Paradoxical Psoriasis
Cytokine blocking therapies have revolutionized the management of psoriasis and atopic dermatitis but can lead to the development of paradoxic psoriasis (PP). Patients treated with biologics should be closely monitored for the development of PP and other paradoxical eruptions (including inflammatory joint disease, inflammatory bowel disease, eczematous eruptions, lupus like eruptions, sarcoidal eruptions, and others) and occasionally the development of cutaneous T-cell lymphoma. Further understanding the immunologic mechanism of these processes will ultimately drive our understanding of and ability to predict and manage PP...
Source: Dermatologic Clinics - April 10, 2024 Category: Dermatology Authors: Mariam Abdelghaffar, Sita Kottilil, Michael J. Murphy, Jeffrey M. Cohen, William Damsky Source Type: research
Oral Psoriasis Therapies
Oral psoriasis therapies include both older traditional immunosuppressants, such as methotrexate, cyclosporine, and acitretin, as well as newer, more targeted agents, such as apremilast, deucravacitinib, and oral interleukin-23 receptor antagonists. Patients may prefer oral therapies to injectable therapies based on the route of administration. Both older and newer oral psoriasis therapies can be utilized effectively in the treatment of psoriasis. Here, we will review oral agents used in the treatment of psoriasis as well as provide commentary on their role in our current, evolving psoriasis treatment paradigm. (Source: Dermatologic Clinics)
Source: Dermatologic Clinics - April 3, 2024 Category: Dermatology Authors: JaBreia James, Tracey Otto, Julia Gao, Martina L. Porter Source Type: research
Prevention of Psoriatic Arthritis
Psoriatic arthritis (PsA) is a systemic chronic inflammatory disease that develops in up to 30% of patients with psoriasis. Mixed data variably support the potential ability to “prevent” and/or delay PsA through use of systemic therapies in psoriasis patients. Though intriguing, almost all of these studies are retrospective in nature, and hold substantial limitations and potential biases that challenge the ability to meaningfully interpretation their results. Thus, the authors believe prospective observational and interventional studies are crucial to understanding our ability to truly modify the transition from psoria...
Source: Dermatologic Clinics - April 3, 2024 Category: Dermatology Authors: Alexander Wu, Jose U. Scher, Alexis Ogdie, Christopher Ritchlin, Joseph F. Merola Source Type: research
Evolving Landscape of Biologic Therapy for Pediatric Psoriasis
This article reviews biological treatment options approved for pediatric psoriasis and identifies others actively under investigation. (Source: Dermatologic Clinics)
Source: Dermatologic Clinics - March 26, 2024 Category: Dermatology Authors: Huongly Do, Kayla Babbush, Karen A. Chernoff, Laura E. Melnick Source Type: research
The Role of Genetics on Psoriasis Susceptibility, Comorbidities, and Treatment Response
This review highlights advances made in psoriasis genetics, including findings from genome-wide association studies, exome-sequencing studies, and copy number variant studies. The impact of genetic variants on various comorbidities and therapeutic responses is discussed. (Source: Dermatologic Clinics)
Source: Dermatologic Clinics - March 24, 2024 Category: Dermatology Authors: Audrey Bui, Faye Orcales, Allison Kranyak, Bo-Young Chung, Kathryn Haran, Payton Smith, Chandler Johnson, Wilson Liao Source Type: research
The Psoriasis Treatment Pipeline
Significant research advances in our understanding of psoriatic disease have led to the development of several highly selective, effective, and safe topical and systemic treatments. These treatments have led to unprecedented levels of disease clearance and control for most patients with psoriasis with cutaneous disease. However, there remains a need for improved treatments for those patients with recalcitrant disease, psoriatic arthritis, or nonplaque disease variants. Recently approved therapies and investigational products in ongoing clinical development programs that target IL-17A/F, IL-23, TYK2, PDE4, AhR or IL-36 cyto...
Source: Dermatologic Clinics - March 23, 2024 Category: Dermatology Authors: Jason E. Hawkes, Miriam Al-Saedy, Nicole Bouch é, Salsabeal Al-Saedy, Delaney T. Drew, Eingun James Song Source Type: research
Disparities in Care for Psoriasis
Race, ethnicity, language, sex, age, income, insurance status, location, and other socioeconomic and demographic factors influence access to and quality of care for patients with psoriasis, which can potentially lead to inequitable outcomes. (Source: Dermatologic Clinics)
Source: Dermatologic Clinics - March 15, 2024 Category: Dermatology Authors: Roman Drozdowski, Neelesh Jain, Christian Gronbeck, Hao Feng Source Type: research
Adherence to Psoriasis Therapies
Understanding the underlying causes of nonadherence among patients with psoriasis and adopting strategies to address these issues may allow providers to share responsibility and work alongside patients to overcome these barriers. The review explores patient adherence to different types of psoriasis treatment, suggestions for interventions to overcome barriers, and methods to promote adherence that have been published in the literature. (Source: Dermatologic Clinics)
Source: Dermatologic Clinics - March 15, 2024 Category: Dermatology Authors: Kawaiola C. Aoki, Summer Wong, Jessica Q. Duong, Steven R. Feldman Source Type: research
Immune Checkpoint Inhibitor-Induced Psoriasis
Immune checkpoint inhibitors (ICIs) are effective antitumor agents but are associated with immune-related adverse events. ICI-induced psoriasis commonly presents in patients with a history of psoriasis but may occur de novo, and it has a significant physical and psychosocial impact. ICI-induced and non-ICI-induced psoriasis are likely mediated by similar cytokines, and similar treatments are employed. Topical treatment often suffices, and when needed, several systemic treatments appear to be effective without impacting antitumor response. Development of psoriasis may indicate a superior response to ICIs. Thus, recognition ...
