriasis and confirms its immunomodulatory role in inflammatory diseases. [ABSTRACT FROM AUTHOR]

Real-world data on anatomically localized psoriasis and its response to systemic therapy across different age-groups and sexes is limited. This study aimed to evaluate the severity and distribution of psoriasis over time in female and male patients receiving systemic therapies, categorized by age within the Swiss psoriasis registry (SDNTT). Patient-data was obtained over 11 years through the SDNTT. The localized Psoriasis Area and Severity Index (locPASI) of the head, trunk, upper and lower extremities was analyzed over two years following the start of systemic non-/biologic treatment. A total of 316 female and 517 male patients were analyzed. Male patients had a higher baseline locPASI for legs, trunk and arms (p < 0.001), but not for the head (p = 0.961). The locPASI for the head in younger female patients (18–40 years) had a higher score than those aged 55 + (p = 0.022) and after two years, middle aged (41–54) showed a lower score compared to younger patients (p = 0.045). Younger male patients revealed a lower score after two years of therapy in the leg- and arm-area compared to older (p = 0.018 and p = 0.048, respectively). Female patients on non-biologics had a fast initial response, converging with male patients’ scores over 24 months. Over 75% locPASI reduction was observed for female head-area (81.4%), male trunk (82.7%) and legs (76.1%). Absolute locPASI ≤ 2 was achieved 3–6 months for all locations with interleukin (IL)-17, IL-12/23 and IL-23-inhibitors, except for the legs of male patients on anti-IL-17 and female patients on anti-IL-12/23 and -IL-23. After two years, male patients did not achieve a locPASI ≤ 2 for any biologic-treatment in the legs, nor for the arms on anti-TNF-α. Significant disparities in localized PASI were observed between female and male patients. The age, sex and severity of distinct localizations should be considered to optimize treatment goals. [ABSTRACT FROM AUTHOR]

Introduction: Psoriasis and psoriatic arthritis (PsA) are interrelated autoimmune conditions sharing similar genetic and immunological pathways. PsA often develops within 10 years of psoriasis onset, though it may precede cutaneous symptoms in some patients. Effective management of these conditions requires a multidisciplinary approach to address skin, bone, joint, and vascular manifestations. Areas covered: The review summarizes the current pharmacotherapies and to provide treatment guidelines for managing cutaneous psoriasis and PsA in psoriatic disease. Expert opinion: The management for mild psoriasis and mild PsA flare-ups can be addressed with topical treatments and with NSAIDs or intra-articular glucocorticoid injections. For more persistent or severe cases, systemic treatments with oral small molecules (Methotrexate, Apremilast, Janus kinase inhibitors) or with biologics (TNF inhibitors, IL-17 inhibitors, IL-23 inhibitors, CTLA-4 Ig) are effective in managing both psoriasis and PsA. With many treatment options, providers can tailor management, which considers patient disease severity, preference, comorbidities, and other factors. Early detection and a multidisciplinary management strategy can optimize patient quality of life and improve health outcomes. [ABSTRACT FROM AUTHOR]

The aim of the research is to develop the composition of solid soaps for the treatment and prevention of exacerbation of psoriasis using a classic recipe based on vegetable oils. Materials and methods. The studied samples of solid soaps were made based on vegetable oils of domestic and foreign production using an aqueous solution of sodium hydroxide for their saponification. Citric acid (China, p. K707784), salicylic acid (China, p. Y1504007) and lactobionic acid (Poland, p. 20161118) were used as active pharmaceutical ingredients. Organoleptic (appearance, shape, color, smell) and physico-chemical (mass fraction of fatty acids, initial volume of foam, mass fraction of soda products) studies were carried out following DSTU 4537:2006 Solid toilet soap. General technical conditions. Indicators were chosen as standards for soap of the special - therapeutic brand. Results. Samples containing a combination of coconut, avocado, castor, jojoba and palm oils, as well as a combination of castor, jojoba, macadamia, mango and avocado oils were found to have insufficient foaming capacity. Most samples are not firm enough, especially those containing rosehip oil. The composition of solid soap based on palm kernel oil, coconut oil, avocado oil, castor oil, almond oil, and olive oil, among others, showed the best organoleptic properties. All the studied samples were within the normal range according to the parameters of the mass fraction of soda products and the mass fraction of fatty acids. At the same time, introducing active substances into the composition did not lead to a deterioration of the developed solid soap's normative or controlled organoleptic and physicochemical properties. Conclusions. The research conducted made it possible to obtain the optimal composition of solid soap, which can be used to prevent psoriasis exacerbation due to the introduction of pomegranate seed oil. Based on this, solid soaps were created for the treatment ofpsoriasis in the period of exacerbation, one of which includes lactobionic acid and the other - a combination of citric and salicylic acids [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]

