OBJECTIVES: Upadacitinib, a selective JAK1 inhibitor, is approved for the treatment of atopic dermatitis but is increasingly used off-label in dermatology. This study aimed to summarize the existing evidence on such off-...OBJECTIVES: Upadacitinib, a selective JAK1 inhibitor, is approved for the treatment of atopic dermatitis but is increasingly used off-label in dermatology. This study aimed to summarize the existing evidence on such off-label use to clarify its potential value and safety in dermatological practice. METHODS: We identified 113 papers ( = 638) on the off-label use of upadacitinib for dermatological conditions PubMed. RESULTS: Our findings indicate that upadacitinib demonstrated potential efficacy in alopecia areata, vitiligo, lupus erythematosus, and other dermatoses. The most common upadacitinib dose is 15 mg/day. Common adverse events included elevated creatine kinase levels, infections, and acne. CONCLUSIONS: While preliminary data show promising results, the evidence is limited to case reports and case series. Future randomized trials are needed to validate efficacy and safety.
OBJECTIVES: To evaluate the efficacy of Dupilumab in treating Netherton Syndrome (SPINK5-sEDD). METHODS: We present a girl with SPINK5-sEDD who failed topical therapy. Treatment with Dupilumab 300mg every 4 weeks was ini...OBJECTIVES: To evaluate the efficacy of Dupilumab in treating Netherton Syndrome (SPINK5-sEDD). METHODS: We present a girl with SPINK5-sEDD who failed topical therapy. Treatment with Dupilumab 300mg every 4 weeks was initiated. RESULTS: Expeditious response to Dupilumab was demonstrated in terms of eczema, itch and hair condition, as evidenced by improvement in the Scoring of Atopic Dermatitis (SCORAD), the Eczema Area and Severity Index (EASI) and the Children's Dermatology Life Quality Index (CDLQI) by more than 40%. However, she continued to experience significant recurrent flares of ichthyosis linearis circumflexa (ILC). CONCLUSIONS: Our case illustrates promising response to dupilumab in terms of eczema and hair growth, as well as a significant drop in serum IgE level, but ichthyosis linearis circumflexa persists.
BACKGROUND: Periorbital hyperpigmentation (POH) is a common benign condition affecting facial esthetics. This study evaluated the efficacy and safety of an injectable sodium hyaluronate complex solution combined with vit...BACKGROUND: Periorbital hyperpigmentation (POH) is a common benign condition affecting facial esthetics. This study evaluated the efficacy and safety of an injectable sodium hyaluronate complex solution combined with vitamin C, tranexamic acid, and glutathione for POH treatment. METHOD: 120 POH patients were randomly divided into two groups. All participants received two treatment injections at two-week intervals. Evaluations were conducted at 4 and 12 weeks posttreatment, assessing periorbital grayscale values, clinical grading changes, Global Esthetic Improvement Score, Dermatologic Quality of Life Index (DLQI), and patient satisfaction. RESULT: The treatment group demonstrated significant improvements in grayscale values (162.10 ± 14.22 to 169.66 ± 13.43) and reduced pigmentation differences from normal skin (23.01 ± 12.73 to 14.44 ± 14.79). The control group showed no significant changes. Treatment group patients exhibited significantly better grayscale values ( < .05), improved DLQI scores, and reduced dark circle severity ( < .05). 96.7% of treated patients reported satisfaction with visible esthetic improvements. CONCLUSION: The hyaluronate-based combination therapy effectively improved POH, demonstrating significant esthetic enhancement and quality of life improvement. This minimally invasive approach proved safe, effective, and highly satisfactory, presenting a promising treatment option for periorbital hyperpigmentation. EVIDENCE LEVEL: Level II.
