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van Hal TW, van den Reek JMPA, Wenink MH, Otero ME, Ossenkoppele PM, Njoo MD, Oostveen A, Peters B, Tjioe M, Kop EN, Körver JEM, Dodemont SRP, Kleinpenning MM, Berends MAM, Veldkamp WR, van Doorn MBA, Mommers JM, Lindhout RJ, Kuijpers ALA, van Lümig PP, de Jonge CEJ, Tupker RA, Hendricksen J, Keijsers RR, van den Hoogen FHJ, Vriezekolk JE, de Jong EMGJ. Impairment in work and activities of daily life in patients with psoriasis: results of the prospective BioCAPTURE registry. J DERMATOL TREAT 2024; 35:2304025. [PMID: 38263716 DOI: 10.1080/09546634.2024.2304025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 01/05/2024] [Indexed: 01/25/2024]
Abstract
Background: Little is known about the extent of impairments in work and activities of daily life (ADL) in patients with psoriasis, and the influence of contextual factors such as disease-related characteristics and treatment. Therefore, this study aimed to assess these impairments in patients with psoriasis who started using biologicals/small molecule inhibitors.Methods: Using data from the prospective BioCAPTURE registry, we collected patient, disease, and treatment parameters, as well as work/ADL impairments at baseline, 6 and 12 months. Changes in impairment parameters and correlations between impairment and patient/disease characteristics were assessed using generalized estimating equations.Results: We included 194 patients in our analysis. After biological initiation, disease activity decreased significantly (PASI 11.2 at baseline versus 3.9 at 12 months, p < 0.001). Work-for-pay in this cohort was lower than in the Dutch general population (53% versus 67%, p = 0.01). In patients who had work-for-pay, presenteeism improved over time (5% at baseline versus 0% at 12 months, p = 0.04). Up to half of the patients reported impairments in ADL, which did not change over time. Associations between impairments and contextual factors varied, but all impairments were associated with worse mental/physical general functioning.Conclusion: Patients with psoriasis using biologicals are less likely to have work-for-pay. Treatment improves the work productivity of employed patients, but we were unable to detect changes in ADL performance.
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Affiliation(s)
- Tamara W van Hal
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, the Netherlands
- Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Juul M P A van den Reek
- Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Mark H Wenink
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, the Netherlands
| | - Marisol E Otero
- Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Paul M Ossenkoppele
- Department of Dermatology, ZiekenhuisGroep Twente, Almelo/Hengelo, the Netherlands
| | - Marcellus D Njoo
- Department of Dermatology, ZiekenhuisGroep Twente, Almelo/Hengelo, the Netherlands
| | - Annet Oostveen
- Department of Dermatology, Gelre Ziekenhuizen, Apeldoorn, the Netherlands
| | - Bas Peters
- Department of Dermatology, Ziekenhuis Rijnstate, Arnhem, the Netherlands
| | - Milan Tjioe
- Department of Dermatology/DermaTeam, Bravis Ziekenhuis, Bergen op Zoom, the Netherlands
| | - Else N Kop
- Department of Dermatology, Bernhoven Ziekenhuis, Uden, the Netherlands
| | - John E M Körver
- Department of Dermatology, Amphia Ziekenhuis, Breda, the Netherlands
| | | | | | - Maartje A M Berends
- Department of Dermatology, Slingeland Ziekenhuis, Doetinchem, the Netherlands
| | | | | | - Johannes M Mommers
- Department of Dermatology, St. Anna Ziekenhuis, Geldrop, the Netherlands
| | - Robert-Jan Lindhout
- Department of Dermatology, Jeroen Bosch Ziekenhuis, 's Hertogenbosch, the Netherlands
| | - Astrid L A Kuijpers
- Department of Dermatology, Maxima Medisch Centrum, Eindhoven, the Netherlands
| | - Paula P van Lümig
- Department of Dermatology, Maastricht UMC+, Maastricht, the Netherlands
| | - C Els J de Jonge
- Department of Dermatology, UMC Utrecht, Utrecht, the Netherlands
| | - Ron A Tupker
- Department of Dermatology, Sint Antoniusziekenhuis, Nieuwegein, the Netherlands
| | - Judith Hendricksen
- Department of Dermatology, Streekziekenhuis Koningin Beatrix, Winterswijk, the Netherlands
| | - Romy R Keijsers
- Department of Dermatology, Zuyderland Medisch Centrum, Sittard-Geleen, the Netherlands
| | | | - Johanna E Vriezekolk
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, the Netherlands
- Department of Research & Innovation, Sint Maartenskliniek, Nijmegen, the Netherlands
| | - Elke M G J de Jong
- Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Dermatology, ZiekenhuisGroep Twente, Almelo/Hengelo, the Netherlands
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Blauvelt A, Armstrong A, Merola JF, Strober B, de Cuyper D, Peterson L, Davies O, Stark JL, Lebwohl M. Mental health outcomes in patients with moderate to severe psoriasis treated with bimekizumab: Analysis of phase 2/3 randomized trials. J Am Acad Dermatol 2024; 91:72-81. [PMID: 38447700 DOI: 10.1016/j.jaad.2024.02.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 02/08/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Patients with psoriasis have increased risk of suicidal ideation and behavior (SIB) and depression. Bimekizumab, a biologic that inhibits interleukin (IL)-17A and IL-17F, received Food and Drug Administration approval in 2023 for moderate to severe plaque psoriasis, following 2021 European Medicines Agency approval. OBJECTIVE To report SIB and depression in patients with moderate to severe psoriasis treated in bimekizumab clinical trials. METHODS Mental health changes, including neuropsychiatric events, were actively monitored across 9 bimekizumab clinical trials in psoriasis phase 2/3 trials. The patient-reported electronic Columbia-Suicide Severity Rating Scale (measuring SIB) and Patient Health Questionnaire-9 (measuring depression) were administered, monitored by an independent Neuropsychiatric Adjudication Committee. RESULTS Throughout 7166 patient-years (PY) of bimekizumab exposure, the adjudicated SIB rate was 0.13/100PY; SIB ranges for the general psoriasis population and patients receiving anti-IL-17A/anti-IL-23 therapies are 0.09 to 0.54/100PY and 0.09 to 0.19/100PY, respectively. At week 16, 92.9% vs 81.1% of bimekizumab- vs placebo-treated patients had no/minimal depression. Newonset positive electronic Columbia-Suicide Severity Rating Scale responses and mean Patient Health Questionnaire-9 scores were low for bimekizumab-treated patients. LIMITATIONS Patient exclusion for significant/severe prespecified SIB/depression history. CONCLUSION The long-term adjudicated SIB rate with bimekizumab was low and within ranges reported in the general psoriasis patient population and psoriasis patients treated with anti-IL-17A/anti-IL-23 biologics. Screening/monitoring questionnaires reported low SIB and depression levels.
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Affiliation(s)
| | - April Armstrong
- University of California Los Angeles (UCLA), Los Angeles, California
| | - Joseph F Merola
- Division of Rheumatology, Departments of Dermatology and Medicine, Division of Rheumatology, Departments of Dermatology and Medicine, UT Southwestern Medical Center, Dallas, Texas
| | - Bruce Strober
- Department of Dermatology, Yale University, New Haven, Connecticut; Central Connecticut Dermatology Research, Cromwell, Connecticut
| | | | | | | | | | - Mark Lebwohl
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
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3
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Staubach P, Körber A, Trüeb RM, Mann C, von Kiedrowski R. A narrative review of fixed combination calcipotriol/betamethasone aerosol foam (Enstilar ®) in the management of psoriasis with scalp involvement. Drugs Context 2024; 13:2024-1-6. [PMID: 38770372 PMCID: PMC11104291 DOI: 10.7573/dic.2024-1-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 04/16/2024] [Indexed: 05/22/2024] Open
Abstract
The scalp is the most common site affected in patients with psoriasis with up to 80% of these patients having some degree of scalp involvement. In this narrative review, we evaluate available data on the use of an innovative aerosol foam formulation of calcipotriol plus betamethasone dipropionate (Cal/BD) to treat patients with psoriasis and scalp involvement. The full PubMed database was searched using the terms "calcipotriol", "betamethasone dipropionate" and "aerosol foam", and all articles relating to "psoriasis with scalp involvement" were retrieved and used in the preparation of this review. The evidence supporting the clinical effectiveness, tolerability and impact on health outcomes of Cal/BD aerosol foam in patients with scalp psoriasis was obtained from a phase II clinical trial and real-world evidence data from a non-interventional study as well as from two case series. The findings from these studies show that Cal/BD aerosol foam is rapidly effective, improves skin condition, alleviates symptoms such as itch, and has a positive impact on patient quality of life. These attributes address several unmet needs for patients with psoriasis with scalp involvement and have the potential to improve individual adherence to treatment.