This article discusses psoriasis with a brief overview of the various types. It considers the symptoms, aetiology and treatment options and hopes to give nurses and non-medical prescribers more confidence in recognising and treating this disease. [ABSTRACT FROM AUTHOR]

Introduction • Psoriasis which affects the skin of palm and soles is called as Palmoplantar Psoriasis. The exact cause of it is unknown. It has predominantly hyperkeratotic plaques, thick scaly skin or an overlapping of both of them. Also called as chronic disease which produces functional disability or significant disfigurement and does substantial impairment of person’s life. Topical therapy, light therapy, oral medications are part of conventional treatment which offers only a palliative effect. Besides conventional treatment patient choose Homoeopathy because it’s a gentle and safe method of treatment that would appear to have positive effects in treatment of Palmoplantar Psoriasis Summary • A 48 years old Male presented with dry, rough cracked skin with intense itching and burning on both palms and right sole. As he was tabla teacher his day to day activities were hampered. After proper case taking and Repertorization by Kentian approach, Sulphur 1M was prescribed after considering all general and particular characteristic symptoms. The repertory used was SYNTHESIS REPERTORY 8.1 from the Homoeopathic software RADAR. After 3 doses of Sulphur 1M at the gap of 2 months & at the end of 8 months, Re-epithelialisation was seen with an absence of itching and burning and no cracks in skin. This evidence based case report is an example of a successful Homoeopathic Management in cases of Palmoplantar Psoriasis with Kent’s approach as Homoeopathy does not treat the disease but the diseased individual. [ABSTRACT FROM AUTHOR]

Context • Psoriasis is a chronic, proliferative, and inflammatory skin disease related to the systemic manifestation of numerous organs. The typical lesion comprises red, scaly, sharply demarcated, indurated plaques, especially over the extensor surfaces and scalp. The degree and severity vary after some time and between people. Morphological variations are normal; both hereditary and environmental factors play important roles in etiology and pathogenesis. Psoriasis is very difficult to treat due to its chronicity. As a medical system, Homoeopathy treats both patients’ physical ailments and overall wellness. The use of highly potentized homoeopathic anti-miasmatic intercurrent medicines will be very beneficial in dealing with this. Fifty-millesimal (LM) potency was a great discovery by Dr. Samuel Hahnemann. While treating numerous chronic illnesses, he was able to quickly relieve symptoms without any aggravation by using fifty-millesimal (LM) potency. Case Report • The present case report is of 24-year-old male patient having psoriasis for one year. This case report describes the homoeopathic management of psoriasis using fifty-millesimal (LM) potency. On the basis of presenting sign and symptoms, Arsenic Album 30C was prescribed with frequent repetitions after repertorisation. During follow-ups, Arsenic Album 1LM was prescribed in to accelerate the cure. Psoriasis is a chronic condition that tends to recur. To prevent the recurrence, Psorinum 1000C was prescribed as an intercurrent anti-miasmatic medicine in a single dose during the course of treatment. Psorinum is a nosode that was chosen for therapy since it is recommended when symptoms reappear and the best selected homoeopathic medicine is not very effective. Psorinum was prescribed in this case to clear the miasmatic obstruction because the Arsenic Album was only temporarily easing the complaints. Result • The patient has exhibited improvement in their mental state and quick alleviation from physical issues after receiving multiple doses of Arsenic Album 1LM and a single dose of Psorinum 1000C, all without their symptoms getting worse. The patient’s condition was followed up on at every appointment for a considerable amount of time, and no new concerns had surfaced as of yet. Conclusion • This case report shows favourable results of homoeopathic medicine in fifty-millesimal (LM) potency. Therefore, it can be concluded that using fifty-millesimal (LM) potency of accurately selected homoeopathic medicine will shorten the cure process without the aggravation of symptoms. Further research studies are required to explore the efficacy of fifty-millesimal (LM) potency of homoeopathic medicine in treatment of chronic illnesses. [ABSTRACT FROM AUTHOR]

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]

