Psoriasis (Auckland, N.Z.)最新文献

{"title":"Genetic Evidence Linking Immune Cell Subsets to Psoriatic Arthritis Susceptibility: A Mendelian Randomization Study.","authors":"Huiwei Wang, Mingxuan Ma, Chenfeng Wang, Yu Zhen, Shanshan Li","doi":"10.2147/PTT.S589733","DOIUrl":"10.2147/PTT.S589733","url":null,"abstract":"<p><strong>Introduction: </strong>Psoriatic arthritis (PsA) involves intricate immune-mediated pathways that extend beyond the well-characterized IL-23/IL-17 axis. Given that many patients show inadequate responses to current therapies, identifying novel immune drivers is essential. To clarify how specific immune cell populations influence PsA susceptibility, we performed a bidirectional two-sample Mendelian randomization (MR) study.</p><p><strong>Methods: </strong>We used genetic instruments for immune traits from a GWAS of 3,757 European individuals and PsA summary data from the IEU database (5,065 cases and 21,286 controls). Applying inverse variance weighting as our principal method.</p><p><strong>Results: </strong>At a nominal significance level (<i>P</i> < 0.05), we detected 14 immune phenotypes linked to heightened risk and 12 associated with reduced risk. Among the risk-associated phenotypes, activated B cells-particularly those expressing CD25 and BAFF-R on IgD⁺CD24⁺ subsets-emerged as prominent markers, a finding that shifts focus toward humoral involvement alongside the conventional emphasis on T cells alone. We also identified pathogenic contributions from specific T cell subsets, notably CCR7⁺naïve CD4⁺T cells and CD127⁺CD45RA⁺CD4⁺T cells. Conversely, certain natural killer T cell phenotypes appeared protective, hinting at a regulatory role for these populations. Reverse MR indicated that PsA liability itself may drive changes in 23 immune phenotypes, including depletion of circulating plasmacytoid dendritic cells and alterations in myeloid compartments-patterns likely reflecting cellular migration into inflamed synovial tissue. Importantly, none of these associations survived false discovery rate correction, indicating that these findings are exploratory.</p><p><strong>Conclusion: </strong>Our findings map the genetic underpinnings of immune dysregulation in PsA and provide a hypothesis-generating resource for therapeutic strategies targeting B cell stimulation. The preliminary nature and uncertainty of these associations necessitates further investigation and validation in independent, larger cohorts alongside current cytokine-directed approaches.</p>","PeriodicalId":74589,"journal":{"name":"Psoriasis (Auckland, N.Z.)","volume":"16 ","pages":"589733"},"PeriodicalIF":5.2,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13094571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Core Differentially Expressed Genes in Psoriasis Lesions: An Integrated Analysis of Four GEO Datasets.","authors":"Mariem Ennouri, Zeliha Görmez, Emna Bahloul, Merouane Khalil Becha, Noura Bougacha Elleuch, Güldal Inal-Gültekin","doi":"10.2147/PTT.S580680","DOIUrl":"10.2147/PTT.S580680","url":null,"abstract":"<p><strong>Purpose: </strong>Psoriasis is a chronic inflammatory skin disease characterized by abnormal keratinocyte proliferation and differentiation, affecting approximately 2% of the global population.</p><p><strong>Patients and methods: </strong>This study explored the role of specific molecular biomarkers in the pathogenesis of psoriasis through integrative bioinformatics analysis, aiming to improve diagnostic precision and uncover therapeutic targets. Four independent transcriptomic datasets (GSE34248, GSE41662, GSE50790, and GSE6710) were analyzed using bioinformatics tools to identify consistently dysregulated genes in psoriatic lesions. Subsequently, we constructed a protein-protein interaction (PPI) network using the STRING database and analyzed key gene modules and hub genes involved in disease pathways.