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Affiliation(s)
- Petra Staubach
- Department of Dermatology and Allergy, University Medical Center, Mainz, Germany
| | - Andreas Körber
- Private Practice, Hautärzte Rue 143, 45130 Essen, Germany
| | - Ralph M Trüeb
- Center for Dermatology and Hair Diseases, Wallisellen, Switzerland
| | - Caroline Mann
- Department of Dermatology and Allergy, University Medical Center, Mainz, Germany
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Akadam-Teker AB, Akşan B. Association of IL-17F rs763780 polymorphism and risk of psoriasis in Turkish population: a case-control study. An Bras Dermatol 2024; 99:357-361. [PMID: 38331704 DOI: 10.1016/j.abd.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/18/2023] [Accepted: 06/18/2023] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Psoriasis represents a chronic inflammatory phenotype shaped by genetic interactions, characterized by keratinocyte hyperproliferation and commonly affecting the skin and joints. Experimental and clinical studies suggest that the IL-17F gene locus plays a role as a central cytokine in the immunopathogenesis of psoriasis. OBJECTIVES Based on the central role of IL-17F in the pathogenesis of psoriasis, the authors thought that variations in this gene could affect the susceptibility and severity of this disease. Therefore, in this study, the authors aimed to analyze whether the IL-17F rs763780 variant has an effect on psoriasis pathogenesis in the Turkish population. METHOD In this case-control study, the study group consisted of 603 people (201 psoriasis patients (73 males/128 females)/402 controls (146 males/256 females) were genotyped in terms of IL-17F rs763780 polymorphism with TaqMan 5' Allelic Discrimination Test. RESULTS The genotype distributions of the IL-17F rs763780 polymorphism between patients and control groups were statistically different, and the TC (heterozygous genotype) and CC (homozygous mutant genotype) genotypes were more represented in the patients group than in the control group (24.9% vs. 10.2%; 2.0% vs. 0.2%, respectively). In addition, the variant C allele was higher in the patients group and this was statistically significant (p < 0.001), and the C allele carriage was associated with a 3.14-fold increased risk of psoriasis (95% CI 2.015‒24.921). STUDY LIMITATIONS The present study has some limitations. The first limitation is the relatively small sample size. The second limitation is that the authors could not measure IL-17F expression levels. However, the present study data draw attention to the importance of IL-17F which deserves to be studied in a larger sample group. CONCLUSION We report that IL-17F rs763780 TC and CC genotype and C allele are associated with an increased risk of psoriasis in the Turkish population.
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Affiliation(s)
| | - Burak Akşan
- Department of Skin Diseases, Giresun University, Faculty of Medicine, Giresun, Turkey
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Megna M, Balato A, Caccavale S, Cacciapuoti S, Calabrese G, Di Brizzi EV, Di Costanzo L, Manzo R, Marino V, Puca RV, Romano F, Sarno O, Scotto di Luzio G, Lembo S. Real-Life Effectiveness and Safety of Guselkumab in Patients with Psoriasis Who Have an Inadequate Response to Ustekinumab: A 3-Year Multicenter Study. J Clin Med 2024; 13:2552. [PMID: 38731081 PMCID: PMC11084800 DOI: 10.3390/jcm13092552] [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: 03/25/2024] [Revised: 04/19/2024] [Accepted: 04/25/2024] [Indexed: 05/13/2024] Open
Abstract
Background: Guselkumab is the first approved human IgG1λ monoclonal antibody selectively targeting the p19 subunit of IL23. Its effectiveness and safety were widely reported by clinical trials. However, these results must be confirmed in real life since its safety deals with more complicated subjects with respect to trials. Currently, real-life data on the use of guselkumab following treatment failure with ustekinumab are limited, and existing studies usually show a small cohort and/or a reduced follow-up period. In this context, the aim of our study was to evaluate the use of guselkumab in patients who previously did not respond to ustekinumab after up to 3 years of treatment. Methods: A multicenter retrospective study was performed. The study enrolled patients affected by moderate-to-severe plaque psoriasis undergoing treatment with guselkumab who were attending the Psoriasis Center of nine different centers in the Campania region of Italy. Demographic and clinical features were collected for each patient at baseline. Moreover, data on psoriasis severity and adverse events (AEs) were collected at each follow-up visit (week (W)16-W36-W52-W104-W156). Results: A total of 112 patients (70 male, 62.5%; mean age 54.8 ± 11.7 years old) were enrolled. Of these, 48 (42.9%), 34 (30.4%), and 16 (14.3%) reached 1, 2, and 3 years, respectively, of follow-up under guselkumab. A statistically significant clinical improvement was observed since W16, and sustained effectiveness was reported at each timepoint up to W156. No serious AEs were collected. Moreover, a sub analysis on the body mass index, involvement of difficult-to-treat areas, and presence of psoriatic arthritis (PsA) showed that the presence of PsA or palmoplantar psoriasis was associated with a reduced clinical improvement at W16 and W36, without differences from W52. In contrast, the efficacy of guselkumab does not seem to be affected by the BMI, involvement of fingernails, or location in the genital or scalp area. Conclusions: To sum up, our long-term real-life multicenter retrospective study confirmed the efficacy and safety of guselkumab following ustekinumab discontinuation up to 156 weeks of treatment.
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Affiliation(s)
- Matteo Megna
- Section of Dermatology–Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Napoli, Italy
| | - Anna Balato
- Dermatology Unit, University of Campania L. Vanvitelli, 80138 Naples, Italy
| | - Stefano Caccavale
- Dermatology Unit, University of Campania L. Vanvitelli, 80138 Naples, Italy
| | - Sara Cacciapuoti
- Section of Dermatology–Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Napoli, Italy
| | - Giulia Calabrese
- Dermatology and Venereology, San Gennaro Hospital, 80136 Naples, Italy
| | | | - Luisa Di Costanzo
- Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, 84084 Salerno, Italy
| | - Raffaella Manzo
- U.O.C. Dermatologia, ASL Salerno Ospedale Tortora Pagani, 84121 Salerno, Italy
| | - Vincenzo Marino
- Dermatology Unit, Fatebenefratelli Hospital, 20121 Benevento, Italy
| | - Rosa Valentina Puca
- Department of Dermatology and Dermosurgery, AOSG San Giuseppe Moscati, 83100 Avellino, Italy
| | | | - Oriele Sarno
- Department of Dermatology and Dermosurgery, AOSG San Giuseppe Moscati, 83100 Avellino, Italy
| | | | - Serena Lembo
- Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, 84084 Salerno, Italy
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Blome C, Hülswitt L, Meineke A, Augustin M, Ohm F, Rusch J, Janke TM. Goals and benefits in topical treatment for psoriasis: development and pilot validation of a patient-reported outcomes tool, the Patient Benefit Index for Topical Treatment (PBI-TOP). Br J Dermatol 2024; 190:701-711. [PMID: 38213122 DOI: 10.1093/bjd/ljad484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/08/2023] [Accepted: 12/02/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND Topical agents are an essential component of psoriasis therapy. OBJECTIVES To develop a new version of the patient-reported Patient Benefit Index assessing the importance and achievement of treatment goals in topical psoriasis therapy in adult patients (PBI-TOP). METHODS Through semi-structured interviews, focus groups and free-text questionnaires, patients reported their needs in topical treatment. Based on qualitative content analysis, items were developed by a consensus group and were refined in cognitive debriefing interviews. A pilot validation assessed the PBI-TOP and convergent criteria [Dermatology Life Quality Index (DLQI); Psoriasis Area and Severity Index (PASI); affected Body Surface Area (BSA)]. RESULTS Thirty patients (26-72 years, mean 47; 60% male) reported various treatment goals relating to the themes 'effectiveness' and 'characteristics of the preparation'. Twenty patients took part in cognitive debriefings (22-84 years, mean 50.6, 50% male). There were 154 patients who participated in the pilot validation (18-85 years, mean 46.9, 63.6% male). An importance-weighted total score on overall effectiveness and three subscales based on exploratory factor analysis were defined: effectiveness on symptoms, effectiveness on quality of life (QoL), and characteristics of the preparation. All scores showed excellent internal consistency (α > 0.9). The global effectiveness score correlated significantly with DLQI (r = -0.41), PASI (r = -0.32) and BSA (r = -0.22). The effectiveness subscales (symptoms; QoL) correlated significantly with DLQI (r = -0.41; -0.32) and PASI (r = -0.27; -0.33). The score on characteristics of the preparation correlated significantly with the DLQI (r = -0.34). CONCLUSIONS The PBI-TOP showed good feasibility and favourable psychometric characteristics in this pilot validation.