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The use of the current available therapies for psoriasis management may sometimes be limited by reduced patients' compliance, safety issues for patients' comorbidities, primary lack of efficacy, loss of effectiveness, development of side effects. In this context, several clinical trials investigating the use of both topical and systemic therapies are ongoing, and other new drugs will be approved soon. The aim of this manuscript is to review current literature and to provide an overview of the current and future trends in psoriasis treatment. A comprehensive review of the English-language medical literature was performed using Pubmed and clinicaltrials.gov databases. Although several therapies are currently available for psoriasis' treatment, unmet needs still exist for patients with moderate and severe psoriasis and hence expanding the therapeutic armamentarium is desirable for a more personalized approach. The ongoing development of innovative therapies could provide effective and safe therapies in the future enhancing the therapeutic management of moderate-severe unresponsive psoriasis. [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]

Biological drugs have dramatically changed the approach to treating moderate‐to‐severe plaque psoriasis, achieving excellent skin clearance and safety outcomes. However, the management of difficult‐to‐treat areas (e.g., scalp, palms/soles, nails, and genitalia) still represents a challenge in psoriasis treatment. Data in the literature on difficult‐to‐treat sites are limited and, frequently, no specific analysis is performed during clinical trials. We conducted a 52‐week, retrospective study to evaluate the effectiveness of ixekizumab in 120 patients with moderate‐to‐severe plaque psoriasis of at least one difficult‐to‐treat area (scalp, palmoplantar surfaces, nails, and genitalia). Ninety‐nine patients had scalp psoriasis, 35 had involvement of the palms or soles, 27 were affected by genital psoriasis, and 22 patients reported involvement of the nails. After 1 year of treatment, 96% of patients with scalp involvement, 95.6% of patients with palmoplantar psoriasis, 95.2% of patients with genital psoriasis, and 85% of patients with nail involvement achieved a site‐specific Physician's Global Assessment of 0 or 1 (clear or almost clear). No serious adverse events were observed during the study. Our study supports the effectiveness of ixekizumab in plaque psoriasis involving difficult‐to‐treat sites. [ABSTRACT FROM AUTHOR]

Obesity and dyslipidemia are frequently observed in patients with psoriasis. This study aimed to evaluate the effects of biological therapy on body weight (BW), body mass index (BMI), appetite, and blood lipid profiles in patients with psoriasis. A total of 83 patients receiving biologic therapy (n=44) [anti-tumor necrosis factor alpha (anti-TNFα) (n=5), interleukin (IL)-12/23 inhibitor (n=13), IL-17 inhibitor (n=20), and IL-23 inhibitor (n=6)] and conventional therapy (n=39) [methotrexate (MTX) (n=25) and acitretin (n=14)] were included in the study. The patient’s baseline and current BW, BMI, waist circumference, total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), plasma triglyceride values, and Psoriasis Area and Severity Index (PASI) were retrospectively screened. Appetite was assessed with the Simplified Nutritional Appetite Questionnaire (SNAQ). The mean BW percent change values were found to increase by 2.40±2.30 kg, 2.38±4.13 kg, and 0.40±3.47 kg in patients taking anti-TNFα, IL-12/23 inhibitor, and IL-17 inhibitor agents, respectively, decrease by -0.60±0.89 kg in those receiving an IL-23 inhibitor; increase by 0.52±3.40 kg and 1.38±2.79 kg in those receiving MTX and acitretin, respectively. The triglyceride percent change rates increased with MTX (27.46±52.87 mg/dl) (p=0.029). Anti-TNFα and ixekizumab increased HDL percent change rates (21.44±20.99 mg/dl and 24.4±35.40 mg/dl, respectively) (p=0.044 and p=0.005). Although the SNAQ scores were similar in patients using conventional and biological drugs, a negative correlation was observed between the SNAQ scores and the PASI change (p=0.049, r=-0.221). In addition, an increase in BMI had a negative correlation with the PASI change (p=0.01, r=-0.282). Anti-TNFα and IL-12-23 inhibitors increased BW. While MTX increased triglyceride levels, anti-TNFα and ixekizumab increased HDL levels. In the treatment of psoriasis, the presence of obesity and blood lipid profiles should be considered in the selection of the appropriate treatment for each patient. [ABSTRACT FROM AUTHOR]