PURPOSE: Atopic dermatitis (AD) is a common, heterogeneous inflammatory skin disease characterized by chronic or relapsing eczematous lesions and intense pruritus, leading to reduced quality of life and increased mental...PURPOSE: Atopic dermatitis (AD) is a common, heterogeneous inflammatory skin disease characterized by chronic or relapsing eczematous lesions and intense pruritus, leading to reduced quality of life and increased mental health burden. Despite recent therapeutic advances, moderate-to-severe AD remains challenging to manage, and conventional treatments often have limited long-term efficacy and safety concerns. Interleukin-31 (IL-31) is a key mediator in AD pathogenesis, driving pruritus, barrier dysfunction, type 2 inflammation, and fibrosis. Nemolizumab, a humanized monoclonal antibody targeting the IL-31 receptor α-chain (IL-31RA), has emerged as a novel therapeutic option. MATERIALS AND METHODS: This narrative review discusses current understanding of the role of IL-31 in AD pathophysiology. It also summarizes the most recent and relevant clinical trial data on the efficacy and safety of nemolizumab. RESULTS: Multiple phase II and III randomized clinical trials have demonstrated nemolizumab efficacy in patients with moderate-to-severe AD, with significant and sustained reductions in pruritus and overall disease severity. Furthermore, nemolizumab has shown a favorable safety profile, with most adverse events reported as mild and non-serious. CONCLUSIONS: IL-31 plays a critical role in the pathogenesis of atopic dermatitis. Findings from clinical trials support the efficacy and safety of nemolizumab in the treatment of moderate-to-severe AD.
UNLABELLED: Onychomycosis is a prevalent fungal infection of the nail unit that disproportionately affects individuals with diabetes, often presenting with increased severity and a higher risk of complications such as im...UNLABELLED: Onychomycosis is a prevalent fungal infection of the nail unit that disproportionately affects individuals with diabetes, often presenting with increased severity and a higher risk of complications such as impaired mobility, secondary bacterial infection, and ulceration. OBJECTIVES: This review examines the pathophysiological relationship between diabetes and onychomycosis, appraises the safety and efficacy profiles of current antifungal therapies, and outlines key considerations in selecting appropriate treatment regimens. It addresses pharmacokinetics, hepatic and renal considerations, and drug-drug interactions, while emphasizing the emerging role of topical therapies and the importance of a patient-centered approach. RESULTS: Early and accurate diagnosis utilizing mycological and molecular techniques such as fungal culture, histopathology, and polymerase chain reaction is essential to guide effective management in this high-risk population and mitigate adverse outcomes. Timely intervention is critical to reduce morbidity and prevent long-term complications. Topical and oral antifungals should be considered for mild to moderate and moderate to severe onychomycosis, respectively. The use of oral agents can be complicated by comorbidities and polypharmacy which heighten the risk of contraindications and drug-drug interactions. Therapeutic success in this population relies not only on appropriate drug selection but also on antifungal stewardship and patient adherence to prescribed regimens. CONCLUSIONS: In view of the expanding aging population and increasing comorbidity burden, physicians should remain cognizant about diagnosing and treating onychomycosis in diabetic patients. An interdisciplinary approach to management is advisable.
BACKGROUND: Janus kinase (JAK) inhibitors, such as abrocitinib, are emerging alternatives to glucocorticoids for treating progressive non-segmental vitiligo (NSV), though long-term data remain limited. OBJECTIVE: To asse...BACKGROUND: Janus kinase (JAK) inhibitors, such as abrocitinib, are emerging alternatives to glucocorticoids for treating progressive non-segmental vitiligo (NSV), though long-term data remain limited. OBJECTIVE: To assess 52-week efficacy and safety of oral abrocitinib with narrow-band ultraviolet B (NB-UVB) phototherapy in progressive NSV. METHODS: Eleven patients with progressive NSV, resistant to systemic glucocorticoids treatment, received abrocitinib (100 mg/day) for 16 weeks, followed by 100 mg every other day for 36 additional weeks. NB-UVB phototherapy was performed twice weekly. Response was assessed using the Total Vitiligo Area Severity Index (T-VASI) and Facial Vitiligo Area Severity Index (F-VASI). Serum biomarkers and adverse events (AEs) were monitored. RESULTS: Median improvement increased from 29.2% (IQR 8.8%-38.6%) at week 24 to 39.6% (IQR 27.7%-47.8%) at week 52 ( = 0.043). By week 24, 54.5% achieved T-VASI25, improving to 72.7% by week 52. Non-responders at week 24 showed no further improvement at week 52. Serum CCL20 decreased at weeks 24 and 52 = 0.0003), while CXCL10 and IFN-γ remained unchanged. Mild AEs (headache, dizziness, nausea) were reported and no severe AE was observed. CONCLUSION: Long-term abrocitinib plus NB-UVB phototherapy demonstrates sustained efficacy and safety in progressive NSV, though non-responders by 24 weeks may not benefit from extension.