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Affiliation(s)
- Christine Blome
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Lennart Hülswitt
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Anna Meineke
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Frenz Ohm
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Judith Rusch
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Toni Maria Janke
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Zeng B, Yan Y, Zhang Y, Wang C, Huang W, Zhong X, Chen Z, Xie M, Yang Z. Dendrobium officinale Polysaccharide (DOP) inhibits cell hyperproliferation, inflammation and oxidative stress to improve keratinocyte psoriasis-like state. Adv Med Sci 2024; 69:167-175. [PMID: 38521458 DOI: 10.1016/j.advms.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 03/14/2024] [Accepted: 03/18/2024] [Indexed: 03/25/2024]
Abstract
PURPOSE Psoriasis is a skin disease characterized by excessive proliferation, inflammation and oxidative stress in keratinocytes. The present study aimed to investigate the therapeutic effects of Dendrobium officinale polysaccharide (DOP) on keratinocyte psoriasis-like models. METHODS The HaCaT keratinocyte inflammation models were induced by interleukin (IL)-22 or lipopolysaccharide (LPS), respectively, and oxidative stress damage within cells was elicited by H2O2 and treated using DOP. CCK-8 and EdU were carried out to detect cell proliferation. ELISA, qRT-PCR, and Western blot were conducted to measure the expression of pro-inflammatory cytokines IL17A, IL-23, IL1β, tumor necrosis factor alpha (TNF-α), and IL-6. Reactive oxygen species (ROS) level in keratinocytes was detected by flow cytometry. Cell proliferation-associated proteins (PCNA, Ki67, Cyclin D1) and pathway proteins (p-AKT and AKT), and oxidative stress marker proteins (Nrf-2, CAT, SOD1) were detected by Western blot. RESULT DOP did not affect the proliferation of normal keratinocytes, but DOP was able to inhibit the proliferative activity of IL-22-induced overproliferating keratinocytes and suppress the expression of proliferation-related factors PCNA, Ki67, and Cyclin D1 as well as the proliferation pathway p-AKT. In addition, DOP treatment was able to inhibit IL-22 and LPS-induced inflammation and H2O2-induced oxidative stress, including the expression of IL17A, IL-23, IL1β, TNF-α, IL-6, and IL1β, as well as the expression levels of intracellular ROS levels and cellular oxidative stress-related indicators SOD, MDA, CAT, Nrf-2 and SOD1. CONCLUSION DOP inhibits keratinocyte hyperproliferation, inflammation and oxidative stress to improve the keratinocyte psoriasis-like state.
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Affiliation(s)
- Bijun Zeng
- School of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha, 410208, China; Hunan Engineering Technology Research Center for Medicinal and Functional Food, Hunan University of Chinese Medicine, Changsha, 410208, Hunan, China; Department of Dermatology, The Second Affiliated Hospital, The Domestic First-Class Discipline Construction Project of Chinese Medicine of Hunan University of Chinese Medicine, Changsha, 410005, Hunan, China
| | - Yining Yan
- Department of Dermatology, The Second Affiliated Hospital, The Domestic First-Class Discipline Construction Project of Chinese Medicine of Hunan University of Chinese Medicine, Changsha, 410005, Hunan, China
| | - Yujin Zhang
- Department of Dermatology, The Second Affiliated Hospital, The Domestic First-Class Discipline Construction Project of Chinese Medicine of Hunan University of Chinese Medicine, Changsha, 410005, Hunan, China
| | - Chang Wang
- Department of Dermatology, The Second Affiliated Hospital, The Domestic First-Class Discipline Construction Project of Chinese Medicine of Hunan University of Chinese Medicine, Changsha, 410005, Hunan, China
| | - Wenting Huang
- Department of Dermatology, The Second Affiliated Hospital, The Domestic First-Class Discipline Construction Project of Chinese Medicine of Hunan University of Chinese Medicine, Changsha, 410005, Hunan, China
| | - Xinyi Zhong
- Department of Dermatology, The Second Affiliated Hospital, The Domestic First-Class Discipline Construction Project of Chinese Medicine of Hunan University of Chinese Medicine, Changsha, 410005, Hunan, China
| | - Zi Chen
- Department of Dermatology, The Second Affiliated Hospital, The Domestic First-Class Discipline Construction Project of Chinese Medicine of Hunan University of Chinese Medicine, Changsha, 410005, Hunan, China
| | - Mengzhou Xie
- School of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha, 410208, China; Hunan Engineering Technology Research Center for Medicinal and Functional Food, Hunan University of Chinese Medicine, Changsha, 410208, Hunan, China.
| | - Zhibo Yang
- Department of Dermatology, The Second Affiliated Hospital, The Domestic First-Class Discipline Construction Project of Chinese Medicine of Hunan University of Chinese Medicine, Changsha, 410005, Hunan, China.
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8
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Wintermann GB, Bierling AL, Peters EMJ, Abraham S, Beissert S, Weidner K. Psychosocial stress affects the change of mental distress under dermatological treatment-A prospective cohort study in patients with psoriasis. Stress Health 2024; 40:e3263. [PMID: 37243509 DOI: 10.1002/smi.3263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 03/21/2023] [Accepted: 04/26/2023] [Indexed: 05/29/2023]
Abstract
Psoriasis is a chronic-inflammatory, immune-mediated disease leading to a state of increased systemic inflammation. Mental comorbidities often occur in the patients and may additionally affect the therapy outcome. Currently, it is unknown whether the disease severity, psychosocial stress or health-related quality of life determines the manifestation of anxiety/depression, or vice versa, in psoriasis. The interplay between these variables during the dermatological treatment of psoriasis remains to be elucidated in order to initiate appropriate psychological interventions and to identify patients at risk for comorbid anxiety/depression. In a prospective cohort study, the impact of disease severity, health-related quality of life and psychosocial stress on anxiety/depression were examined during the dermatological treatment in patients with moderate to severe psoriasis (patients with psoriasis = PSO). Patients were examined before (T1) and about 3 months after (T2) the beginning of a new treatment episode, in most cases by means of systemic therapy. Data were analysed, exploratory, using Bivariate Latent Change Score Models and mediator analyses. Assessments included patient-reported outcomes (Hospital Anxiety and Depression Scale/HADS, Perceived Stress Scale/PSS, Childhood Trauma Questionnaire/CTQ, Dermatology Life Quality Index-DLQI, Body Surface Area-BSA), at both T1 and T2. 83 PSO patients (37.3% women, median age 53.7, IQR 37.8-62.5, median BSA 18.0, IQR 9.0-40.0) with complete data of HADS and DLQI were included. In the total group, a higher anxiety/depression at T1 was associated with a lower improvement in psoriasis severity in the course of the dermatological treatment (γBSA = 0.50, p < 0.001). In subgroups of PSO with low/high CTQ scores, anxiety/depression at T1 had no impact on the change in psoriasis severity. Only by tendency, in CTQ subgroups, a higher psoriasis severity at T1 was linked with a higher improvement in anxiety/depression at T2 (low/high CTQ, γHADS = -0.16/-0.15, p = 0.08). An improvement in the health-related quality of life was positively associated with an improvement in anxiety/depression (Pearson's r = 0.49, p = 0.02). Here, the reduction of acute psychosocial stress seems to be a decisive factor, mediating this association (β = 0.20, t [2,60] = 1.87; p = 0.07, 95% CI -0.01, 0.41). The results allude, that the initial severity of anxiety/depression may presumably have an impact on the treatment outcome in the total group. In contrast, analysing subgroups of patients with high/low childhood trauma, the impact of the initial disease severity on the course of anxiety/depression after a switch to a new dermatological treatment could not be conclusively ruled out. The latter results from the latent change score modelling should be treated cautiously because of the small sample size. A common aetiopathological mechanism for psoriasis and anxiety/depression might be assumed with impact of dermatological treatment on both. The change in perceived stress seems to play an important role in the manifestation of anxiety/depression, substantiating the need for adequate stress management in patients with increased psychosocial stress during their dermatological treatment.