</p><p><strong>Results: </strong>This integrative approach led to the identification of 32 genes consistently dysregulated across all four datasets. Pathway enrichment highlighted significant involvement in biological processes such as keratinization (p = 1.53 × 10^-6) and cornified envelope formation (p = 1.93 × 10^-5), which are central to the epidermal alterations observed in psoriasis. Several gene families implicated in skin homeostasis and inflammatory regulation were found to contribute to psoriasis pathogenesis.</p><p><strong>Conclusion: </strong>These findings underscore the relevance of these core genes and pathways in the molecular landscape of psoriasis and offer potential targets for future functional validation and therapeutic intervention.</p>","PeriodicalId":74589,"journal":{"name":"Psoriasis (Auckland, N.Z.)","volume":"16 ","pages":"580680"},"PeriodicalIF":5.2,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13055856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of Trichoscopy and Novel Non-Invasive Imaging Techniques in the Diagnosis and Management of Patients with Scalp Psoriasis.","authors":"Aleksandra Kuchnicka, Urszula Fałkowska, Piotr Konopelski, Aleksandra Anderson, Adriana Rakowska, Marta Kurzeja, Małgorzata Olszewska, Lidia Rudnicka","doi":"10.2147/PTT.S549372","DOIUrl":"10.2147/PTT.S549372","url":null,"abstract":"<p><p>Scalp psoriasis affects up to 80% of patients with psoriasis and possesses a significant challenge as a difficult-to-treat area. A comprehensive literature search was conducted in PubMed using relevant keywords to identify recent studies focusing on scalp psoriasis diagnosis and treatment. The diagnosis is mainly based on clinical evaluation and trichoscopy. Other diagnostic tools, such as histopathology, optical coherence tomography, reflectance confocal microscopy (RCM) and line-field confocal optical coherence tomography (LC-OCT) may offer valuable insights in doubtful cases. Topical therapies (glucocorticosteroids, a betamethasone-calcipotriol combination or calcineurin inhibitors) remain the first-line therapy for mild to moderate cases. Patients with severe scalp psoriasis and those who do not respond to topical treatment are candidates for systemic therapy, including targeted therapy (interleukin-17 inhibitors, interleukin-23 inhibitors, tumor necrosis alpha inhibitors) or classic treatment (methotrexate, cyclosporine) Recent studies have demonstrated promising outcomes with novel treatments including Janus kinase (JAK) inhibitors and other new small molecules. This review provides updated information focused on diagnostic methods and targeted treatment of scalp psoriasis with relevance to clinical management of patients.</p>","PeriodicalId":74589,"journal":{"name":"Psoriasis (Auckland, N.Z.)","volume":"16 ","pages":"549372"},"PeriodicalIF":5.2,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indole-3-Lactic Acid Attenuates IMQ-Induced Psoriasiform Dermatitis in Mice via AhR-Dependent Suppression of IL-17A.","authors":"Zhen Meng, Jieru Ren, Yuhsien Lai, Siyao Lu, Huiyan Wu, Yanyun Jiang, Zhan Zhang, Guozhen Tan, Zhenrui Shi","doi":"10.2147/PTT.S585731","DOIUrl":"10.2147/PTT.S585731","url":null,"abstract":"<p><strong>Purpose: </strong>Psoriasis is a chronic immune-mediated skin disease increasingly linked to skin and gut dysbiosis. Microbiota-derived tryptophan catabolites act as endogenous ligands of the aryl hydrocarbon receptor (AhR) and modulate inflammation, but their role in psoriasis remains incompletely defined. Here, we aimed to determine whether the microbiota-derived tryptophan metabolite indole-3-lactic acid (ILA) modulates psoriasiform inflammation and to define its underlying mechanisms and therapeutic potential.</p><p><strong>Methods: </strong>Using the imiquimod (IMQ)-induced mouse model of psoriasiform dermatitis (PsD), we profiled tryptophan metabolites by targeted LC-MS/MS in feces and serum. Mice received oral or topical ILA, with or without the AhR antagonist CH-223191. Ex vivo cervical lymph node (cLN) cells were stimulated with IL-23 + IL-1β to assess IL-17A production by γδ T cells. Separate cohorts received oral <i>Lactobacillus reuteri</i> supplementation. Public transcriptomic datasets were interrogated for cell type-specific AhR expression.