Dermatology and Therapy最新文献

{"title":"Inflammatory Bowel Disease Prevalence in Patients with Hidradenitis Suppurativa Using Prospective Symptom-Based Questionnaires and Fecal Calprotectin Testing.","authors":"Niamh Kearney, Emily K Pender, Rosalind Hughes, Collette McCourt, Graham Turner, Graham Morrison, Glen Doherty, Juliette Sheridan, Donal O'Kane, Brian Kirby","doi":"10.1007/s13555-025-01438-7","DOIUrl":"10.1007/s13555-025-01438-7","url":null,"abstract":"<p><strong>Introduction: </strong>Hidradenitis suppurativa (HS) is associated with inflammatory bowel disease (IBD). Using healthcare databases, an estimated 2.1% of patients with HS have IBD. Prospective screening of patients with HS with IBD sign/symptom-based questions and fecal calprotectin (FC) has not been studied. Our aim was to evaluate the prevalence of IBD in HS and the utility of a sign/symptom-based questionnaire and FC testing.</p><p><strong>Methods: </strong>All patients with HS attending two clinics were invited to participate. Information was collected on demographics, HS severity, and IBD risk factors. Fecal samples were returned by patients for calprotectin testing (≤ 50 μg/g = negative, 50-150 μg/g = borderline, ≥ 150 μg/g = positive).</p><p><strong>Results: </strong>We recruited 150 patients including 124 women (82.7%) with a median age of 36 years and Hurley stage 2/3 disease (88.6%); 11 patients had established IBD (7.3%). Up to 44.7% of patients reported gastrointestinal symptoms. In 98 patients who returned a fecal sample for calprotectin measurement, 10 had previously diagnosed IBD (10.3%), 81 had a negative FC (82.7%), 13 had a borderline FC (13.3%) and 4 had a positive FC (4.1%). Among 4 patients with a positive result, 2 had known IBD (50%); 2 without established IBD were referred to gastroenterology and 1 had a negative endoscopy reporting an acute diarrheal illness at the time of their FC. The second patient was diagnosed with endoscopic and histologic Crohn's disease.</p><p><strong>Conclusions: </strong>We report an IBD prevalence of 8%, higher than previous studies. Routine IBD sign/symptom-based assessment is currently recommended. In our study, this would result in a referral rate of 44.7%. Among 88 FC tests in patients without established IBD, 1 patient was diagnosed with incident occult Crohn's disease. At a number needed to screen (NNS) of 88, routine evaluation of all patients with HS with FC may be justified especially prior to the use of interleukin (IL)-17 antagonists.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1901-1913"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Step Therapy on Individuals with Psoriatic Disease in the USA: Patient and Provider Perspectives.","authors":"Georgia Marquez-Grap, Dayna L Pham, Andrea Leung, Melissa C Leeolou, Allison Kranyak, Wilson Liao","doi":"10.1007/s13555-025-01430-1","DOIUrl":"10.1007/s13555-025-01430-1","url":null,"abstract":"<p><p>The management of psoriatic disease has been revolutionized by biologic medications in recent years. Despite their efficacy and safety, patients are often required by insurance plans in the USA or national formulary guidelines in other countries to try and fail other treatments first, which is a strategy called step therapy. Originally designed to contain costs of specialty drugs, step therapy has a number of negative impacts on patients and providers, both personally and clinically. This article is coauthored by a patient with psoriasis and psoriatic arthritis who navigated step therapy. She describes her early experiences with psoriasis and achieving disease control with biologic medication, only to later be diagnosed with psoriatic arthritis and need to revise this treatment plan. She then explains how insurance denials and step therapy impact her life physically, emotionally, socially, and medically. This case is then discussed from the perspective of a dermatologist specializing in inflammatory skin disease. We highlight the psychosocial burden of psoriatic disease, as well as the burden of step therapy and its impacts on patients, providers, and the entire medical system.