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Affiliation(s)
- Gloria-Beatrice Wintermann
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Antonie Louise Bierling
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Department of Clinical Psychology, Friedrich-Schiller-Universität, Jena, Germany
- Institute for Materials Science, Technische Universität Dresden, Dresden, Germany
| | - Eva M J Peters
- Psychoneuroimmunology Laboratory, Department of Psychosomatic Medicine and Psychotherapy, Justus-Liebig University Giessen, Giessen, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Charité Center 12 Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Susanne Abraham
- Department of Dermatology, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Stefan Beissert
- Department of Dermatology, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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9
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Rogner D, Heimerl L, Heyer S, Biedermann T, Sattler E, Zink A. Patients' perspective, quality of life and treatment goals in Hailey-Hailey disease: Lessons learned from the German National Registry. J Eur Acad Dermatol Venereol 2024; 38:419-429. [PMID: 37863661 DOI: 10.1111/jdv.19583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 09/06/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Hailey-Hailey disease (HHD) remains a difficult-to-treat dermatosis and little is known about the patient's perception of the disease activity, the treatment success and its impact on quality-of-life (QoL). OBJECTIVE To obtain better understanding of HHD patients' needs regarding their medical condition, financial burden, QoL, subjective well-being and treatment thereof as well as satisfaction to evaluate common treatments' 'real-life' relevance. METHODS With initiation of the national registry for Darier's disease (DD; Morbus Darier, MD) and Hailey-Hailey disease (HH) MDHHgermany, patients with HHD diagnosis were included starting June 2020. To assess subjective symptoms, patients filled out questionnaires such as the DLQI (dermatological life quality index), numeric rating scale (NRS) for itch, pain and burning sensation, as well as the SWLS (satisfaction with life scale) questionnaire to quantify overall satisfaction in life. Additionally, data on therapies were collected along with the patients' satisfaction of those and their medical care. Furthermore, patients assessed financial aspects and work ability. RESULTS One hundred and two patients were recruited from dermatology clinics, office-based dermatologists and self-help platforms across Germany between June 2020 and February 2023, 90 were eligible and analysed (mean: 49.91 years, 73.33% females, 26.67% males). 39.77% stated according to the DLQI their life is severely/very severely affected. Satisfaction with life was mediocre. Burning sensation was most pronounced among subjective symptoms (NRS 5.85 ± 2.80). Systemic treatments were rated as ineffective according to 56.92%, 25.56% had never received one. Most prescribed systemic treatments were corticosteroids (73.8%), followed by low-dose naltrexone (LDN) (26.2%), retinoids (15.4%) and antibiotics (13.8%). Satisfaction with medical care was generally low. CONCLUSION Our 'real-life' data state a major disease burden and impact on the QoL for affected individuals, as well as limited disease control due to inadequate therapies. MDHHgermany can provide insights into improvement of healthcare support with this debilitating disease and improve QoL. In the long term, it aims to provide basis for further clinical trials, epidemiological studies and immunological investigations.
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Affiliation(s)
- D Rogner
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - L Heimerl
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
- Department of Pharmacology and Toxicology, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany
| | - S Heyer
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - T Biedermann
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - E Sattler
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - A Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
- Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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10
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Strober B, Paul C, Blauvelt A, Thaçi D, Puig L, Lebwohl M, White K, Vanvoorden V, Deherder D, Gomez NN, Eyerich K. Bimekizumab efficacy and safety in patients with moderate to severe plaque psoriasis: Two-year interim results from the open-label extension of the randomized BE RADIANT phase 3b trial. J Am Acad Dermatol 2023; 89:486-495. [PMID: 37182701 DOI: 10.1016/j.jaad.2023.04.063] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 04/13/2023] [Accepted: 04/18/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Bimekizumab is a monoclonal IgG1 antibody that inhibits interleukin-17A/F. Bimekizumab is more efficacious than secukinumab over 1 year in the treatment of psoriasis. OBJECTIVE Evaluate the safety and efficacy of bimekizumab through 2 years in patients with moderate to severe plaque psoriasis. METHODS The BE RADIANT phase 3b randomized controlled trial consisted of a 48-week double-blinded period, where patients received bimekizumab (320 mg every 4 or 8 weeks) or secukinumab (300 mg weekly to Week 4, then every 4 weeks), and an open-label extension (OLE). From Week 48, all patients received bimekizumab in the OLE. RESULTS At Week 48, more patients achieved complete skin clearance (PASI 100; modified non-responder imputation) with bimekizumab than secukinumab (74.8% vs 52.8%). PASI 100 responses were maintained to Week 96 in continuous bimekizumab patients (70.8%); patients who switched from secukinumab to bimekizumab had increased rates at Week 96 (76.6%). The most common adverse events were: nasopharyngitis, oral candidiasis, and urinary tract infection. Safety data were consistent with the known safety profile of bimekizumab. LIMITATIONS Limited racial diversity; overlap with the COVID-19 pandemic. CONCLUSIONS High PASI 100 responses achieved with bimekizumab over 48 weeks were sustained through Week 96; secukinumab patients who switched to bimekizumab achieved similar responses by Week 96.
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Affiliation(s)
- Bruce Strober
- Department of Dermatology, Yale University, New Haven, Connecticut; Central Connecticut Dermatology Research, Cromwell, Connecticut.
| | - Carle Paul
- Toulouse University and INSERM Infinity, Toulouse, France
| | | | - Diamant Thaçi
- Insititute and Centre for Inflammation Medicine, University of Lübeck, Lübeck, Germany
| | - Luis Puig
- Hospital de la Santa Creu I Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mark Lebwohl
- Icahn School of Medicine at Mount Sinai, New York, New York
| | | | | | | | | | - Kilian Eyerich
- Department of Dermatology, Medical Center, University of Freiburg, Freiburg, Germany
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11
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Langenbruch A, Mohr N, Andrees V, Kessens I, Reich A, Czarnecka-Operacz M, Puig L, Dauden E, Iversen L, Augustin M. PsoBarrier EU study: a Multicentre, Cross-sectional Survey Investigating the Quality of Psoriasis Care in Four European Countries. Acta Derm Venereol 2023; 103:adv6532. [PMID: 37649411 PMCID: PMC10496845 DOI: 10.2340/actadv.v103.6532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 07/11/2023] [Indexed: 09/01/2023] Open
Abstract
Enhanced treatment options for psoriasis and growing use of guidelines increased the potential to better quality of psoriasis care in Europe. The aim of the PsoBarrier EU study is to compare the quality and processes of psoriasis care in four European countries with different healthcare systems, based on validated quality indicators. This cross-sectional survey was conducted in dermatology centres in Denmark, Germany, Poland and Spain on 1,304 patients, using standardized patient and physician questionnaires. Measured by quality of psoriasis care indicators, patients in Poland had the most critical outcomes, such as the highest disease severity (Psoriasis Area and Severity Index; PASI) and lowest health-related quality of life (Dermatology Life Quality Index; DLQI). This indicates differences in psoriasis care, with Polish participants experiencing more severe psoriasis and its consequences. Differences in the healthcare systems, which create barriers to accessing treatments, could explain variations in quality of care.
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Affiliation(s)
- Anna Langenbruch
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Germany.
| | - Nicole Mohr
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Germany
| | - Valerie Andrees
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Germany
| | - Ihno Kessens
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Germany
| | - Adam Reich
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszów, Poland
| | | | - Luis Puig
- Department of Dermatology, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - Esteban Dauden
- Department of Dermatology, Hospital Universitario de la Princesa, Madrid, Spain
| | - Lars Iversen
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Germany
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12
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Lee LL, Huo AP, Chen SL. Experiences and coping behaviours of patients with psoriasis: a qualitative study. J DERMATOL TREAT 2023; 34:2193661. [PMID: 36942918 DOI: 10.1080/09546634.2023.2193661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
BACKGROUND Psoriasis is a complex, chronic, lifelong inflammatory skin disease characterized by the development of erythematous, indurated, scaly, pruritic and often painful skin plaques, and it is currently incurable. It profoundly affects psychological wellbeing and social functioning and has significant associated co-morbidities. To improve clinical approaches, understanding of the experiences of patients with psoriasis is needed. OBJECTIVE To explore the experiences and coping behaviours of patients with psoriasis. METHODS A qualitative study approach was conducted. Through semi-structured interviews, 20 patients with psoriasis were recruited from general practices and specialist dermatology practices in a regional teaching hospital in Taiwan. Recorded interviews were transcribed and analysed by content analysis. RESULTS Three themes and nine subthemes were identified: 1. Symptoms distress: (a) trouble with scaling, (b) bothersome itching, and (c) complex pain experiences; 2. Psychological distress: (a) encountering discrimination and (b) feeling stigmatised; 3. Managing psoriasis: (a) coping with symptoms, (b) seeking alternative methods, (c) using biologic agents, and (d) changing thinking and coexisting with the disease. CONCLUSION The experience of patients with psoriasis has significant negative impacts on their lives. The findings of this study can provide healthcare professionals with a reference for the care of patients with psoriasis.