BACKGROUND: The assessment of patient-centered outcomes in clinical practice is essential for optimal care. While a core domain set (CDS) for vitiligo clinical trials was established in 2015 (CDS for trials) to standardi...BACKGROUND: The assessment of patient-centered outcomes in clinical practice is essential for optimal care. While a core domain set (CDS) for vitiligo clinical trials was established in 2015 (CDS for trials) to standardize outcomes, no CDS currently exists for clinical practice, resulting in inconsistent assessment complicating effective disease management. OBJECTIVE: This study aimed to investigate outcomes and characteristics currently assessed by vitiligo experts in clinical practice and represents one of the steps toward developing a core outcome set (COS) including outcomes and outcome measurement instruments for clinical practice. METHODS: A cross-sectional survey was conducted among 31 vitiligo experts from six continents. The survey consisted of 28 predefined outcomes and characteristics. Participants were given the opportunity to propose additional options, which were considered 'generally assessed' when assessed by ≥ 70%. RESULTS: Six outcomes and 21 characteristics were 'generally assessed'. The most frequently chosen outcomes included vitiligo evolution, tolerability of treatment/adverse events, followed by disease activity and vitiligo extent. CONCLUSION: This study shows similarities but also remarkable differences in assessed outcomes compared to the CDS for clinical trials. These results serve as a preparatory step toward developing a COS for clinical practice with the involvement of expert and non-expert dermatologists and patients.
BACKGROUND: Facial wrinkles, caused by aging and repetitive muscle contractions, are commonly treated with botulinum neurotoxin type A (BoNT-A). However, excessive toxin diffusion can cause side-effects like muscle weakn...BACKGROUND: Facial wrinkles, caused by aging and repetitive muscle contractions, are commonly treated with botulinum neurotoxin type A (BoNT-A). However, excessive toxin diffusion can cause side-effects like muscle weakness. OBJECTIVES: This study aimed to compare the diffusion, efficacy, and safety of letibotulinum toxin A with two other BoNT-A products for treating forehead wrinkles. METHODS: In a double-blind, randomized, split-face controlled trial, 20 participants with moderate-to-severe horizontal forehead wrinkles received letibotulinum toxin A on one side and prabotulinum or onabotulinum toxin A on the other. The primary outcome was diffusion profile assessed via anhidrosis area (iodine-starch test at 2 weeks); secondary outcomes included wrinkle reduction, assessed by photographic analysis, and safety. RESULTS: Results show that letibotulinum toxin A exhibited diffusion patterns and wrinkle-reduction efficacy comparable to the control products. No statistically significant differences were observed be-tween the groups for the primary or secondary outcomes. CONCLUSION: Letibotulinum toxin A is a safe, effective alternative for wrinkle treatment, potentially minimizing excessive diffusion risks and related side effects, making it a valuable addition to available treatment options.
OBJECTIVES: Chronic spontaneous urticaria (CSU) is a debilitating disease that impacts patients' wellbeing. Herein, we report the burden of CSU on the health-related quality of life (HRQoL), unmet needs, treatment patter...OBJECTIVES: Chronic spontaneous urticaria (CSU) is a debilitating disease that impacts patients' wellbeing. Herein, we report the burden of CSU on the health-related quality of life (HRQoL), unmet needs, treatment patterns, and expectations of Italian patients with CSU from the Urticaria Voices study. METHODS: Urticaria Voices, a multi-national, cross-sectional, survey study, was conducted in adult patients with CSU. Patients completed an online survey on the impact of CSU on patients' HRQoL, unmet needs, and treatments. Data were analyzed descriptively. RESULTS: Overall, 64 Italian patients with CSU participated in the Urticaria Voices study (mean age: 42.4 years; 70% women). The average time since diagnosis was 7.8 years. Patients rated CSU's negative impact as 6.3/10, with the top impact being reduced confidence (28.1%). The main unmet need was treatments with fewer side effects (39.1%). Most patients (82.8%) used antihistamine, with 77.4% of them being switched to another antihistamine and 43.4% being updosed. Patients reported freedom from itch and hives as the top treatment expectation (7.69/10). CONCLUSION: CSU imparts a substantial disease burden that negatively impacts the HRQoL of Italian patients. More effective treatments for CSU emerged as an important unmet need. Raising disease awareness and improving access to new treatments can facilitate enhanced CSU care.