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1599-1606"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Local Corticosteroids for Alopecia Areata: A Narrative Review.","authors":"Samantha Gregoire, Basil McIntosh, Katherine Sanchez, Ursula Biba, Arash Mostaghimi","doi":"10.1007/s13555-025-01421-2","DOIUrl":"10.1007/s13555-025-01421-2","url":null,"abstract":"<p><p>Alopecia areata (AA) is an autoimmune condition of non-scarring hair loss that affects 2% of the population worldwide. Topical and intralesional (IL) corticosteroids are the two most commonly used treatments for AA. These locally acting glucocorticoid derivatives are thought to treat AA by reducing the CD8+ T-cell-mediated immune attack on hair follicles. Topical corticosteroids are safe and well tolerated with moderate efficacy in mild AA, but recurrence is common after treatment cessation. They are recommended for children and adults with mild AA who cannot tolerate IL injections. IL steroids are more effective than topical steroids given their ability to penetrate the dermis, where the hair follicle resides. Success rates are higher than topical steroids in mild-to-moderate AA. IL steroids are safe and well tolerated; however, treatment is limited by pain during the procedure. Further research is needed on ideal treatment regimens, long-term safety, preferred candidates, and the role of combination therapy to further elucidate the role of local corticosteroids for AA in clinical practice.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1607-1631"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management and Burden of Hidradenitis Suppurativa: An Italian Hybrid Real-World Study.","authors":"Anna Balato, Marina Venturini, Massimiliano Scalvenzi, Caterina Foti, Giovanni Maifredi, Simona Serao Creazzola, Stefania Antonacci, Arianna Tonelli, Diletta Valsecchi, Donatella Vassellatti, Riccardo Cipelli, Alessandra Ori, Lucia Casoli","doi":"10.1007/s13555-025-01407-0","DOIUrl":"10.1007/s13555-025-01407-0","url":null,"abstract":"<p><strong>Introduction: </strong>Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease that severely impacts quality of life and carries a substantial economic burden.</p><p><strong>Methods: </strong>This multicenter observational study generated real-world evidence on HS in Italy, focusing on clinical profiles, management, and costs. Data were collected from 50 adults at four specialized centers, combining primary data with retrospective administrative data.</p><p><strong>Results: </strong>Patients with moderate-to-severe disease had longer diagnostic delays (median 1.8 versus 0.7 years), lower symptom control (40.7% versus 95.2%), and worse quality of life (Dermatology Life Quality Index: 11.8 versus 8.0) than those with mild disease. Furthermore, HS was associated with higher costs in moderate-to-severe cases, including greater direct (€2214 versus €873) and indirect expenses (€2435 versus €262).</p><p><strong>Conclusions: </strong>The findings highlight the social and economic burden of HS and emphasize the need for increased healthcare awareness for earlier diagnosis and better management.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1771-1785"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Persistent Psoriasis Lesions Using Calcipotriol/Betamethasone Foam Combitherapy: Real-World Evidence Case Series from France.","authors":"Marc Perrussel, Zaruhi Arakelyan","doi":"10.1007/s13555-025-01431-0","DOIUrl":"10.1007/s13555-025-01431-0","url":null,"abstract":"<p><strong>Introduction: </strong>Psoriasis is a chronic disease and prevalent among 2-3% of the global population. Several therapeutic options alongside recent biologics have allowed the decrease and control of psoriasis lesions reaching a Psoriasis Area Severity Index (PASI) clearance of PASI75 or PASI90. Despite clinical improvements in lesions and provided PASI scores by clinicians as treatment success, patients have expressed varied satisfaction and perceptions. We present a case series that provides real-world evidence of combitherapy with calcipotriol and betamethasone dipropionate (Cal/BD) foam and biologics/systemics for the treatment of persistent psoriatic lesions.</p><p><strong>Methods: </strong>A retrospective, single-center study involving 10 patients was conducted from July to December 2023. Data were retrieved before initiation of the combitherapy and at the 6-month follow-up at the Centre Hospitalier Universitaire de Rennes Pontchaillou in France. Patients included were adults (≥ 18 years old), diagnosed with moderate to severe psoriasis by a dermatologist, and treated with Cal/BD foam as well as either biologics and/or systemics medication. Psoriasis severity and the dynamics of the treatments were described using mean (m)PASI, body surface area (BSA) %, sleep disturbance, patient satisfaction, dermatology life quality index (DLQI) scores and itch observation.