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Affiliation(s)
- Lin-Lin Lee
- Department of Nursing, Hungkuang University, Taichung 433304, Taiwan
| | - An-Ping Huo
- Department of Internal Medicine, Jen-Ai Hospital, Dali, Taichung 412224, Taiwan
| | - Shu-Ling Chen
- Department of Nursing, Hungkuang University, Taichung 433304, Taiwan
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13
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Taylor A, Singh R, Feldman SR. Review of Calcipotriene and Betamethasone Dipropionate Cream in the Treatment of Psoriasis. Ann Pharmacother 2023; 57:341-347. [PMID: 35730211 DOI: 10.1177/10600280221105508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To review the pharmacokinetics, efficacy, and safety of recently approved calcipotriene and betamethasone dipropionate (C-BD) cream. DATA SOURCES A literature review was conducted using MEDLINE (PubMed) and ClinicalTrials.gov from 2002 to mid-May 2022. STUDY SELECTION AND DATA EXTRACTION Articles in English discussing the use of C-BD cream in the treatment of psoriasis were included. DATA SYNTHESIS In 2 phase I trials, there was no phototoxic or photoallergic skin reaction at irradiated C-BD cream sites at baseline, 24 hours, 48 hours, and 72 hours postirradiation. In 2 phase III trials, after 8 weeks of treatment, more subjects treated with C-BD cream achieved Physician's Global Assessment treatment success (37.4%), compared to C-BD topical suspension (TS) (22.8%, P < 0.0001) and vehicle (3.7%, P < 0.0001). More subjects had greater mean percentage decline in Modified Psoriasis Area Severity Index (Trial 1: 52.9% and Trial 2: 64.6%), when compared to C-BD TS (Trial 1: 51.3%, P < 0.0001 and Trial 2: 56.4%, P < 0.0001) and vehicle (Trial 1: 22.9%, P < 0.0001 and Trial 2: 20.0%, P < 0.0001). RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE Psoriasis has a multifactorial pathogenesis and topical treatments are considered first line. Poor adherence is a major hurdle in management; the combination of 2 separate first-line drugs may address this by decreasing the complexity of treatment regimens. A cream formulation can be preferred, and C-BD is now Food and Drug Administration (FDA) approved as one. CONCLUSIONS Newly FDA-approved C-BD cream with novel polyaphron dispersion (PAD) technology provides a safe efficacious combination therapy for mild-to-moderate psoriasis which may be preferred by some patients.
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Affiliation(s)
- Alexandra Taylor
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Rohan Singh
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Steven R Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
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14
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Jaworecka K, Rzepko M, Marek-Józefowicz L, Tamer F, Stefaniak AA, Szczegielniak M, Chojnacka-Purpurowicz J, Gulekon A, Szepietowski JC, Narbutt J, Owczarczyk-Saczonek A, Reich A. The Impact of Pruritus on the Quality of Life and Sleep Disturbances in Patients Suffering from Different Clinical Variants of Psoriasis. J Clin Med 2022; 11:jcm11195553. [PMID: 36233422 PMCID: PMC9572740 DOI: 10.3390/jcm11195553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 09/18/2022] [Accepted: 09/20/2022] [Indexed: 11/27/2022] Open
Abstract
Background: Quality of life (QoL) and sleep, which are essential for well-being in the mental, physical, and socioeconomic domains, are impaired in psoriatic patients. However, the exact role of the clinical subtype of psoriasis in this aspect remains poorly studied. Objectives: The aim of this study was to investigate differences in QoL impairment and sleeping problems in patients suffering from various clinical subtypes of psoriasis and to evaluate the effects of pruritus on QoL. Methods: This cross-sectional, multicenter study included 295 eligible subjects with diagnosed psoriasis. Each patient was examined with the use of the same questionnaire. Measures included predominant subtype of psoriasis, disease severity, pruritus scores, patients’ health-related QoL and the incidence of sleep disturbance. Results: The QoL of most patients was decreased irrespectively of clinical psoriasis subtype, however, the most impaired QoL was in patients with erythrodermic psoriasis. The majority of patients reported sleep disturbances caused by pruritus, albeit there was no relevant differences between analyzed subgroups in this aspect of patients’ well-being. Pruritus was an important factor determining QoL and sleeping problems in the studied population. Conclusions: Identifying the most disturbing area of life and recognizing the most bothersome subjective symptoms of psoriasis are pivotal to focusing on the most relevant treatment goal and achieving therapeutic success.
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Affiliation(s)
- Kamila Jaworecka
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-310 Rzeszow, Poland
| | - Marian Rzepko
- Institute of Physical Culture Sciences, Medical College of Rzeszow University, 35-310 Rzeszow, Poland
| | - Luiza Marek-Józefowicz
- Department of Dermatology and Venerology, Faculty of Medicine, Nicolaus Copernicus University in Toruń, Ludwik Rydygier, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland
| | - Funda Tamer
- Department of Dermatology, Gazi University School of Medicine, 06570 Ankara, Turkey
| | - Aleksandra A. Stefaniak
- Department of Dermatology, Venerology and Allergology, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Magdalena Szczegielniak
- Department of Dermatology, Pediatric Dermatology and Oncology, Medical University of Łódź, 92-215 Lodz, Poland
| | - Joanna Chojnacka-Purpurowicz
- Department and Clinic of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, Faculty of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-720 Olsztyn, Poland
| | - Ayla Gulekon
- Department of Dermatology, Gazi University School of Medicine, 06570 Ankara, Turkey
| | - Jacek C. Szepietowski
- Department of Dermatology, Venerology and Allergology, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Joanna Narbutt
- Department of Dermatology, Pediatric Dermatology and Oncology, Medical University of Łódź, 92-215 Lodz, Poland
| | - Agnieszka Owczarczyk-Saczonek
- Department and Clinic of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, Faculty of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-720 Olsztyn, Poland
| | - Adam Reich
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-310 Rzeszow, Poland
- Correspondence: ; Tel.: +48-605-076722
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15
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Staubach P, Veelen K, Zimmer S, Sohn A, Lang BM, Peveling-Oberhag A, Grabbe S, Kaluza-Schilling W, Schwarting A, Wegner J. Multidisziplinarität als Schlüssel zum Erfolg. DIE DERMATOLOGIE 2022; 73:866-871. [PMID: 36069996 PMCID: PMC9592635 DOI: 10.1007/s00105-022-05051-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/27/2022] [Indexed: 11/25/2022]
Abstract
Hintergrund Patienten mit systemischen Autoimmun- und/oder autoinflammatorischen Erkrankungen (AI/AInf) bedürfen in der Regel einer multidisziplinären Zusammenarbeit durch verschiedene Fachrichtungen. Ziel der Arbeit (Fragestellung) Wir evaluierten, ob die Etablierung eines multidisziplinären Boards (sog. Rheumaboard [RB]) zur Optimierung der Versorgung von Patienten mit Psoriasisarthritis (PsA) oder anderen AI/AInf führt. Material und Methoden Es wurden n = 272 Patienten mit AI/AInf eingeschlossen, die in 3 Gruppen eingeteilt wurden; Gruppe 1: 41 Patienten mit oder mit Verdacht auf (V. a.) PsA, von der Dermatologie in der Rheumatologie konsiliarisch avisiert; Gruppe 2: 166 Patienten mit oder mit V. a. PsA, vorstellig in der Dermatologie und im RB; Gruppe 3: 65 Patienten mit anderen AI/AInf, vorstellig in der Dermatologie und im RB. Evaluiert wurde die durchschnittliche Zeit von der initialen Vorstellung bis zur Therapieeinleitung nach erfolgter Beurteilung und Diagnostik durch beide Fachrichtungen. Darüber hinaus wurden die Diagnosesicherung/-bestätigung und die Therapieweiterführung/-optimierung bei allen 3 Gruppen analysiert. Ergebnisse Die durchschnittliche Zeitspanne von der initialen Vorstellung bis zur Therapieeinleitung betrug in Gruppe 1 85 ± 42,24 (5 bis 173) Tage, in Gruppe 2 15 ± 13,09 (0 bis 78) Tage und in Gruppe 3 20 ± 16,71 (1 bis 75) Tage. In Gruppe 2 und 3 konnte die Diagnose schneller gesichert oder bestätigt sowie die Wartezeit auf Diagnostik und Therapie deutlich reduziert werden. Diskussion Durch die Etablierung eines RB zeigt sich eine signifikante Verkürzung der Zeitspanne zwischen Erstvorstellung und Therapieeinleitung und damit eine deutliche Verbesserung des Versorgungsmanagements bei Patienten mit AI/AInf inklusive Diagnosesicherung und Therapieoptimierung. Graphic abstract ![]()
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Affiliation(s)
- Petra Staubach
- Hautklinik und Poliklinik, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
- Universitäres Centrum für Autoimmunität (UCA) Mainz, Universitätsmedizin Mainz, Mainz, Deutschland
| | - Katrin Veelen
- Hautklinik und Poliklinik, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
- Universitäres Centrum für Autoimmunität (UCA) Mainz, Universitätsmedizin Mainz, Mainz, Deutschland
| | - Sebastian Zimmer
- Hautklinik und Poliklinik, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
- Universitäres Centrum für Autoimmunität (UCA) Mainz, Universitätsmedizin Mainz, Mainz, Deutschland
| | - Anna Sohn
- Hautklinik und Poliklinik, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
- Universitäres Centrum für Autoimmunität (UCA) Mainz, Universitätsmedizin Mainz, Mainz, Deutschland
| | - Berenice M Lang
- Hautklinik und Poliklinik, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
- Universitäres Centrum für Autoimmunität (UCA) Mainz, Universitätsmedizin Mainz, Mainz, Deutschland
| | - Adriane Peveling-Oberhag
- Hautklinik und Poliklinik, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
- Universitäres Centrum für Autoimmunität (UCA) Mainz, Universitätsmedizin Mainz, Mainz, Deutschland
| | - Stephan Grabbe
- Hautklinik und Poliklinik, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
- Universitäres Centrum für Autoimmunität (UCA) Mainz, Universitätsmedizin Mainz, Mainz, Deutschland
| | - Wiebke Kaluza-Schilling
- Rheumatologie, Universitätsmedizin Mainz, Mainz, Deutschland
- Universitäres Centrum für Autoimmunität (UCA) Mainz, Universitätsmedizin Mainz, Mainz, Deutschland
| | - Andreas Schwarting
- Rheumatologie, Universitätsmedizin Mainz, Mainz, Deutschland
- Universitäres Centrum für Autoimmunität (UCA) Mainz, Universitätsmedizin Mainz, Mainz, Deutschland
| | - Joanna Wegner
- Hautklinik und Poliklinik, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland.