Introduction: Tildrakizumab, a humanized monoclonal antibody targeting the p19 subunit of interleukin-23 (IL-23), has shown promise in the management of moderate-to-severe plaque psoriasis, offering potential improvements in clinical outcomes and quality of life. Objectives: The study aimed to identify patient characteristics that indicate the initiation of a 200-mg dosage of tildrakizumab in a real-world setting, focusing on factors that enhance treatment efficacy and safety. Methods: This prospective study included 54 adult patients with moderate-to-severe plaque psoriasis treated with tildrakizumab 200 mg from March 2023 to March 2024 across 13 Italian Dermatology Units. Data collected included demographics, disease duration, comorbidities, and previous treatments. PASI, BSA, and DLQI scores were recorded at baseline, week 4, 16, and 28. Safety was assessed through adverse event reporting. Univariate analysis was performed to identify baseline characteristics significantly associated with achieving PASI ≤ 5 at week 16. Results: Significant reductions in PASI scores were observed at week 4 (9 ± 6.9, p 30) had higher odds (OR = 4.333, p < 0.05) of achieving PASI ≤ 5. Longer disease duration and starting with a 100 mg dose also correlated with better outcomes. The safety profile was favorable, with minimal adverse events reported. Conclusions: Tildrakizumab 200 mg is effective and safe for moderate-to-severe psoriasis, particularly in obese patients. These findings support its use as a long-term treatment option.

Abstract 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.

Background: Psoriasis is a chronic skin disease driven by immune system dysfunction and associated with increased cardiovascular risk and metabolic disorders. Risankizumab is an anti-interleukin-23 humanized monoclonal antibody approved for the treatment of moderate-to-severe plaque psoriasis.Objective: We conducted a 3-year retrospective study to evaluate the effectiveness and the safety of risankizumab in patients with moderate-to-severe psoriasis, comparing those with and without the presence of at least one cardiometabolic comorbidity (CMD).Results: Our study included 333 patients treated with risankizumab for at least one year. One hundred and sixty-two patients had at least one CMD. After one year of treatment, a reduction of at least 90% and 100% in Psoriasis Area and Severity Index (PASI) score compared with baseline (PASI90 and PASI100, respectively) was observed in 80.3% and 63% of patients with CMDs compared to 83% and 63.2% of patients without CMDs. No statistically significant differences were observed between the two cohorts of patients in terms of effectiveness and rates of adverse events. No significant safety findings were observed throughout the study period. Our study supports data from clinical trials and real-world studies, even in patients with concomitant cardiometabolic comorbidities.

AbstractPurpose Tildrakizumab is a selective inhibitor of IL-23 approved for the treatment of moderate-to-severe plaque psoriasis in two dosages. We conducted a 16-week multicenter retrospective study to compare the effectiveness and safety of tildrakizumab 200 mg versus tildrakizumab 100 mg in patients with a high disease burden or high body weight.Materials and methods Our retrospective study included 134 patients treated with tildrakizumab 200 mg and 364 patients treated with tildrakizumab 100 mg from 28 Italian Dermatology Units affected by moderate-to-severe plaque psoriasis. The patients had a body weight above 90 kg 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 16 weeks of treatment with tildrakizumab 200 mg, 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 100 mg achieved PASI90 and PASI100, respectively.Conclusions Our data suggest that tildrakizumab 200 mg has better effectiveness than tildrakizumab 100 mg in patients with a body weight ≥ 90 kg and a high disease burden.

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 65 years 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-to-treat areas.Materials and methods: We enrolled forty-nine patients aged 65 years old or more (mean age 73.1 ± 6.0), all treated with tildrakizumab for at least 28 weeks. 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 28 weeks 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 28 weeks.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.

Psoriasis is a common chronic, immune-mediated inflammatory skin disease associated with various comorbidities. Managing psoriasis is often challenging as the therapy is decided based on the area of the disease, associated comorbidities and impairment in quality of life, besides the patient's preference. Making progress in the development of new molecules that can be used topically or orally, effectively controlling the disease with minimal side effects and providing long-lasting remissions are the needs of the hour. Recent developments in understanding the complexities of the pathogenesis of psoriasis have resulted in the reinforcement of treatment modalities, leading to the evolution of various biologics and small-molecule inhibitors. In comparison with biologics, both patients and treating physicians prefer small molecules for various reasons such as avoiding injections and side effects that are associated with biologics biologics. Moreover small molecules are economical than biologics. Newer small molecules, both topical and oral, are promising additions to the therapeutic arsenal in the management of psoriasis in the future. [ABSTRACT FROM AUTHOR]

Psoriasis continues to affect a large percentage of patients worldwide and strongly appears to be a systematic disease. Efforts are being made to understand its etiology, which have led to research extended to genomic analysis with a focus on the role of pro-inflammatory cytokines, which play a major role in the pathogenesis of the disease. Plasma proteomic analysis in various diseases has provided promising results for choosing the right treatment for psoriasis, suggesting that it could play a key role in the prevention, prognosis, and treatment of the disease by individualizing treatment choices based on the proteomic profile of each patient. In this review, we focus on existing data in the bibliography on proteomic analysis in psoriasis and relevant approaches to future targeted therapies. [ABSTRACT FROM AUTHOR]