</p><p><strong>Results: </strong>Patients were mostly male (n = 7), had a mean age of 53.3 years and psoriasis history of 13.0 years (missing data = 2). All patients were treated by biologics/systemics with Cal/BD combitherapy, and improved mPASI after six months (p < 0.001). Most patients had a reduced BSA (60.0%) (p = 0.024) and lowered itch (70.0%). Sleep disturbance reported by four patients was improved. Most patients reported an improved DLQI (mean score from 11.8 to 0.1). Patient satisfaction was positive.</p><p><strong>Conclusions: </strong>Our insight into treatment combinations of Cal/BD foam may present an opportunity to improve standard care and patient satisfaction for hard-to-treat and persistent psoriasis lesions.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1973-1983"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Observational Study of Corticosteroid Phobia Using the TOPICOP Score among Adults and Caregivers of Children with Atopic Dermatitis in Japan.","authors":"Takeshi Nakahara, Hiroyuki Murota, Shinichi Noto, Miyuki Matsukawa, Rikiya Toda, Yasuhito Konishi, Daisaku Michikami","doi":"10.1007/s13555-025-01439-6","DOIUrl":"10.1007/s13555-025-01439-6","url":null,"abstract":"<p><strong>Introduction: </strong>Topical corticosteroid (TCS) phobia, which tends to interfere with the continuation of TCS treatment for atopic dermatitis (AD), has not been elucidated in Japan using the topical corticosteroid phobia (TOPICOP) scale. We aimed to clarify TCS phobia among patients with AD in Japan and evaluate its relationship with AD conditions.</p><p><strong>Methods: </strong>This observational study, using the database of health receipt (between October 2021 and October 2022) and online questionnaire (conducted in October 2022) data, included adult respondents with and without AD and caregivers who responded to the questionnaire about their children aged ≤ 18 years, with and without AD. The TOPICOP scores measuring TCS phobia were summarized and compared according to AD severity, consultation with a doctor, and presence of AD using an analysis of covariance (ANCOVA) model (covariates: sex and age).</p><p><strong>Results: </strong>In this study, 1507 adults with AD and 525 caregivers of children with AD were included. Among adults with AD, the mean TOPICOP score (± standard deviation) was 42.5 ± 18.9, while it was 41.7 ± 18.6 among caregivers of children with AD. Of the three TOPICOP domains (knowledge and beliefs, fears, and behaviors), the fear domain questions showed the highest percentage of agreement in both adults and caregivers of children with AD. In the ANCOVA models, the scores did not differ significantly according to AD severity, consultation with a doctor, or the presence of AD in adults and caregivers but significantly differed by sex and age (both p < 0.001) in adults.</p><p><strong>Conclusion: </strong>We obtained the latest TOPICOP scores that were independent of AD conditions in Japan. Most adults and caregivers of children with AD had TCS phobia, regardless of the AD conditions. Periodic education may be required for a wide range of patients and caregivers to ease TCS phobia and enable them to continue appropriate AD treatment.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1851-1865"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging Therapies in the Treatment of Prurigo Nodularis: Biological Therapy and Systematic Review of Literature.","authors":"Gaetano Licata, Mariachiara Arisi, Caterina Mariarosaria Giorgio, Cesare Ariasi, Cesare Tomasi, Simone Soglia, Sara Mezzana, Benedetta Galli, Grazia Linda Artelli, Mariateresa Rossi, Cecilia Catapano","doi":"10.1007/s13555-025-01437-8","DOIUrl":"10.1007/s13555-025-01437-8","url":null,"abstract":"<p><strong>Introduction: </strong>Prurigo nodularis (PN) is a chronic, intensely pruritic dermatosis characterized by hyperkeratotic nodules and a persistent itch-scratch cycle. Recent insights highlight the role of T helper type 2 cell (Th2)-driven immune dysregulation and neuroinflammation, with cytokines such as interleukin (IL)-4, IL-13, and IL-31 implicated in disease pathogenesis. PN is associated with significant morbidity and multiple comorbidities, and conventional therapies often yield suboptimal outcomes, underscoring the need for targeted treatments.</p><p><strong>Methods: </strong>A systematic review was conducted using PubMed, Scopus, and Google Scholar to identify studies published from January 2020 to March 2025 on PN pathogenesis and treatment. Search terms included combinations of \"prurigo nodularis,\" \"biologic therapy,\" \"JAK inhibitors,\" \"IL-4,\" \"IL-13,\" and \"targeted therapy.