</p><p><strong>Results: </strong>Targeted metabolomics revealed reduced ILA levels in both feces and serum of IMQ-treated mice. Oral or topical ILA attenuated disease severity, reduced epidermal proliferation and neutrophil infiltration, and suppressed the expression of inflammatory transcripts, including Il17a. Notably, topical ILA was superior to benvitimod, a synthetic AhR agonist approved for the treatment of psoriasis, in suppressing IMQ-induced PsD. The AhR antagonist CH-223191 partially abrogated the protective effects of oral ILA. Ex vivo, ILA selectively suppressed IL-17A production by γδ T cells, and this effect was reversed by AhR antagonism. <i>Lactobacillus reuteri</i> supplementation ameliorated PsD in an AhR-dependent manner, with fecal ILA levels inversely correlating with ear thickness and cutaneous neutrophil infiltration. Analysis of public datasets showed increased AhR expression in psoriatic T cells and a positive correlation of AhR and CYP1B1 with IL17A/IL17F.</p><p><strong>Conclusion: </strong>These findings identify a microbiota-derived ILA-AhR axis that limits γδT17/IL-17-driven skin inflammation, and support metabolite supplementation or probiotic augmentation as potential therapeutic strategies for psoriasis.</p>","PeriodicalId":74589,"journal":{"name":"Psoriasis (Auckland, N.Z.)","volume":"16 ","pages":"585731"},"PeriodicalIF":5.2,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Psoriatic Disease Assessment Index (PSODAI) Score to Evaluate Systemic Involvement of Psoriasis.","authors":"Yanhua Liang, Baoqing Deng, Epipode Ntawuyamara, Hervé Bachelez, Fuxi Wang, Hao Zhang, Zhenying Zhang, Zhengfeng Li, Lin Dang, Yajie Wang, Xianbiao Zou, Li Wang, Dejian Duan, Hongxiang Chen, Wenjun Zheng, Hui Huang, Min Zhang, Qingxian Cai, Ye Chen, Yingli Zhang, Zeyuan Lu, Yalin Ren, Jinxian Huang","doi":"10.2147/PTT.S548700","DOIUrl":"10.2147/PTT.S548700","url":null,"abstract":"<p><strong>Background: </strong>To the best of our knowledge, no validated scoring instrument currently exists that comprehensively evaluates both cutaneous manifestations and systemic comorbidities of psoriasis. This multicenter study aimed to develop and validate a novel multidimensional scoring system addressing this clinical gap.</p><p><strong>Methods: </strong>Under the guidance of the Shenzhen Psoriasis Academy, we conducted seven expert meetings to analyze existing evidence from PubMed, Wanfang, and CNKI databases. Through iterative Delphi consensus processes involving 26 specialists across 10 disciplines, we established the Psoriasis Disease Assessment Index (PSODAI). This 60-point composite instrument evaluates cutaneous involvement and nine key organ/system comorbidities. An accompanying online calculator (http://www.psodai.com.cn/) was developed for clinical implementation. Validation involved 254 psoriasis patients from six tertiary centers, with comparative analyses against PASI and DLQI metrics.</p><p><strong>Results: </strong>The PSODAI framework stratifies disease severity as mild (0-20), moderate (21-40), and severe (41-60). Comparative analysis revealed comparable proportions of moderate-to-severe cases between PSODAI and conventional tools (PASI/DLQI) (p>0.05). Notably, 11 patients (4.3%) classified as severe by PASI were re-categorized as mild through PSODAI's systemic evaluation, primarily due to limited extracutaneous manifestations.</p><p><strong>Conclusion: </strong>As the first comorbidity-integrated assessment tool, PSODAI enables cross-specialty collaboration for holistic patient management. Its clinical adoption may facilitate timely comorbidity detection and preventive interventions. Further multicenter validation is warranted to confirm these preliminary findings.