Background: Psoriasis is a chronic, recurring, and immune-mediated inflammatory skin disease. Throughout the period of the last few decades, phototherapy has become widely used in treating stable psoriatic lesions. For the treatment of psoriasis, several light/laser therapies with distinct modes of action have been developed. Cold laser therapy might be an effective therapeutic choice for localized plaque psoriasis. Objective: To assess the safety and efficacy of cold laser therapy clinically and microscopically in localized plaque psoriasis treatment. Patients and methods: 40 patients with localized mild plaque psoriasis were selected from the Dermatology and Venereology outpatient clinic-Tanta University Hospitals and enrolled in the clinical trial. They were treated by cold laser 808nm wavelength (Endolaser 422, Enraf-nonious B.V. Rotterdam, Netherlands) one session for 10 min on each plaque twice weekly separated by 2 days until clinical cure or for a maximum of 8 weeks. Evaluation was done immediately after the last session by taking the average of three blinded dermatologists of the photos, the modified Psoriasis Area and Severity Index [mPASI], dermoscopic examination, patients' satisfaction scale and histopathological and electron microscopic examination of punch biopsy specimens taken before and after the end of treatment from psoriatic lesions in four patients only. Results: There was a statistically significant clinical improvement after the end of treatment compared with before treatment as 16 patients (40%) showed excellent improvement, 8 patients (20%) showed good improvement, 9 patients (22.5%) showed mild improvement, and 7 patients (17.5%) showed poor improvement. As regard mPASI, a statistically significant decrease in mPASI was found after the end of treatment (P<0.001). Regarding dermoscopic examination, a statistically significant reduction in the percentage of patients showing dermoscopic red dots and white scales after the end of treatment (P<0.01). As regard the patients' satisfaction scale, 82.5% of patients were satisfied from the results. Histopathological and ultrastructural evaluation revealed normalization of the psoriatic microscopic changes with cold laser. Conclusion: The use of cold laser therapy for the management of localized mild plaque psoriasis is safe, tolerable, effective, and can be used as an alternative therapy for psoriasis. [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: 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 is a chronic inflammatory skin disorder, and current treatments include topical therapies, phototherapy, systemic immune modulators, and biologics, aiming to alleviate symptoms and improve quality of life. The prevalence of psoriasis varies globally, affecting around 2% of the population. However, challenges persist, such as adverse effects, treatment resistance, high costs, and variability in response among individuals Phototherapy using PUVA or UVB is another option for moderate to severe cases.The future of psoriasis treatment shows promising emerging trends. New biologic agents targeting novel pathways, such as interleukin 23 inhibitors like mirikizumab, offer enhanced efficacy. Small molecule inhibitors like RORγt inhibitors and ROCK2 inhibitors provide additional treatment options. Combination therapies, including biologics with methotrexate, may improve treatment response. Advancements in topical treatments utilizing microneedles and nanoparticle-based carriers can enhance drug delivery and improve therapeutic outcomes. Biomarkers and multi-omics technologies hold potential for personalized treatment approaches, thus aiding in diagnosis, predicting treatment response, and guiding therapeutic decisions. Collaboration among researchers, clinicians, and industry stakeholders is crucial to translating these scientific break throughs into clinical practice. By addressing current challenges and exploring these promising trends, we can optimize psoriasis management and improve the lives of those affected by this chronic condition. [ABSTRACT FROM AUTHOR]

As a humanized monoclonal antibody targeting interleukin-17A, ixekizumab is increasingly used for the treatment of psoriasis vulgaris. Here, we present a male patient who developed acneiform eruption after using ixekizumab for psoriasis vulgaris. We described acneiform eruption without comedones on the anterior and posterior trunks of a 35-year-old patient with an estimated psoriasis area and severity index score of 32 at the sixth month of treatment. We successfully treated the patient within 1 month with benzoyl peroxide/clindamycin gel and oral azithromycin. Here, acneiform eruption represents a negative event that does not cause discontinuation of ixekizumab. We felt the need to write this case report to raise awareness of the association of this dermatological side effect, which we accept as a paradoxical reaction, with ixekizumab. [ABSTRACT FROM AUTHOR]

Generalized pustular psoriasis (GPP) is a disease that presents with fever and multiple sterile pustules on flushed skin all over the body. GPP should be considered as systemic inflammatory response syndrome (SIRS), and is occasionally associated with respiratory failure. We encountered a case of GPP with organizing pneumonia (OP) during treatment for rheumatoid arthritis (RA). A 74-year-old Japanese woman with RA developed fever and erythema with small pustules on the trunk and extremities. She was diagnosed as GPP and admitted to our hospital. During the clinical course, she suffered hypoxia from OP. Although RA and OP are known to coexist, GPP and OP share the involvement of cytokines such as interleukin 8 in the pathogenesis. These cytokines are therefore also involved in the complications of GPP and OP. [ABSTRACT FROM AUTHOR]