BACKGROUND: Pincer nail deformity is a rare but clinically significant toenail malformation characterized by excessive transverse curvature of the nail plate, often causing pain and functional impairment. Current treatme...BACKGROUND: Pincer nail deformity is a rare but clinically significant toenail malformation characterized by excessive transverse curvature of the nail plate, often causing pain and functional impairment. Current treatments include surgical and conservative treatments, while existing orthotic devices may cause varying degrees of damage to the nail. OBJECTIVE: The purpose of this study is to evaluate the efficacy of a memory metal wire (originally used in dentistry) in three subtypes of pincer nail deformity. METHODS: A total of 45 patients with various subtypes (Tile-Shaped: 28 cases, Trumpet-Shaped: 10 cases, Fan-Shaped: 7 cases) underwent orthotic treatment. Data collection included demographic questionnaires, Visual Analog Scale (VAS) for pain, and self-reported esthetic satisfaction scores. Pre- and postoperative surveys were analyzed to assess treatment outcomes. RESULTS: Postoperative improvements in VAS scores and self-reported esthetic satisfaction were statistically significant compared to preoperative values ( < 0.05), and no significant differences were observed among subtypes ( > 0.05). CONCLUSION: The modified pincer nail deformity correction technique using cotton packing, dental resin, and nickel-titanium wire demonstrates universal applicability and favorable therapeutic efficacy across various subtypes, offering a promising clinical approach for pincer nail deformity correction.
Çetinarslan T, Mergen MA, Türel Ermertcan A
… +32 more, Bülbül Başkan E, Yazıcı S, An İ, Gürel G, Adışen E, Demirbaş A, Dursun R, Aslancan B, Topkarcı Z, Esen M, Türkoğlu Z, Canat D, Kandiş S, Kılıç A, Ertam Sağduyu İ, Yazıcı EI, Gökyayla E, Demirel Öğüt N, Karstarlı Bakay ÖS, Temiz SA, Erdemir VA, Hapa FA, Aydin Ö, Hızlı P, Solak B, Bütüner M, Aytekin S, Albayrak H, Daye M, Türsen Ü, Sarıbaş Yıldırım AN, Cengiz Özyurt B
PURPOSE/AIM OF THE STUDY: The efficacy of bimekizumab was shown in moderate to severe plaque psoriasis. The aim of this study was to investigate the early super responder (ESR) profile (at week 4) to bimekizumab. MATERIA...PURPOSE/AIM OF THE STUDY: The efficacy of bimekizumab was shown in moderate to severe plaque psoriasis. The aim of this study was to investigate the early super responder (ESR) profile (at week 4) to bimekizumab. MATERIALS AND METHODS: We performed a multicenter retrospective study in 20 Dermatology outpatient clinics in Turkey. Adult patients with moderate-to-severe psoriasis who were under bimekizumab for at least 12 weeks were enrolled. RESULTS: A total of 341 adult patients were included. 136 had nail psoriasis (39.9%), 148 had psoriatic arthritis (PsA) (43.4%), 223 (65.4%) had at least one difficult-to-treat area involvement, 155 (45.5%) were bio-naïve, 110 (32.5%) had ≥ 2 biologics history. At week 4, PASI75 was achieved in 144 patients (49.8%), PASI90 was achieved in 88 patients (30.4%), PASI100 was achieved in 51 patients (17.6%). Family history ( = 0.041), palmoplantar involvement ( = 0.008), PsA ( = 0.097), and bio-experienced status ( = 0.060) were associated with lower odds of being an ESR, whereas each 1-point increase in baseline PASI was associated with significantly lower odds of ESR ( < 0.001). Gender, age, disease duration, history of conventional systemic treatment, and presence of any comorbidity were not significantly associated with the likelihood of being an ESR (all > 0.05). CONCLUSION: Bimekizumab is the effective treatment in both bio-naïve and bio-experienced patients; however, it may have a more rapid onset of action in bionaive patients. Further studies are needed on the long-term efficacy and safety data of bimekizumab.