- Universitäres Centrum für Autoimmunität (UCA) Mainz, Universitätsmedizin Mainz, Mainz, Deutschland.
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16
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How important is subjective well-being for patients? A qualitative interview study of people with psoriasis. Qual Life Res 2022; 31:3355-3363. [PMID: 35948788 PMCID: PMC9587968 DOI: 10.1007/s11136-022-03189-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2022] [Indexed: 11/01/2022]
Abstract
PURPOSE This qualitative study aimed to investigate the importance of subjective well-being (SWB) as an outcome of psoriasis treatment from patient's perspective. We focused on the affective component of SWB as assessed with the Daily Experience Sampling Questionnaire (DESQ), a validated daily diary. METHODS Semi-structured qualitative telephone interviews were conducted with in-patients of a dermatological rehabilitation clinic, after participants had completed the DESQ for up to seven days to get familiar with the concept of SWB. Patients were asked to reflect on the importance of SWB as treatment goal and on its relative importance as compared with other treatment outcomes. We also addressed whether SWB could be an indirect measure of benefit in that it reflects other important outcomes. Transcripts were analyzed using content analysis. RESULTS Eleven patients participated (24-63 years, mean 53 years, 8 male, 3 female). Participants uniformly confirmed that changes in SWB reflected treatment benefit. All but one considered SWB to be a central aspect of treatment benefit-either as the most important treatment goal or as an indirect benefit indicator. In particular, participants described positive associations of SWB with other outcomes, such as symptoms. They reported that both the disease and the medical treatment had an impact on their SWB, which was reflected in the DESQ. CONCLUSION Our findings suggest that SWB is a relevant indicator of treatment benefit for patients with psoriasis. Therefore, SWB measures, such as the DESQ, could be used to operationalize patient-relevant benefit of psoriasis treatment, complementing outcome measures currently used.
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17
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Chicharro P, Llamas-Velasco M, Armesto S, Herrera-Acosta E, Vidal D, Vilarrasa E, Rivera R, De la Cueva P, Martorell A, Ballescà F, Belinchón I, Carretero G, Rodríguez L, Romero-Maté A, Pujol-Montcusí J, Salgado L, Sahuquillo-Torralba A, Coto-Segura P, Baniandrés O, Feltes R, Alsina M, Daudén E. Fast and sustained Improvement of Patient-reported outcomes in psoriatic patients treated with secukinumab in a daily practice setting. Dermatol Ther 2022; 35:e15653. [PMID: 35731640 DOI: 10.1111/dth.15653] [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: 05/17/2022] [Accepted: 06/15/2022] [Indexed: 11/28/2022]
Abstract
Psoriasis is a chronic dermatological disease with great impact on patients' quality of life (QoL). The main objective of this study was to assess the impact of secukinumab treatment on different patient-reported outcomes (PROs) during a long-term follow-up in Spanish patients with moderate-to-severe psoriasis under real-world conditions. Retrospective, observational, open-label, nationwide multicenter cohort study that included patients who initiated treatment with secukinumab in daily clinical practice conditions. PROs assessing disease impact and QoL included Dermatology Life Quality Index (DLQI), Patient's Global Psoriasis Assessment, Itch Numerical Rating Scale and EuroQoL Thermometer Visual Analogue Scale. Outcomes, including PROs and Psoriasis Area and Severity Index (PASI), were assessed at months 3, 6, 12, 18 and 24 during treatment. A total of 238 patients were enrolled in the study. Patients had a mean DLQI score of 14.9 at baseline; 78.3%, 73.7% and 71.7% of them achieved a DLQI 0/1 response at months 6, 12 and 24, respectively. DLQI score was lower in the long term for naïve patients. A sharp decrease in mean DLQI was observed during the first three months, reaching a plateau that was maintained until the end of follow-up. Similar findings were observed for the rest of QoL assessments. There was a close association between improvement in QoL and skin clearance (PASI), which progressively increased during follow-up. In this study, secukinumab sustainably improved patient's QoL during a 24-month follow-up, with strongest effects in patients naïve to biological therapies and with a direct correlation with PASI improvement. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Pablo Chicharro
- Department of Dermatology, Hospital Universitario de la Princesa, Madrid
| | - Mar Llamas-Velasco
- Department of Dermatology, Hospital Universitario de la Princesa, Madrid
| | - Susana Armesto
- Department of Dermatology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | - David Vidal
- Department of Dermatology, Hospital de Sant Joan Despí Moisés Broggi, Barcelona
| | - Eva Vilarrasa
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona
| | - Raquel Rivera
- Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid
| | - Pablo De la Cueva
- Department of Dermatology, Hospital Universitario Infanta Leonor, Madrid
| | | | - Ferran Ballescà
- Department of Dermatology, Hospital Universitario Germans Trias i Pujol, Barcelona
| | - Isabel Belinchón
- Department of Dermatology, Hospital General Universitario de Alicante - ISABIAL, Alicante, Spain
| | - Gregorio Carretero
- Department of Dermatology, Hospital Universitario Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - Lourdes Rodríguez
- Department of Dermatology, Hospital Universitario Virgen del Rocío, Sevilla
| | | | - Josep Pujol-Montcusí
- Department of Dermatology, Hospital Universitario de Tarragona "Joan XXIII", Tarragona, Spain
| | - Laura Salgado
- Department of Dermatology, Complejo Hospitalario Universitario, Pontevedra, Spain
| | - Antonio Sahuquillo-Torralba
- Department of Dermatology, Hospital Universitario y Politécnico La Fe, Instituto de Investigación Sanitária La Fe, Valencia
| | - Pablo Coto-Segura
- Department of Dermatology, Hospital Vital Alvarez-Buylla de Mieres, Asturias, Spain
| | - Ofelia Baniandrés
- Department of Dermatology, Hospital General Universitario Gregorio Marañón, Madrid
| | - Rosa Feltes
- Department of Dermatology, Hospital Universitario la Paz, Madrid
| | - Mercè Alsina
- Department of Dermatology, Hospital Clínic i Provincial, Barcelona
| | - Esteban Daudén
- Department of Dermatology, Hospital Universitario de la Princesa, Madrid
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18
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The Relationship between Alexithymia and Mental Health Is Fully Mediated by Anxiety and Depression in Patients with Psoriasis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063649. [PMID: 35329336 PMCID: PMC8950845 DOI: 10.3390/ijerph19063649] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/10/2022] [Accepted: 03/16/2022] [Indexed: 02/06/2023]
Abstract
Background: Psoriasis is a common skin disease that affects quality of life, especially mental health. Alexithymia has been considered a relevant feature in psoriasis patients. Moreover, psoriasis was found to be associated with negative psychological health, including anxiety and depression. As the pathways linking alexithymia and mental health remain unclear among patients with psoriasis, we aimed to examine the mediating role of anxiety and depression in the relationship between alexithymia and mental health in these patients. Methods: To explore our variables of interest, we used the Toronto Alexithymia Scale (TAS-20), the 12-Item Short Form Health Survey (SF-12), and the Hospital Anxiety and Depression Scale (HADS). Results: Forty-four percent of patients were alexithymic and reported higher anxiety and depression, and lower quality of life compared to non-alexithymic patients. Alexithymic patients also had lower educational attainment. A correlation analysis showed positive associations between alexithymia and both anxiety and depression, whereas mental and physical health were negatively associated with alexithymia. Moreover, anxiety and depression fully mediated the relationship between alexithymia and mental health. Conclusions: Our findings highlight the importance of assessing alexithymia and psychological distress in clinical practice to identify vulnerable patients and to implement interventions aimed at improving negative emotional states.