Psoriasis is a chronic inflammatory skin condition affecting millions of individuals worldwide. Over the years, various treatment modalities have been explored to alleviate the symptoms and improve the quality of life for patients with psoriasis. Among these treatment options, lasers and lights have emerged as promising non-invasive approaches with significant efficacy. This review aims to provide an overview of the current understanding and clinical applications of lasers and lights in the management of psoriasis. We have discussed the mechanisms of action behind different laser and light therapies and their impact on psoriatic plaques. Additionally, we discuss the various types of lasers and lights utilized, including excimer lasers, pulsed dye lasers, and narrowband ultraviolet B (NB-UVB) phototherapy, highlighting their unique properties and clinical outcomes. Moreover, we have addressed important considerations related to patient selection, treatment protocols, and potential side effects associated with lasers and lights. We emphasize the need for proper evaluation, monitoring, and customization of treatment plans to ensure optimal outcomes and minimize adverse events. [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]

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]

The goal of this investigation is to improve the topical delivery of medicine by preparing and maximizing the potential of a nanotransferosome gel infused with Solanum xanthocarpum methanolic extract (SXE) to provide localized and regulated distribution. Thin-film hydration was used to create SXE-infused nanotransferosomes (SXE-NTFs), and a Box–Behnken design was used to improve them. Phospholipon 90G (X1), cholesterol (X2) and sodium cholate (X3) were chosen as the independent variables, and their effects on vesicle size (Y1), polydispersity index (PDI) (Y2) and the percentage of entrapment efficiency (EE) (Y3) were observed both individually and in combination. For the SXE-NTFs, the vesicle size was 146.3 nm, the PDI was 0.2594, the EE was 82.24 ± 2.64%, the drug-loading capacity was 8.367 ± 0.07% and the drug release rate was 78.86 ± 5.24%. Comparing the antioxidant activity to conventional ascorbic acid, it was determined to be 83.51 ± 3.27%. Ex vivo permeation tests revealed that the SXE-NTF gel (82.86 ± 2.38%) considerably outperformed the SXE gel (35.28 ± 1.62%) in terms of permeation. In addition, it seemed from the confocal laser scanning microscopy (CLSM) picture of the Wistar rat's skin that the rhodamine-B-loaded SXE-NTF gel had a higher penetration capability than the control. Dermatokinetic studies showed that the SXE-NTF gel had a better retention capability than the SXE gel. According to the experimental results, the SXE-NTF gel is a promising and successful topical delivery formulation. [ABSTRACT FROM AUTHOR]

Microneedle patches are attractive drug delivery systems that give hope for treating skin disorders. In this study, to first fabricate a chitosan-based low-cost microneedle patch (MNP) using a CO2 laser cutter for in vitro purposes was tried and then the delivery and impact of Glycyrrhiza glabra extract (GgE) on the cell population by this microneedle was evaluated. Microscopic analysis, swelling, penetration, degradation, biocompatibility, and drug delivery were carried out to assess the patch's performance. DAPI staining and acridine orange (AO) staining were performed to evaluate cell numbers. Based on the results, the MNs were conical and sharp enough (diameter: 400–500 μm, height: 700–900 μm). They showed notable swelling (2 folds) during 5 min and good degradability during 30 min, which can be considered a burst release. The MNP showed no cytotoxicity against fibroblast cell line L929. It also demonstrated good potential for GgE delivery. The results from AO and DAPI staining approved the reduction in the cell population after GgE delivery. To sum up, the fabricated MNP can be a useful recommendation for lab-scale studies. In addition, a GgE-loaded MNP can be a good remedy for skin disorders in which cell proliferation needs to be controlled. [ABSTRACT FROM AUTHOR]

