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Hari G, Kishore A, Karkala SRP. Treatments for psoriasis: A journey from classical to advanced therapies. How far have we reached? Eur J Pharmacol 2022; 929:175147. [PMID: 35820531 DOI: 10.1016/j.ejphar.2022.175147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 06/29/2022] [Accepted: 07/06/2022] [Indexed: 11/03/2022]
Abstract
Psoriasis is considered an autoimmune, inflammatory disorder with a genetic basis. The underlying aetiology is yet unclear. Evidence suggests the congregation of immune cells and their secreted inflammatory cytokines, leukocytes, and other inflammation-promoting factors in large amounts within the epidermal layers of the skin, driving an inflammatory milieu. Although psoriasis is not a fatal condition, patients experience severe pain and suffering. It has a debilitating effect on the physiological and psychological state of the patient. Its distinguishing features are inflammation, formation of plaques on the skin and hyperproliferation of keratinocytes. Therapeutic strategies for treating psoriasis witnessed a radical improvement from traditional therapies to the approval of specific therapies like biologics and small molecules. The emerging evidence about new pharmacological targets and mechanisms in psoriasis has widened the scope for expanding therapeutic strategies. Our review discusses the existing treatments for plaque psoriasis and updates on therapies based on novel pharmacological targets in clinical development.
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Affiliation(s)
- Gangadhar Hari
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Anoop Kishore
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Sreedhara Ranganath Pai Karkala
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.
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Atakan N, Yazici AC, Özarmağan G, İnalÖz HS, Gürer MA, Sabuncu İ, Kİremİtçİ Ü, Alper S, Aytekİn S, Arican Ö, Polat M, Doğan S, Aldİnç E. TUR-PSO: A cross-sectional, study investigating quality of life and treatment status of psoriasis patients in Turkey. J Dermatol 2015; 43:298-304. [PMID: 26365805 DOI: 10.1111/1346-8138.13081] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 07/15/2015] [Indexed: 12/15/2022]
Abstract
Psoriasis is a common inflammatory disease that has a severe impact on quality of life. There is lack of data regarding epidemiological and clinical features of psoriasis patients in Turkey, a country with a population of 76 million. The aim of this study was to define the demographic and clinical characteristics, quality of life and treatment patterns of psoriasis patients in Turkey. A cross-sectional observational study was conducted at 40 centers, chosen from geographically diverse locations in Turkey. Patients diagnosed with psoriasis were assessed by investigators who were specialists of dermatology using standardized study questionnaire forms. Dermatology Life Quality Index (DLQI) and EuroQol-5 dimension (EQ-5D) forms were also filled out by each patient. 3971 psoriasis patients were included in this study. 24.2% of plaque psoriasis patients had moderate to severe psoriasis (Psoriasis Area and Severity Index, ≥10). Mean DLQI was 7.03 ± 6.02; quality of life was moderately, severely or very severely affected in 49.2% of patients. The most severely affected component of EQ-5D was anxiety/depression. Among all patients, 22.9% were not receiving any treatment, 39.8% were receiving only topical treatment, 11.5% were on phototherapy, 26.1%, were taking conventional systemic agents and 4.1% were on a biologic treatment. 31.3% of psoriasis patients with moderate to severe disease were treated with only topical agents and only 30.5% of moderate to severe psoriasis patients were receiving systemic therapy. Moderate to severe psoriasis has a considerable impact on quality of life. Treatment in Turkey of patients with moderate to severe psoriasis is insufficient.
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Affiliation(s)
- Nilgün Atakan
- Department of Dermatology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Ayça Cordan Yazici
- Department of Dermatology, Mersin University School of Medicine, Mersin, Turkey
| | - Güzin Özarmağan
- Department of Dermatology, Istanbul University Istanbul School of Medicine, Istanbul, Turkey
| | - Hüseyin Serhat İnalÖz
- Department of Dermatology, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Mehmet Ali Gürer
- Department of Dermatology, Gazi University School of Medicine, Ankara, Turkey
| | - İlham Sabuncu
- Department of Dermatology, Osmangazi University School of Medicine, Eskisehir, Turkey
| | - Ümmühan Kİremİtçİ
- Dermatology Clinic, Istanbul Education and Research Hospital, Istanbul, Turkey
| | - Sibel Alper
- Department of Dermatology, Ege University School of Medicine, Izmir, Turkey
| | - Sema Aytekİn
- Department of Dermatology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Özer Arican
- Department of Dermatology, Trakya University School of Medicine, Edirne, Turkey
| | - Mualla Polat
- Department of Dermatology, Izzet Baysal University School of Medicine, Bolu, Turkey
| | - Sibel Doğan
- Department of Dermatology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Emre Aldİnç
- Medical Department, Pfizer Turkey, Istanbul, Turkey
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Abstract
Nail psoriasis is common, occurring in up to half of patients with psoriasis and in 90% of patients with psoriatic arthritis. Left untreated, it may progress to debilitating nail disease, which leads to significant functional impairment. The most common clinical signs of nail psoriasis are nail plate pitting and onycholysis. Other classical signs include oil drop discoloration, subungual hyperkeratosis, and splinter hemorrhages. The modified Nail Psoriasis Severity Index (mNAPSI) can be used to grade the severity of nail psoriasis, while the Nail Psoriasis Quality of Life Scale (NPQ10) is a questionnaire that evaluates the impact of nail psoriasis on the patient's functional status and quality of life. Treatment of nail psoriasis should be individualized according to the patient's preferences, severity of nail changes, and presence of skin and/or joint involvement. Both topical and intralesional therapies are safe and effective treatment modalities for nail disease, but are limited by poor adherence and pain, respectively. Systemic therapy such as oral retinoids may be considered for widespread nail disease causing significant morbidity. Among biologic agents, tumor necrosis factor-α inhibitors and T-cell-targeted therapies such as ustekinumab may be useful for refractory severe nail psoriasis.
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MINEEVA AA, KOZHUSHNAYA OS, VOLNUKHIN VA, FRIGO NV, ZNAMENSKAYA LF, KUBANOV AA, MELEKHINA LE. Study of the genetic factors predisposing to the development of psoriasis. VESTNIK DERMATOLOGII I VENEROLOGII 2012. [DOI: 10.25208/vdv681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Background papers on psoriasis epidemiology, pathogenesis and genetics are presented. Special attention is given to genetic factors of the aptitude to psoriasis development. Were analysed researches, dedicated to the genome-wide screening of associations of polymorphic genetic locus with psoriasis development. Obtained results allow to reveal pathogenic psoriasis mechanisms, to forecast the character of the clinical course of the disease, as well as the efficiency of therapy and forecast the risk of psoriasis origination at patient’s relatives.
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Comparison of gene expression profiles reveals aberrant expression of FOXO1, Aurora A/B and EZH2 in lesional psoriatic skins. Mol Biol Rep 2010; 38:4219-24. [DOI: 10.1007/s11033-010-0544-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2010] [Accepted: 11/16/2010] [Indexed: 12/15/2022]
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