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Wei JCC, Chang YJ, Wang YH, Yeh CJ. The Risk of Gout in Patients with Psoriasis: A Population-Based Cohort Study in Taiwan. Clin Epidemiol 2022. [PMID: 35309101 PMCID: PMC8928107 DOI: 10.2147/clep.s346128] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Previous research has pointed to the relationship between psoriasis and the development of gout. However, most previous studies had either small sample sizes or short study durations. Therefore, in this nationwide cohort study, we investigated the effect of psoriasis on the risk of gout development. Methods The study group included one million patients from Taiwan, whom we followed for 14 years. The participants were divided into two cohorts designated as psoriasis and non-psoriasis. A 1:4 propensity score matching test was used to compare age, sex, and index year between the two cohorts. Cox proportional hazard regression was used to determine the hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of gout. Sensitivity analyses were conducted to evaluate the HR for gout after the occurrence of psoriasis. Results The incidence densities of gout in the psoriasis and non-psoriasis cohorts were 6.96 and 5.09 per 1000 person-years, respectively. After adjusting for age, sex, urbanization, comorbidities, and nonsteroidal anti-inflammatory drug (NSAID) use, the adjusted hazard ratio (aHR) with 95% CI for incidental gout in the psoriasis group was 1.38 (1.2–1.6). Moreover, the aHR (95% CI) values for gout risk in patients with psoriasis using NSAIDs and those who did not were 1.21 (1.0–1.47) and 1.65 (1.33–2.05), respectively. Conclusion This study demonstrated an association between psoriasis and risk of developing gout. Clinically, patients with psoriasis should be evaluated for incidental gout.
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Affiliation(s)
- James Cheng-Chung Wei
- Department of Allergy, Immunology & Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Medicine, College of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| | - Yi-Jung Chang
- Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Yu-Hsun Wang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chih-Jung Yeh
- Department of Public Health, Chung Shan Medical University, Taichung, Taiwan
- Correspondence: Chih-Jung Yeh, Department of Public Health, Chung Shan Medical University, No. 110, Sec. 1, Jianguo N. Road, South District, Taichung, 40201, Taiwan, Tel +886 4 24739595 #11794, Fax +886 4 24637389, Email
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20
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Thakur V, Mahajan R. Novel Therapeutic Target(s) for Psoriatic Disease. Front Med (Lausanne) 2022; 9:712313. [PMID: 35265634 PMCID: PMC8898896 DOI: 10.3389/fmed.2022.712313] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 01/28/2022] [Indexed: 11/28/2022] Open
Abstract
Psoriasis and psoriatic arthritis, together known as psoriatic disease, is highly prevalent chronic relapsing inflammatory disease affecting skin, joints or both and is associated with several comorbidities such as cardiovascular, metabolic, psychiatric, renal disease etc. The etiopathogenesis of psoriasis is complex and mainly driven by aberrant immune response owing to the genetic susceptibility and various environmental factors such as trauma, infections and drugs. Recent advances in understanding molecular and cellular pathways have identified tumor necrosis factor-α (TNF-α), interleukin-17 (IL-17), IL-23, IL-22 as major contributors in psoriasis pathogenesis. Advances in the knowledge of pathophysiology, the interaction of autoinflammation and clinical phenotypes have led to the development of highly effective targeted therapeutic agents which include TNF-α, IL-17, IL-23, IL-1 α/β or IL-36 inhibitors or receptor blockers, small molecule drugs like phosphodiesterase-4 inhibitors (apremilast), Janus kinase (JAK) inhibitors, retinoic acid receptor-related orphan receptor γt (RORγt) inhibitors. These novel drugs have promised the potential of improved disease control. In recent years, the transition from biologics to biosimilars especially with TNF-α inhibitors had significant impact on decreasing health care cost and increasing therapeutic options to the patients. However, selection of right treatment for an individual patient still remains challenging. Moreover, interplay between different epigenetic mechanisms such as the DNA methylation, chromatin modifications and noncoding RNA regulation has recently been started to be deciphered. Enzymes inhibitors involved in epigenetic pathways such as DNA methyltransferases and histone deacetylases demonstrated to restore normal epigenetic patterns in clinical settings and have provided the potential as novel therapeutic targets for psoriasis. In this review, we will discuss novel biologic agents and newer therapeutic approaches in treatment of psoriatic disease.
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21
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Karapetyan S, Davtyan H, Khachikyan K, Hakobyan G. Impact of Supplemental Essential Phospholipids on Treatment Outcome and Quality of Life of Patients With Psoriasis With Moderate Severity. Dermatol Ther 2022; 35:e15335. [PMID: 35088499 DOI: 10.1111/dth.15335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 01/06/2022] [Accepted: 01/23/2022] [Indexed: 02/03/2023]
Abstract
Aim of this study was to evaluate effect of supplemental of Essential Phospholipids (EPL) on the treatment efficacy in patients with moderate psoriasis. 132 subjects over 18 years of age with diagnosed psoriasis participated in this study. Patients were randomly assigned 2 treatment groups. 2 types of treatment were used for the treatment of the patients. First group of patients received conventional treatment which included systemic immunosuppresant, antihistamine, calcium gluconate and topical salicylic acid. Second group (n = 67) received same treatment with supplemental Essential Phospholipids (EPL) Data was comprised of age, gender, psoriasis area and severity index (PASI) and dermatological life quality index (DLQI) scores, other clinical/laboratory characrteristics including TNF-α, IL-1α, IL-2, INF-γ, IL-10, TGF-β. All measurements were done before and after treatments. After treatment in the treatment groups the PASI scores decreased to 4.5 (SD ± 2.66) and 2.09 (SD ±1.09) respectively. The observed difference was statistically significant (p < 0.001). Change of PASI score was greater in group II on average by 2.81 (SD ±0.38). After treatment in both groups the DLQI scores decreased to 4.42 (SD ± 1.23) and 3.91 (SD ± 0.34) respectively. The observed difference was statistically significant (p < 0.001). Change of DLQI score was greater in group II on average by 4.29 (SD ±0.44). We can state that addition of Essential Phospholipids to the standard treatment can improve treatment outcomes and quality of life in patients with moderate psoriasis.
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Affiliation(s)
- Shushanik Karapetyan
- Department of Dermotology, Yerevan State Medical University Named after M. Heratsi, Yerevan, Armenia
| | - Hayk Davtyan
- Research and Prevention Center NGO, Yerevan, Armena, Hayk Davtyan MPHTB, Armenia
| | - Khachik Khachikyan
- Department of Dermotology, Yerevan State Medical University Named after M. Heratsi, Yerevan, Armenia
| | - Gagik Hakobyan
- Department of Oral and Maxillofacial Surgery, Yerevan State Medical University after M. Heratsi, Armenia; Gagik Hakobyan DMSc, PhD, Head of Department of Oral and Maxillofacial Surgery
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22
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Wintermann GB, Bierling AL, Peters EMJ, Abraham S, Beissert S, Weidner K. Childhood Trauma and Psychosocial Stress Affect Treatment Outcome in Patients With Psoriasis Starting a New Treatment Episode. Front Psychiatry 2022; 13:848708. [PMID: 35546938 PMCID: PMC9083906 DOI: 10.3389/fpsyt.2022.848708] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/21/2022] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Traumatic childhood experiences and psychosocial stress may predispose the evolvement of somatic diseases. Psoriasis is a multifactorial chronic inflammatory skin disease that often associates with current and past stress. Both may entail pathological alterations in major stress axes and a balance shift in the level of T helper type 1 (Th1) and 2 (Th2) cytokines, affecting the development and course of psoriasis. Until now, it is unclear whether traumatic stress experiences during the childhood or current stress are more frequent in psoriatic compared to skin-healthy individuals, and if they interact with treatment outcome. METHOD In a prospective cohort study, the impact of acute and early childhood stress on the course of dermatological treatment were studied in patients with moderate to severe psoriasis (PSO). Patients were examined before (T1) and about 3 months after (T2) the beginning of a new treatment episode. Assessments included clinical outcomes (Psoriasis Area and Severity Index-PASI, Structured Clinical Interview SCID-I) and patient-reported outcomes (PRO) (Childhood Trauma Questionnaire-CTQ, Perceived Stress Scale-PSS, itching/scratching, Dermatology Life Quality Index-DLQI, Hospital Anxiety and Depression Scale, Body Surface Area, Self-Administered PASI). RESULTS N = 83 PSO patients (median age 53.7, IQR 37.8, 62.5) and n = 66 skin-healthy control subjects (HC) (median age 51.5, IQR 33.3, 59.2) participated. PSO had higher CTQ physical neglect than HC, as well as higher PRO levels. The positive impact of improved skin on the skin-related quality of life was moderated by the perceived stress. Acute stress at T1 had a positive effect both on the skin severity and the skin-related quality of life. CTQ total closely interacted with baseline psoriasis severity, and was associated with higher improvement from T1 to T2. CONCLUSION One might tentatively conclude, that chronic psychosocial stressors like childhood maltreatment may predispose the manifestation of psoriasis. The latter may be amplified by acute psychological stressors. In addition, the present evidence suggests that systemic therapies work well in PSO, with childhood trauma and acute psychosocial stress. Both should therefore be routinely assessed and addressed in PSO.