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Introduction: The development of several effective biological drugs for moderate-to-severe plaque psoriasis has dramatically changed the lives of patients. Despite the wide use of interleukin (IL) inhibitors, limited data are available to date regarding long-term treatment persistence. Method: This multicenter retrospective real-world study evaluated 5932 treatment courses across 5300 patients, all treated with interleukin inhibitors. Drug survival was expressed by using the Kaplan-Meier estimator for each biological drug at 6, 12, 24, 36 and 48 months. We also stratified by discontinuation associated with primary or secondary ineffectiveness. Results: In our study, the most prescribed drugs were secukinumab (1412), ixekizumab (1183), and risankizumab (977). After four years of follow-up, risankizumab emerged as the treatment with the highest drug survival overall, as 91.6% of patients were still on treatment. The overall probability of drug survival at four years was comparable for tildrakizumab (83.5%), ixekizumab (82.6%), guselkumab (82.4%) and brodalumab (81.8%). When evaluating only patients who discontinued the treatment because of ineffectiveness, once again risankizumab was the molecule with the highest drug survival at 4 years (93.4%), this time followed by ixekizumab (87%). Our study, in which all IL inhibitors were adequately represented, confirmed a slightly better treatment persistence for IL-23 inhibitors, consistent with other real-world studies. Conclusion: Our experience showed that IL-23 inhibitors, and risankizumab in particular, had a higher probability of drug survival overall during a 4-year followup. Risankizumab and ixekizumab were less likely to be discontinued because of ineffectiveness after four years. [ABSTRACT FROM AUTHOR]

Introduction: Psoriasis is a common dermatological condition with multifactorial aetiology. Its cutaneous manifestations represent only a part of the spectrum. It is established that hypocalcaemia is associated with von Zumbusch type, although its correlation with severity is debatable. Increased mitotic activity and rapid cell turnover are implicated in psoriasis. Since uric acid is the end product of purine metabolism, it is expected to rise in psoriasis. This study was undertaken to analyse the debatable association of serum calcium and uric acid levels with the severity of psoriasis compared to other pruritic dermatoses taken as the control. To determine the association of serum calcium and uric acid levels in psoriasis and assess their correlation with severity. Material and methods: 50 psoriasis cases and 50 controls (other pruritic dermatoses) were enrolled in this cross-sectional study. Cases were classified on the basis of severity (PASI and BSA). Serum calcium and serum uric acid levels were measured, and the data were analysed. Results: The mean serum calcium level in the psoriasis group (8.87 ±1.01 mg/dl) was lower than the mean calcium level in the other pruritic dermatoses group (9.66 ±0.71 mg/dl) with a statistically significant difference (p = 0.010) i.e. hypocalcaemia was associated with psoriatic cases as compared to other pruritic dermatoses. There was no significant difference in the serum uric acid level between two groups (p = 0.280). The severity of psoriasis was positively correlated to serum uric acid levels (Pearson correlation coefficient 0.446) and negatively correlated to serum calcium (Pearson correlation coefficient -0.320). Conclusions: Hypocalcaemia and hyperuricemia are both associated with severity of psoriasis. [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]

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 is a rare variant of psoriasis. Evidence recommending generalized pustular psoriasis treatment with secukinumab is limited. This report aims to evaluate the use of secukinumab in two patients with generalized pustular psoriasis. The standard treatment regimen for secukinumab was as follows: 300mg subcutaneously once weekly in weeks 0-4, followed by 300mg every four weeks. The efficacy was evaluated by analyzing the psoriasis area and severity index (PASI) and dermatology life quality index (DLQI). One patient had generalized pustular psoriasis, which had developed from palmoplantar pustulosis over 12 years. The second patient was an adolescent with recurrent generalized pustular psoriasis. The first patient achieved PASI-75 response by week 3 and both PASI-90 and a DLQI score of 0 were observed by week 8. The second patient achieved PASI-75 response by week 4 and complete clinical resolution, except for nail changes, and a DLQI of 0 by week 8, without any adverse events. [ABSTRACT FROM AUTHOR]

Aim: investigate the possible anti-psoriatic effect of ivermectin in mice based on observational and histopathological outcomes and biomarkers. Methods: Sixty male Swiss Albino Mice were divided into six groups (Groups I-VI); each group contained ten mice with shaved dorsal skin. The clinical, pathological, and laboratory effects were measured. Results: Topical Ivermectin significantly decreased vascular endothelial growth factor levels. At the same time, the combination of ivermectin plus Clobetasol showed a more significant reduction in tumor necrosis factor-alpha (TNF-α) and Interleukin-17 (IL-17) levels. Regarding the Interleukin-10 (IL-10) level, the Ivermectin and Ivermectin/Clobetasol combination groups showed a significant increase in IL-10. Conclusion: Topical Ivermectin's anti-psoriasis activity increases IL-10 levels and could be used efficiently to alleviate psoriatic symptoms. Its combination treatment with Clobetasol holds promise for the management of psoriasis. [ABSTRACT FROM AUTHOR]