\" Of 123 articles screened, 26 were selected on the basis of inclusion criteria prioritizing biologics, JAK inhibitors, randomized controlled trials, cohort studies, and real-world evidence.</p><p><strong>Results: </strong>Advances in understanding the neuroimmune basis of PN have led to the development of novel therapies. Dupilumab, targeting IL-4Rα, demonstrated significant reductions in pruritus and lesion burden in phase III trials (PRIME/PRIME2) and is approved by the US Food and Drug Administration (FDA) and European Medicines Agency (EMA). Nemolizumab, an IL-31RA antagonist, received EMA approval in 2025 and shows rapid and sustained efficacy. Other promising agents include JAK inhibitors, vixarelimab (dual IL-31/oncostatin M (OSM) blockade), rocatinlimab (anti-OX40), and anti-IgE therapy with omalizumab. Biomarker-driven endotyping (e.g., eosinophilia, race-specific cytokine profiles) may refine patient selection.</p><p><strong>Discussion: </strong>Biologics and JAK inhibitors represent a paradigm shift in PN management, offering durable relief through immune and neurogenic modulation. Dupilumab and nemolizumab emerge as first-line therapies with favorable safety profiles, while JAK inhibitors provide rapid relief for refractory cases. The heterogeneity of PN underscores the importance of personalized treatment approaches based on immunologic profiling.</p><p><strong>Conclusion: </strong>Targeted therapies are revolutionizing PN treatment. Integrating clinical efficacy, immunologic endotyping, and real-world data will be pivotal to optimizing therapeutic strategies, enhancing outcomes, and personalizing care in prurigo nodularis.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1705-1718"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Clindamycin Phosphate 1.2%/Adapalene 0.15%/Benzoyl Peroxide 3.1% Gel: Post Hoc Analysis by Baseline Disease Severity.","authors":"Michael Gold, Ted Lain, Julie C Harper, Hilary Baldwin, Eric Guenin, Linda Stein Gold","doi":"10.1007/s13555-025-01440-z","DOIUrl":"10.1007/s13555-025-01440-z","url":null,"abstract":"<p><strong>Introduction: </strong>Clindamycin phosphate (CLIN) 1.2%/adapalene (ADAP) 0.15%/benzoyl peroxide (BPO) 3.1% gel (CAB) is the only triple-combination topical approved for acne. These post hoc analyses assessed efficacy and safety of CAB gel compared with component dyads and branded ADAP 0.3%/BPO 2.5% gel in participants stratified by baseline acne severity.</p><p><strong>Methods: </strong>Data were pooled from two phase 2 and two phase 3 12-week studies. Participants were randomized to once-daily CAB or vehicle; one phase 2 study included dyad combinations of CAB active ingredients (ADAP/BPO, CLIN/BPO, and CLIN/ADAP) and the other included a head-to-head comparison with branded ADAP 0.3%/BPO 2.5%. Assessments included percent changes from baseline in inflammatory/noninflammatory lesions (IL/NIL) and treatment success (≥ 2-grade reduction from baseline in Evaluator's Global Severity Score [EGSS] and clear/almost clear skin). Treatment-emergent adverse events (TEAEs) and cutaneous safety/tolerability were assessed.</p><p><strong>Results: </strong>At week 12, IL reductions in moderate participants (EGSS = 3; n = 1557) were significantly greater with CAB vs vehicle, dyads, and branded ADAP/BPO (77.1% vs 54.1%, 64.4-69.4%, and 72.8%, respectively; P < 0.05, all). IL reductions in severe participants (EGSS = 4; n = 230) were significantly greater with CAB vs vehicle, ADAP/BPO, and CLIN/BPO (74.5% vs 44.4%, 63.9%, and 61.3%; P < 0.05, all), and similar to CLIN/ADAP and branded ADAP/BPO (73.7%/75.4%). IL reductions were greater than NIL. Moderate participants achieved greater treatment success rates with CAB vs vehicle, dyads, or branded ADAP/BPO (53.9% vs 19.5%, 31.5-35.3%, and 38.1%; P ≤ 0.001, all); only CAB- and CLIN/ADAP-treated severe participants had significantly greater rates vs vehicle (30.9% and 34.0% vs 9.0%; P < 0.05). Most TEAEs were of mild to moderate severity. All mean cutaneous safety/tolerability scores were ≤ 1 (1 = mild).</p><p><strong>Conclusions: </strong>CAB demonstrated superior efficacy to three dyads and branded ADAP 0.3%/BPO 2.5% in moderate acne participants, and generally numerically greater efficacy in severe acne participants. To our knowledge, these analyses include data from the only double-blind, vehicle-controlled, head-to-head study.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier NCT03170388, NCT04892706, NCT04214639, and NCT04214652.