</p>","PeriodicalId":74589,"journal":{"name":"Psoriasis (Auckland, N.Z.)","volume":"16 ","pages":"548700"},"PeriodicalIF":5.2,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistence and Long-Term Disease Control of Interleukin-17 Inhibitors and Interleukin-23 Inhibitors in Patients with Psoriasis: A Nationwide Cohort Study in Japan.","authors":"Youran Xu, Tong Li, Chia-Ling Chang, Yongjing Zhang, Junya Masuda, Grace Hui-Min Wu, Bryan Wahking, Shinichi Imafuku, Hong Qiu","doi":"10.2147/PTT.S565823","DOIUrl":"10.2147/PTT.S565823","url":null,"abstract":"<p><strong>Introduction: </strong>Interleukin-17 inhibitors (IL-17i) and interleukin-23 inhibitors (IL-23i) are advanced therapeutic options for moderate-to-severe psoriasis. In real-world settings, biologic persistence is commonly used as a proxy for effectiveness and safety, and a treatment-free status following biologic discontinuation may provide insights into disease remission. This study aimed to assess persistence and treatment-free status for IL-17i versus IL-23i among biologic-naïve patients with psoriasis in Japan.</p><p><strong>Patients and methods: </strong>This retrospective cohort study analyzed data from the Japanese Medical Data Vision database from 01 January 2015 to 31 December 2022. Patients diagnosed with psoriasis who initiated IL-17i or IL-23i during this study period were included. Persistence of the index biologic and post-discontinuation treatment-free status were assessed using Kaplan-Meier methodology. Propensity score methods with inverse probability of treatment weighting and matching were employed to control potential confounding between treatment cohorts.</p><p><strong>Results: </strong>There were 1,751 and 1,721 patients included in the IL-17i cohort and IL-23i cohort, respectively. Persistence rates for IL-17i were 55.7% [95% CI 53.2-58.1%] at the first year and 21.5% [95% CI 18.9-24.2%] at the fourth year, versus 77.7% [95% CI 75.4-79.8%] and 47.8% [95% CI 42.2-53.2%], respectively, for IL-23i. The risk of discontinuation of IL-23i was half that of IL-17i (adjusted hazard ratio [aHR]=0.49 [95% CI 0.44-0.54]). After discontinuation, 19.2% [95% CI 16.1-22.4%] and 31.5% [95% CI 27.8-41.2%] of patients in the IL-17i and IL-23i cohorts, respectively, remained treatment-free for at least 1 year. Patients treated with IL-23i had a lower risk for resuming systemic therapy after biologic discontinuation (aHR=0.57 [95% CI 0.49-0.67]).</p><p><strong>Conclusion: </strong>IL-23i was associated with longer persistence and a longer post-discontinuation treatment-free period than IL-17i in patients with psoriasis. These findings may provide actionable insights for healthcare providers and patients as they develop treatment strategies. Future research integrating comprehensive clinical data is warranted to evaluate different treatment strategies, thereby informing clinical decision-making.</p>","PeriodicalId":74589,"journal":{"name":"Psoriasis (Auckland, N.Z.)","volume":"16 ","pages":"565823"},"PeriodicalIF":5.2,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12911970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Genital Psoriasis and Its Impact on Patients' Sexual Life in Routine Care: Epidemiologic Survey in Germany.","authors":"Toni Maria Janke, Christina Sorbe, Rachel Sommer, Thomas Bickert, Ulrich Mrowietz, Susana Gomis-Kleindienst, Marius Schild, Kristina Lohmann, Matthias Augustin","doi":"10.2147/PTT.S516803","DOIUrl":"10.2147/PTT.S516803","url":null,"abstract":"<p><strong>Purpose: </strong>Psoriatic disease (PsO) involving the genital region (GenPsO) or areas of sexual interest (ASI; anal region, gluteal area, groin, lower back, and chest/breast) is associated with impaired quality of life (QoL), sexual burden, and avoidance of sexual life. This nested cohort study investigated the prevalence and effect of GenPsO and PsO at any ASI in routine German care.</p><p><strong>Methods: </strong>Adult patients enrolled in the PsoBest registry were surveyed by mail. Main endpoints were prevalences of GenPsO and PsO at any ASI in the past 12 and 24 months. The reasons for sexual impairment (RSI) questionnaire, the Genital Psoriasis Symptoms Scale (GPSS), the Genital Psoriasis Sexual Impact Scale, demographics, and disease characteristics were assessed.