Psoriasis is a lifelong immune-driven skin condition characterized by excessive epidermal overgrowth and inflammatory cell infiltration. Gemifloxacin is a fourth-generation fluoroquinolone with improved immunomodulatory and anti-inflammatory properties that are believed to possess an attractive role in psoriasis via suppressing the production of cytokines, chemokines, and eosinophil and neutrophil chemotaxis. The aim of this research is to investigate the ameliorative effects of prolonged topical gemifloxacin (GMF) alone and combined with clobetasol propionate (CLO) on an imiquimod (IMQ)-induced mouse model of psoriasis. Forty-eight Swiss albino mice were divided into six groups of eight. All groups except the negative controls got 62.5 mg of IMQ 5% topically for 8 days. Mice in the control group (controls) got Vaseline instead. Following the induction in the IMQ 5% group, mice in treatment groups CLO 0.05, GMF 1%, GMF 3%, and CLO + GMF obtained clobetasol propionate 0.05%, GMF 1% and 3%, and a combination of both, respectively, for an additional 8 days, rendering the experiment 16 days long. Our results revealed that gemifloxacin alleviated erythematous, thickened, and scaly psoriatic lesions and inhibited the tissue level of inflammatory cytokines, including interleukin (IL)-8, IL-17A, IL-23, tumor necrosis factor-α (TNF-α), and transforming growth factor-β1 (TGF-β1). The anti-inflammatory effect also occurred by hindering nuclear factor-kappa B (NF-κB) signaling and reversing histopathological problems. Gemifloxacin acts effectively in mitigating psoriasis-associated lesions and restricting NF-κB-mediated inflammation, recommending gemifloxacin as a promising adjuvant candidate for additional studies on the long-term treatment of autoimmune and autoinflammatory dermatoses like psoriasis. [ABSTRACT FROM AUTHOR]

Background: Psoriasis often coexists with psychiatric disorders and decreased quality of life (QoL), with treatments commonly overlooking the psychological impact of the disease. Heart rate variability biofeedback (HRVB) may offer a mind-body solution by providing real-time feedback on autonomic functions, teaching individuals to manage stress via controlled breathing. Objective: To examine the impact of a 7-week HRVB protocol on skin severity (SS), QoL, and mental health (MH) in individuals with psoriasis and determine the sustainability of any outcomes post-intervention. Methods: A single-arm, proof-of-concept pre-post trial was conducted at Bastyr University Clinic in San Diego, CA. Five individuals were recruited, screened, and underwent a 7-week HRVB protocol. Assessments included SS through the Psoriasis Area and Severity Index (PASI-P and PASI-C), QoL via the Cardiff Dermatology Life Quality Index (DLQI), and MH using the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). Data collection points were baseline, post-protocol, and 1-month follow-up. Results: Notable improvements were observed between baseline and post-protocol for PASI-P, DLQI, and GAD-7. A significant change remained for GAD-7 between baseline and follow-up. No major differences were identified for PASI-C and PHQ-9 across any timeframe, and other scales remained consistent between post-protocol and follow-up. Conclusion: HRVB showed promise in enhancing perceived SS, QoL, and anxiety over 7 weeks. Further studies should expand participant numbers and diversify initial scores, comparing HRVB with a control group. Trial registration: ClinicalTrials.gov NCT05506644, retrospectively registered on 16 August 2022. [ABSTRACT FROM AUTHOR]

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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]

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Summary: Background and Objectives: This study analyzed the extent to which the recent introduction of more effective treatments has led to an improvement in real‐world psoriasis patients. Patients and Methods: Patient characteristics and the first‐year treatment effectiveness in biologic‐naive patients have been analyzed since 2004 until now, irrespective of treatment switches. Results: Data from 2,729 patients were eligible for this analysis. The proportion of female patients increased significantly over the years from 29.9% to 36.2% (p < 0.028), while the number of patients with psoriatic arthritis declined from 36.6% to 30.0% (p < 0.001). Moreover, the duration of psoriatic disease and PASI at the start of the treatment significantly decreased. Last observation carrief forward (LOCF) analysis indicated that PASI 90 response increased from 18.9 to 44.6% at 3 months and from 32.9 to 66.8% at 12 months after treatment started. Similary, the PASI ≤ 3 rates increased from 33.2% to 66.0% at 3 months and from 41.9% to 78.9% at 12 months after the treatment started. Conclusions: The continuous introduction of more efficient biologics has led to significant improvements in patient care and clinical outcomes. Though one out of three to five patients, depending on the endpoint selected, nowadays still does not achieve an entirely satisfactory treatment response (i.e., PASI 90 or PASI ≤ 3). [ABSTRACT FROM AUTHOR]