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1867-1882"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Narrative Review of Pemphigoid Diseases: Bridging Associations, Comorbidities, and Management.","authors":"Emma L Myers, Donna A Culton","doi":"10.1007/s13555-025-01444-9","DOIUrl":"10.1007/s13555-025-01444-9","url":null,"abstract":"<p><p>Pemphigoid diseases are a group of rare, chronic autoimmune blistering disorders (AIBD) characterized by subepidermal blister formation due to autoantibody-mediated targeting of structural components of the basement membrane zone (BMZ). This narrative review provides an updated overview of four key subtypes: bullous pemphigoid (BP), mucous membrane pemphigoid (MMP), linear IgA bullous dermatosis (LABD), and epidermolysis bullosa acquisita (EBA) with specific emphasis on disease associations that dermatologists should be aware of for comprehensive patient care. BP, the most common subepidermal blistering disorder, is frequently associated with neurological and cardiovascular comorbidities, while MMP primarily affects mucosal surfaces, often leading to significant scarring and functional impairment and can be associated with malignancy in certain subtypes. LABD and EBA are less common but can be linked with systemic autoimmune conditions such as inflammatory bowel disease (IBD). Shared challenges across these subtypes include difficulties in diagnosis due to overlapping clinical and histopathologic features, treatment-related complications from prolonged corticosteroid use, and the substantial impact on patients' quality of life. Advances in therapeutic strategies, including biologic agents such as rituximab and dupilumab, offer promising alternatives to traditional treatments, yet access to new targeted therapies remains a significant barrier. This review emphasizes the need for large-scale studies to better understand disease associations, the identification of biomarkers for personalized therapy, improved treatment options, and the implementation of multidisciplinary care approaches.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1755-1770"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Tildrakizumab 200 mg in Moderate-to-Severe Plaque Psoriasis: A Multicenter Real-World Study Analyzing Patient Outcomes by Weight, PASI, BMI, and Previous Therapies.","authors":"Emanuele Trovato, Tommaso Bianchelli, Giulia Odorici, Aldo Cuccia, Vito Giuseppe Di Lernia, Claudia Lasagni, Marco Manfredini, Massimiliano Nicolini, Giulia Rech, Francesca Satolli, Alessandra Cartocci, Federico Bardazzi, Anna Campanati","doi":"10.1007/s13555-025-01442-x","DOIUrl":"10.1007/s13555-025-01442-x","url":null,"abstract":"<p><strong>Introduction: </strong>Psoriasis is a chronic immune-mediated disease with significant systemic implications. Tildrakizumab, an IL-23p19 inhibitor, has demonstrated efficacy in moderate-to-severe plaque psoriasis. Higher doses may be beneficial for patients with elevated body weight or greater disease burden. This study evaluates the effectiveness of tildrakizumab 200 mg in a real-world setting, analyzing outcomes based on weight, Psoriasis Area Severity Index (PASI), body mass index (BMI), and prior biologic exposure.</p><p><strong>Methods: </strong>A multicenter retrospective study was conducted across 10 Italian hospitals. Adult patients (≥ 18 years) with moderate-to-severe plaque psoriasis treated with tildrakizumab 200 mg for ≥ 36 weeks were included. Patients were stratified by weight (≥ 90 kg vs. < 90 kg), BMI (≥ 30 vs. < 30), PASI (≥ 15 vs. < 15), and biologic history (naïve vs. biologic (bio)-experienced). PASI100 response rates at 36 weeks were assessed. Statistical analyses included Fisher's exact test (p < 0.05 significant).</p><p><strong>Results: </strong>Among 137 patients, PASI100 response rates were 67.1% for patients < 90 kg vs. 49.2% for ≥ 90 kg (p = 0.04), 61.5% for PASI < 15 vs. 50% for PASI ≥ 15 (p = 0.03), and 60.8% for bio-naïve vs. 57.1% for bio-experienced (p = 0.08). BMI ≥ 30 was associated with lower PASI100 (44.2%) compared to BMI < 30 (61.4%) (p = 0.05). Despite subgroup differences, all patients exhibited clinical improvement.</p><p><strong>Conclusion: </strong>Tildrakizumab 200 mg effectively treated moderate-to-severe psoriasis across diverse patient subgroups. While higher weight and PASI were associated with slightly lower PASI100 rates, significant improvements were observed, supporting its role in difficult-to-treat patients.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"1941-1952"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}