PURPOSE: This study aims to evaluate the clinical efficacy, recurrence rate, and drug retention rate of plaque psoriasis with different severity levels treated with Ixekizumab. MATERIALS AND METHODS: A retrospective, mul...PURPOSE: This study aims to evaluate the clinical efficacy, recurrence rate, and drug retention rate of plaque psoriasis with different severity levels treated with Ixekizumab. MATERIALS AND METHODS: A retrospective, multicenter, real-world study was conducted using the China Cathay database to analyze 354 Chinese patients with mild-to-moderate and severe psoriasis who received ixekizumab therapy. Psoriasis Area and Severity Index (PASI) 75/90/100 response rates, absolute PASI values, 3-year drug retention, and recurrence rates were assessed at 2, 4, 12, 24, and 52 weeks. RESULTS: The baseline PASI scores for the mild-to-moderate group (PASI <10) and severe group (PASI ≥ 10) were 5.6± 2.6 and 20 ± 11, respectively. Except for a difference in the proportion of male patients, there were no differences between the two groups in terms of age,duration of illness, hypertension, hyperlipidemia, cardiovascular diseases, gout and arthropathy. The mild-moderate group showed superior PASI75/90 responses at most timepoints and consistently higher PASI100 rates (all < 0.05). Absolute PASI values were lower in mild-moderate patients at all timepoints except PASI90 (2/12 weeks) and PASI75 (24 weeks). Severe patients had longer 3-year drug retention ( = 0.007), while recurrence rates were comparable. CONCLUSIONS: Ixekizumab demonstrates superior efficacy in mild-moderate versus severe psoriasis, suggesting greater benefit with early biologic intervention.
BACKGROUND: Vunakizumab (anti-interleukin-17A antibody) has shown favorable efficacy and safety in treating moderate-to-severe plaque psoriasis. The morbidity and severity of psoriasis vary in different regions of China....BACKGROUND: Vunakizumab (anti-interleukin-17A antibody) has shown favorable efficacy and safety in treating moderate-to-severe plaque psoriasis. The morbidity and severity of psoriasis vary in different regions of China. OBJECTIVE: This post-hoc exploratory analysis aims to investigate the efficacy and safety of vunakizumab in patients with moderate-to-severe plaque psoriasis across different regions of China. METHODS: This post-hoc exploratory analysis used data from a phase III trial (NCT04839016), with 461 patients receiving vunakizumab categorized into North ( = 118), Central ( = 252), and South ( = 91) China groups. RESULTS: Psoriasis area and severity index (PASI)75/90/100 and static physician's global assessment (sPGA) 0/1 response rates were similar among the three groups at week 12 (W12). Additionally, W12-W52 sustained PASI 75/90/100 and sPGA 0/1 response rates were also similar among groups. Similar improvements in patient-reported outcomes, including dermatology life quality index, itch-numerical rating scale, EuroQol-5D, and short form-36, were observed in the three groups. The incidence of adverse events was 80.5%, 90.1%, and 90.1% in the North, Central, and South China groups, respectively. CONCLUSION: The efficacy and safety of vunakizumab are not affected by different regions of China in patients with moderate-to-severe plaque psoriasis.
Marquez-Grap G, Leung A, Orcales F
… +13 more, Kranyak A, Johnson C, Smith P, Haran K, Mills H, Schenk G, Kahlon A, Kaur J, Dhaliwal N, Lucas M, Rudrapatna V, Cula GO, Liao W
PURPOSE/AIM: Remote clinical research has potential to increase study diversity, reduce costs for researchers and participants, and increase efficiency of studies. This study evaluates the reliability and feasibility of...PURPOSE/AIM: Remote clinical research has potential to increase study diversity, reduce costs for researchers and participants, and increase efficiency of studies. This study evaluates the reliability and feasibility of using SkinTracker, a mobile application, for remote AD severity assessment through mobile-app based photography and surveys. METHODS: This single-center observational study enrolled 28 participants (18 with AD and 10 healthy controls) in an eight-week hybrid clinical study. Participants completed bi-weekly tasks and submitted standardized skin photographs via the SkinTracker app, and clinic-based skin exams and digital single-lens reflex (SLR) photos were obtained at baseline and week 8. Eczema Area Severity Index and Investigator Global Assessment scores were assigned to the photographs by a grader. Intraclass correlation coefficients were used to evaluate agreement between app-based, in-person, and SLR assessments for the 18 participants with AD. RESULTS: App-based AD assessment scores had excellent agreement with in-person scores, indicating the reliability of SkinTracker to assess disease activity remotely. Furthermore, all participants had high compliance and satisfaction with app-based activities, indicating that using SkinTracker for remote clinical research is achievable and even preferred by participants. CONCLUSION: Overall, these findings show that SkinTracker is both reliable and feasible for monitoring atopic dermatitis disease activity remotely.