</p><p><strong>Results: </strong>Questionnaires were returned by 811/2010 (40.3%) patients; 795 (39.6%) complete sets were analyzed. Mean (SD) age at onset was 35.0 (14.0) years for GenPsO, and 34.1 (14.9) years for PsO at any ASI. Period prevalence was 21.6% (n=172) for GenPsO and 49.2% (n=391), for PsO at any ASI in the last 24 months, and 10.8% (n=86) and 26.7% (n=212), respectively, at day of survey. Systemic therapy was used by 84.9% (n=73) of patients with GenPsO and 83.0% (n=176) with PsO at any ASI. Mean (SD) GPSS sum score was 27.6 (18.6). In the past 30 days, 60.5% (n=52) of patients with GenPsO and 35.4% (n=75) with PsO at any ASI experienced sexual impairment. Among patients with GenPsO, 40.7% (n=35) reported always avoiding sexual activities during the past week. RSI included stress, lack of self-confidence, and PsO-related pain/movement restrictions.</p><p><strong>Conclusion: </strong>Given the high prevalence of GenPsO and its extensive effect on patient QoL and sexual well-being, it is essential that genital and ASI regions are examined at each routine clinical appointment and that appropriate treatment is offered to minimize negative consequences and cumulative life course impairment.</p>","PeriodicalId":74589,"journal":{"name":"Psoriasis (Auckland, N.Z.)","volume":"16 ","pages":"516803"},"PeriodicalIF":5.2,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13005197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bidirectional Associations Between Substance Abuse and Psoriasis: A Prospective Cohort Study.","authors":"Xuanlin Che, Jiatong Zhou, Anqi Wang, Jia Guo, Chengcheng Zhang, Yi Xiao","doi":"10.2147/PTT.S557781","DOIUrl":"10.2147/PTT.S557781","url":null,"abstract":"<p><strong>Background: </strong>Psoriasis and substance abuse remains a serious healthcare burden. However, associations between substance abuse and psoriasis have not been elucidated.</p><p><strong>Objective: </strong>To evaluate the bidirectional associations between substance abuse and psoriasis.</p><p><strong>Methods and subjects: </strong>Based on the UK Biobank data, we conducted two prospective cohort studies to compare the risk of incident psoriasis in participants with versus without substance abuse (Cohort 1) and the risk of incident substance abuse in participants with versus without psoriasis (Cohort 2). Incident substance abuse (ICD: F10-F19) and psoriasis (ICD: L40) were primarily determined from hospital and primary care data, death registries and self-assessments.</p><p><strong>Results: </strong>In Cohort 1, 4,097 of 454,245 developed psoriasis during follow-up. Baseline substance abuse was linked to an increased psoriasis risk (hazard ratio [HR]: 2.31, P<0.001), notably in alcohol and tobacco users (HRs: 2.29 and 2.33, <i>P</i><0.001). Those with high genetic risk and substance abuse had the greatest psoriasis risk (HR: 5.19, <i>P</i><0.001). In Cohort 2, 25,176 out of 451,547 were diagnosed with substance abuse during follow-up. A notable association between baseline psoriasis and subsequent substance abuse (HR: 1.28, <i>P</i><0.001) was observed, slightly mediated by depression, anxiety, and sleep quality (1.7% to 3.4%; all <i>P</i><0.001). Sensitivity analyses showed consistent results.</p><p><strong>Conclusion: </strong>Our findings identify bidirectional positive associations of substance abuse with psoriasis. This association is especially pronounced in those with both high genetic risk and alcohol or tobacco abuse. It is suggested that clinicians should consider alcohol or tobacco abuse among psoriasis patients to improve their life quality.</p>","PeriodicalId":74589,"journal":{"name":"Psoriasis (Auckland, N.Z.)","volume":"16 ","pages":"557781"},"PeriodicalIF":5.2,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12790952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Treatment of Two Rare Pediatric Keratinization Disorders with Secukinumab: Epidermolytic Ichthyosis and PRP-GPP Overlap.","authors":"Qianyue Xu, Jia Zhang","doi":"10.2147/PTT.S553794","DOIUrl":"10.2147/PTT.S553794","url":null,"abstract":"<p><p>Pediatric erythroderma can arise from either inherited keratin defects or cytokine-driven inflammation, yet evidence for biologic therapies in these settings is limited. We report two rare pediatric cases