Source: Dermatologic Clinics - March 15, 2024 Category: Dermatology Authors: Jolanta J. Pach, Nina Mbonu, Shaman Bhullar, Jeffrey M. Cohen, Jonathan S. Leventhal Source Type: research
Phototherapy for Psoriasis in the Age of Biologics
Phototherapy has utility as a psoriatic therapy, given its relatively high clinical efficacy, low side effect profile, and lower cost compared to newer effective treatments like biologics and small molecules. Phototherapy has shown Psoriasis Area and Severity Index (PASI)-75 and PASI-90 rates comparable to those of biologics and small molecules, with similarly rapid onsets of action, rates of remission, and quality of life scores. Certain patients may particularly benefit from phototherapy, such as those with localized disease or contraindications to systemic immunomodulatory medication. Phototherapy can be more cost-effec...
Source: Dermatologic Clinics - March 14, 2024 Category: Dermatology Authors: Aaron Gabriel W. Sandoval, Arjun Mahajan, Elizabeth Buzney Source Type: research
Biologics for Psoriasis
Biologic therapies targeting tumor necrosis factor alpha (TNF- α) (infliximab, adalimumab, certolizumab, etanercept), the p40 subunit shared by IL-12 and IL-23 (ustekinumab), the p19 subunit of IL-23 (guselkumab, tildrakizumab, risankizumab), IL-17A (secukinumab, ixekizumab), IL-17-RA (brodalumab) and both IL-17A and IL-17F (bimekizumab) have revolutionized th e treatment of psoriasis. In both the short and long term, risankizumab had highest Psoriasis Area and Severity Index 90 scores compared to other oral and injectable biologics. IL-23 inhibitors had lowest rates of short-term and long-term adverse events and most fav...
Source: Dermatologic Clinics - March 13, 2024 Category: Dermatology Authors: Anthony Mitchel Wride, Gloria F. Chen, Sarah L. Spaulding, Elizabeth Tkachenko, Jeffrey M. Cohen Source Type: research
Psoriasis Comorbidities and Their Treatment Impact
This article explores the prevalence, clinical manifestations, screening mechanisms, and laboratory testing by which to evaluate these comorbidities. Treatment approach for these comorbidities must combine patient preference with established treatment algorithms while recognizing innovative therapeutics currently under development. (Source: Dermatologic Clinics)
Source: Dermatologic Clinics - March 13, 2024 Category: Dermatology Authors: Mark Taliercio, Mark Lebwohl Source Type: research
Treatment of Nail Psoriasis
This article reviews available intralesional, topical, and systemic treatment options for nail psoriasis, and discusses efficacy and safety of studied agents. Also reviewed are consensus treatment guideline recommendations. An updated algorithm to aid physicians in selection of specific treatment options is provided. (Source: Dermatologic Clinics)
Source: Dermatologic Clinics - March 9, 2024 Category: Dermatology Authors: Jonathan K. Hwang, Shari R. Lipner Source Type: research
Generalized Pustular Psoriasis, Acute Generalized Exanthematous Pustulosis, and Other Pustular Reactions
Generalized pustular rashes have various etiologies and can be challenging to diagnose and manage at first presentation. The authors provide an in-depth analysis of common pustular skin eruptions including generalized pustular psoriasis (GPP) and acute generalized exanthematous pustulosis, focusing on their pathophysiology, triggers, clinical presentation, diagnostic challenges, and management strategies. The article also highlights recent advances in genetic research and biologic therapies for GPP and the future directions in personalized medicine and prevention strategies. (Source: Dermatologic Clinics)
Source: Dermatologic Clinics - February 28, 2024 Category: Dermatology Authors: Elisabeth G össinger, Roni Dodiuk-Gad, Beda Mühleisen, Hazel H. Oon, Choon Chiat Oh, Julia-Tatjana Maul, Alexander A. Navarini Source Type: research
Neutrophilic Dermatoses
DERMATOLOGIC CLINICS (Source: Dermatologic Clinics)
Source: Dermatologic Clinics - February 28, 2024 Category: Dermatology Authors: Stanislav N. Tolkachjov Source Type: research