BACKGROUND: Exploring predictors of early response is meaningful to optimize treatment strategies of patients with psoriasis. However, predictors of early response to vunakizumab remain unidentified. OBJECTIVE: This stud...BACKGROUND: Exploring predictors of early response is meaningful to optimize treatment strategies of patients with psoriasis. However, predictors of early response to vunakizumab remain unidentified. OBJECTIVE: This study aimed to investigate the early response rates to vunakizumab and identify predictors in patients with moderate-to-severe plaque psoriasis. METHODS: Data were derived from a phase-III trial (NCT04839016), and 461 patients with moderate-to-severe plaque psoriasis receiving vunakizumab were included. Early response was defined as ≥50% improvement in the Psoriasis Area Severity Index (PASI 50) by week 2 of treatment. RESULTS: A total of 54.0% of patients achieved early response. The proportion of males with early response (71.1%) was lower than males without that (82.5%) ( = 0.004). Regarding patients who had previous local treatment, the proportion of patients with early response (77.1%) was lower than patients without that (85.4%) ( = 0.024). Male [adjusted odds ratio (OR)=0.558, = 0.027] and previous local treatment (adjusted OR = 0.586, = 0.039) independently predicted lower possibility of early response. The nomogram demonstrated good calibration performance (mean absolute error: 0.021) with a limited discriminative ability (C-index: 0.580). CONCLUSION: Early response rate to vunakizumab was 54.0% in patients with moderate-to-severe plaque psoriasis, where female gender and naïve status to local therapy predicted early response.
PURPOSE: Twenty-nail dystrophy (TND) is a chronic nail disorder affecting all or some nails and posing a significant therapeutic challenge for dermatologists. Janus kinase (JAK) inhibitors have recently emerged as a prom...PURPOSE: Twenty-nail dystrophy (TND) is a chronic nail disorder affecting all or some nails and posing a significant therapeutic challenge for dermatologists. Janus kinase (JAK) inhibitors have recently emerged as a promising treatment modality for refractory nail diseases. RESULTS: We report a case of a patient with idiopathic TND for 12 years duration, and successfully treated with oral tofacitinib, which offered a potential new therapeutic choice for this challenging entity. Some successful cases of treating inflammatory nail diseases with Janus kinase (JAK) inhibitors were reviewed. CONCLUSION: Janus kinase (JAK) inhibitors may be a promising therapeutic option for patients with twenty-nail dystrophy.
OBJECTIVES: Papuloerythroderma of Ofuji (PEO) is a rare disorder characterized by the 'deck-chair sign' and is diagnosed according to the criteria proposed by Torchia et al. in 2009. This study aims to summarize the clin...OBJECTIVES: Papuloerythroderma of Ofuji (PEO) is a rare disorder characterized by the 'deck-chair sign' and is diagnosed according to the criteria proposed by Torchia et al. in 2009. This study aims to summarize the clinical manifestations, emerging treatments, and prognosis of PEO, and to explore the efficacy and paradoxical flares associated with dupilumab treatment. METHODS: We report two cases associated with dupilumab treatment and conducted a search of PubMed, Embase, the China Knowledge Resource Integrated, and the Wanfang databases using the keywords 'papuloerythroderma of Ofuji' for the period from July 2009 to October 2024. RESULTS: A total of 52 patients were included, with onset most commonly occurring in their 70s. The systemic treatments included dupilumab ( = 7), cyclosporine ( = 6), oral glucocorticoids ( = 5), acitretin ( = 4), methotrexate ( = 3), and apremilast ( = 1). Dupilumab was administered to seven patients, and the skin lesions improved within a short period. No adverse effects were reported in three patients, although elevated eosinophil counts accompanied by worsening lesions were observed in one patient. CONCLUSIONS: Our findings suggest that dupilumab is the most commonly utilized treatment for PEO; however, elevated eosinophil counts and potential exacerbation of clinical symptoms warrant attention. Additionally, Tripterygium glycosides may be an effective therapy to improve these conditions.