successfully treated with secukinumab, an IL17A-targeted monoclonal antibody: (i) a 2-year-old boy with genetically confirmed epidermolytic ichthyosis (EI, KRT10 mutation:c.467G>A, p.Arg156His) refractory to conventional care, who achieved >60% improvement in erythema and scaling one week after a single off-label 150 mg subcutaneous secukinumab dose, with remission maintained for 12 months on monthly dosing; and (ii) an 11-year-old girl with coexistent Type III (juvenile) pityriasis rubra pilaris and acute generalized pustular psoriasis (PRP-GPP overlap) unresponsive to acitretin and methotrexate, who attained complete remission for 12 months following standard secukinumab induction (300mg weekly ×5) and maintenance every four weeks. These cases extend the potential utility of IL17A blockade beyond psoriasis vulgaris to both structural keratinopathies and inflammatory pustular dermatoses in children. While limited by the nature of a two-patient case series, these findings warrant prospective studies to clarify optimal dosing and long-term safety of IL-17A blockade in pediatric dermatology.</p>","PeriodicalId":74589,"journal":{"name":"Psoriasis (Auckland, N.Z.)","volume":"16 ","pages":"553794"},"PeriodicalIF":5.2,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13047699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Experience of Guselkumab in the Elderly Population.","authors":"Zeno Fratton, Stefano Bighetti, Luca Bettolini, Vincenzo Maione, Mariateresa Rossi, Marina Venturini, Vanessa Mazzoletti, Enrico Zelin, Giuseppe Stinco, Enzo Errichetti","doi":"10.2147/PTT.S549502","DOIUrl":"10.2147/PTT.S549502","url":null,"abstract":"<p><strong>Introduction: </strong>Psoriasis is a chronic inflammatory disease whose burden peaks in older age groups. Despite the increasing prevalence of elderly patients with moderate-to-severe psoriasis, real-world data on biologics in this population remain limited, particularly for anti-IL-23 agents like guselkumab. This study evaluates the long-term effectiveness and safety of guselkumab in patients aged ≥65 years.</p><p><strong>Methods: </strong>This retrospective study included 66 patients aged ≥65 years with plaque psoriasis treated with guselkumab 100 mg between June 2019 and June 2024. PASI scores were recorded at baseline and during follow-up visits at weeks 4, 16, 24, 36, 52, 76, and 104. Effectiveness was assessed using PASI75/90/100 and PASI ≤ 2 responses. Multivariable logistic regression with Firth correction identified baseline predictors of PASI90 and PASI100 at weeks 16 and 52. Safety outcomes included treatment-emergent adverse events (TEAEs).</p><p><strong>Results: </strong>Mean PASI improved from 13.3 at baseline to 1.0 at week 24 and remained stable through week 104. PASI90 and PASI100 were achieved by 83.9% and 71.0% at week 36 and maintained in 69.2% and 61.5% at week 104. Higher baseline PASI independently predicted PASI90 and PASI100 at week 16, while lower eosinophil-to-lymphocyte ratio (ELR) independently predicted PASI100. At week 52, chronic beta-blocker intake and PASI90 at week 16 predicted PASI90 response, while PASI100 was independently associated with low-dose aspirin use and positive family history of psoriasis. TEAEs occurred in 16.7% of patients, with treatment discontinued in 9.1%. Eczematous or urticarial AEs were associated with elevated baseline eosinophils and ELR.</p><p><strong>Conclusion: </strong>Guselkumab is effective and well tolerated in older adults with psoriasis. Baseline ELR, early PASI response, and chronic use of beta-blockers or aspirin may influence long-term treatment outcomes. While limited by the small sample size (66 patients), our findings represent the longest real-world follow-up to date among older psoriatic patients treated with guselkumab and support its use as a valuable therapeutic option in this population.</p>","PeriodicalId":74589,"journal":{"name":"Psoriasis (Auckland, N.Z.)","volume":"15 ","pages":"581-601"},"PeriodicalIF":5.2,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12753844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}