Bernardini N, Dattola A, Gemma GPA
… +28 more, Atzori L, Artosi F, Biondi G, Campione E, Cuccia A, Dessi P, Di Cesare A, Dragotto M, Frau A, Giordano D, Mazzotta A, Megna M, Michelucci A, Montesu MA, Mugheddu C, Orsini C, Pagnanelli G, Panduri S, Persechino S, Potestio L, Prignano F, Ricceri F, Rizzuto G, Trovato E, Virone M, Pellacani G, Potenza C, Skroza N
BACKGROUND: Psoriasis is a chronic inflammatory disease associated with systemic comorbidities. The Charlson Comorbidity Index (CCI) quantifies comorbidity burden and estimates survival, but its relationship with psorias...BACKGROUND: Psoriasis is a chronic inflammatory disease associated with systemic comorbidities. The Charlson Comorbidity Index (CCI) quantifies comorbidity burden and estimates survival, but its relationship with psoriasis severity and biologic therapies remains underexplored. OBJECTIVE: To evaluate the association between psoriasis severity and comorbidities, assess the impact of biologic disease-modifying antirheumatic drugs (bDMARDs, in particular (adalimumab [ADA], risankizumab [RISA], secukinumab [SECU]) on CCI and estimate 10-year survival in psoriatic patients versus controls. METHODS: In this multicenter cross-sectional study, 343 psoriasis patients and 343 matched controls from 13 Italian centers were analyzed. CCI scores and comorbidity profiles were stratified by disease severity PASI score [Psoriasis Area and Severity Index] and treatment groups. Survival probabilities were estimated using a predictive model. RESULTS: Psoriasis patients had significantly higher age-adjusted CCI compared to controls ( = 0.021), particularly in severe cases (PASI >10; = 0.003). Peripheral vascular disease, cerebrovascular disease, and myocardial infarction correlated with disease severity. ADA-treated patients showed lower CCI than those on RISA or SECU ( < 0.05). The estimated 10-year survival did not differ significantly between psoriasis and controls. CONCLUSIONS: Psoriasis severity is associated with increased comorbidity burden, highlighting the importance of cardiovascular and metabolic screening. Biologic therapies may differentially affect comorbidity progression, supporting personalized treatment approaches.
OBJECTIVES: To evaluate the therapeutic efficacy and safety of spesolimab in pediatric GPP treatment. METHODS: We report a 10-year-old male pediatric patient with refractory Generalized Pustular Psoriasis (GPP), comorbid...OBJECTIVES: To evaluate the therapeutic efficacy and safety of spesolimab in pediatric GPP treatment. METHODS: We report a 10-year-old male pediatric patient with refractory Generalized Pustular Psoriasis (GPP), comorbid epilepsy, hyperactivity, hypoproteinaemia. The coexistence of IL36RN: c.115 + 6T > C homozygous mutation and c.227C > T(p.P76L) heterozygous variation may have worsened his disease phenotype. RESULTS: Spesolimab treatment achieved a complete and rapid response. Pustules, erythema, and scales cleared within a week. CONCLUSIONS: Spesolimab is effective in treating pediatric GPP patients, and it is potential to be a clinical treatment strategy for pediatric GPP in the future.
BACKGROUND: Solar lentigo (SL) is a skin disorder associated with photoaging. Studies suggest that high-intensity focused ultrasound can improve UV-induced hyperpigmentation and melasma. OBJECTIVES: To evaluate the effic...BACKGROUND: Solar lentigo (SL) is a skin disorder associated with photoaging. Studies suggest that high-intensity focused ultrasound can improve UV-induced hyperpigmentation and melasma. OBJECTIVES: To evaluate the efficacy and safety of high-intensity macro-focused ultrasound (HI-MFU) for treating SL in Chinese. METHODS: This is a prospective, single-center study. Twenty-one patients with SL on both cheeks underwent HI-MFU treatment. Follow-ups at baseline and 2, 4, 6, and 8 weeks post-treatment were conducted to assess improvements using clinical imaging, noninvasive skin assessments, and the Global Esthetic Improvement Scale. RESULTS: The lesional and non-lesional areas showed an increase in L* values at all time points ( < 0.05). Transepidermal water loss values decreased on the left at 8 weeks ( < 0.001). Only two patients experienced transient mild pain and localized edema post-treatment. Two-photon microscopy revealed an uneven two-photon-excited fluorescence signal enhancement surrounding the nuclei of the stratum granulosum and stratum spinosum cells in the SL. At 8 weeks post-treatment, fluorescence signals in both areas were reduced compared to those at baseline. CONCLUSIONS: HI-MFU effectively and safely treats SL and enhances skin tightness, lightness, and barrier function, suggesting its ultrasound-toning potential.