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Affiliation(s)
- Gloria-Beatrice Wintermann
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus Dresden, Technische Universitaet Dresden, Dresden, Germany
| | - Antonie Louise Bierling
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus Dresden, Technische Universitaet Dresden, Dresden, Germany
| | - Eva M J Peters
- Psychoneuroimmunology Laboratory, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Giessen, Gießen, Germany.,Universitätsmedizin Charité, Berlin, Germany
| | - Susanne Abraham
- Department of Dermatology, University Hospital Carl Gustav Carus Dresden, Technische Universitaet Dresden, Dresden, Germany
| | - Stefan Beissert
- Department of Dermatology, University Hospital Carl Gustav Carus Dresden, Technische Universitaet Dresden, Dresden, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus Dresden, Technische Universitaet Dresden, Dresden, Germany
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23
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Gottlieb AB, Warren RB, Augustin M, Garcia L, Cioffi C, Peterson L, Pelligra C, Ciaravino V. Psychometric Validation of the Psoriasis Symptoms and Impacts Measure (P-SIM): A Novel Patient-Reported Outcome Instrument for Patients with Plaque Psoriasis, Using Reported Data from the BE RADIANT Phase 3b Trial. Adv Ther 2021; 38:5253-5269. [PMID: 34471992 PMCID: PMC8478739 DOI: 10.1007/s12325-021-01836-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 06/18/2021] [Indexed: 11/25/2022]
Abstract
Introduction This analysis assessed the psychometric properties of the Psoriasis Symptoms and Impacts Measure (P-SIM), a novel patient-reported outcome (PRO) tool designed to capture patient experiences of the signs, symptoms and impacts of psoriasis. Methods Blinded data from the BE RADIANT phase 3b trial of bimekizumab were analysed. In BE RADIANT, patients were randomised 1:1 to bimekizumab 320 mg every 4 weeks (Q4W) or secukinumab 300 mg (weekly until Week 4, then Q4W). Three items (itching, skin pain and scaling) of the P-SIM were electronically assessed throughout the trial and were scored from 0 to 10 (none to very severe signs/symptoms/impacts). Test–retest reliability was determined using intraclass correlations. Convergent validity was assessed between P-SIM and other relevant PRO and clinician-reported outcome (ClinRO) scores. Known-groups validity was assessed by comparing mean P-SIM item scores between patient subgroups based on the Psoriasis Area and Severity Index (PASI)/Investigator’s Global Assessment (IGA) scores. Responsiveness was assessed via correlations between changes from baseline in P-SIM item scores and other relevant PRO and ClinRO scores. Anchor-based responder analyses and empirical cumulative distribution function (eCDF) curves determined responder thresholds. Results The three P-SIM items yielded high intraclass coefficients (> 0.70). By Week 48, the three P-SIM items had moderate (> 0.30 and ≤ 0.50) to strong (> 0.50) correlations with other PROs and weaker correlations with ClinROs, demonstrating good convergent validity. For almost all known-group comparisons, statistically significant between-subgroup score differences were seen across all three P-SIM items. Changes from baseline in the P-SIM and other relevant outcomes were above the acceptable threshold of ≤ 0.30, demonstrating sensitivity to change. Anchor-based analyses determined a ≥ four-point reduction from baseline to indicate marked clinically meaningful improvement for the P-SIM. Conclusion These results support the validity, reliability and sensitivity to change of the P-SIM in assessing key symptoms (itching, skin pain and scaling) in patients with moderate to severe plaque psoriasis. Trial registration NCT03536884. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-021-01836-1.
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Affiliation(s)
| | - Richard B Warren
- Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester NIHR Biomedical Research Centre, The University of Manchester, Manchester, UK
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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24
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Psoriasis and Atherosclerosis-Skin, Joints, and Cardiovascular Story of Two Plaques in Relation to the Treatment with Biologics. Int J Mol Sci 2021; 22:ijms221910402. [PMID: 34638740 PMCID: PMC8508744 DOI: 10.3390/ijms221910402] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/21/2021] [Accepted: 09/24/2021] [Indexed: 02/06/2023] Open
Abstract
It is known that both psoriasis (PSO) limited to the skin and psoriatic arthritis (PSA) increase the risk of cardiovascular complications and atherosclerosis progression by inducing systemic inflammatory response. In recent decades, the introduction of biological medications directed initially against TNF-α and, later, different targets in the inflammatory cascade brought a significant breakthrough in the efficacy of PSO/PSA treatment. In this review, we present and discuss the most recent findings related to the interplay between the genetics and immunology mechanisms involved in PSO and PSA, atherosclerosis and the development of cardiac dysfunction, as well as the current PSO/PSA treatment in view of cardiovascular safety and prognosis.
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25
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Zeng C, Tsoi LC, Gudjonsson JE. Dysregulated epigenetic modifications in psoriasis. Exp Dermatol 2021; 30:1156-1166. [PMID: 33756010 DOI: 10.1111/exd.14332] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/08/2021] [Accepted: 03/18/2021] [Indexed: 02/06/2023]
Abstract
The observed incidence of psoriasis has been gradually increasing over time (J Am Acad Dermatol, 03, 2009, 394), but the underlying pathogenic factors have remained unclear. Recent studies suggest the importance of epigenetic modification in the pathogenesis of psoriasis. Aberrant epigenetic patterns including changes in DNA methylation, histone modifications and non-coding RNA expression are observed in psoriatic skin. Reversing these epigenetic mechanisms has showed improvement in psoriatic phenotypes, making epigenetic therapy a potential avenue for psoriasis treatment. Here, we summarize relevant evidence for epigenetic dysregulation contributing to psoriasis susceptibility and pathogenesis, and the factors responsible for epigenetic modifications, providing directions for potential future clinical avenues.
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Affiliation(s)
- Chang Zeng
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Lam C Tsoi
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
- Department of Computational Medicine and Bioinformatics and Department of Biostatistics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Johann E Gudjonsson
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
- A. Alfred Taubman Medical Research Institute, Ann Arbor, MI, USA
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26
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Psychometric Validation of the Psoriasis Symptoms and Impacts Measure (P-SIM), a Novel Patient-Reported Outcome Instrument for Patients with Plaque Psoriasis, Using Data from the BE VIVID and BE READY Phase 3 Trials. Dermatol Ther (Heidelb) 2021; 11:1551-1569. [PMID: 34260044 PMCID: PMC8484391 DOI: 10.1007/s13555-021-00570-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 06/16/2021] [Indexed: 11/26/2022] Open
Abstract
Introduction Plaque psoriasis can significantly impact patients’ quality of life. We assessed psychometric properties of the Psoriasis Symptoms and Impacts Measure (P-SIM), developed to capture patients’ experiences of signs, symptoms and impacts of psoriasis. Methods Pooled, blinded, 16-week data from 1002 patients in the BE VIVID and BE READY bimekizumab phase 3 trials were analysed. The suitability of the P-SIM missing score rule (weekly scores considered missing if ≥ 4 daily scores were missing) was assessed. Test–retest reliability was evaluated using intraclass correlation coefficients (ICCs). Convergent validity was assessed between P-SIM and relevant patient-reported outcome (PRO) (Dermatology Life Quality Index [DLQI], DLQI item 1 [skin symptoms], Patient Global Assessment of Psoriasis) and clinician-reported outcome (ClinRO) scores (Psoriasis Area and Severity Index [PASI], Investigator’s Global Assessment [IGA]) at baseline and week 16. Known-groups validity was assessed, comparing P-SIM scores between patient subgroups predefined using PASI/IGA scores. Sensitivity to change over 16 weeks was evaluated; responder definition (RD) thresholds were explored. Results The missing score rule used did not impact P-SIM scores. Test–retest reliability analyses demonstrated excellent score reproducibility (ICC 0.91–0.98). Inter-item correlations at baseline and week 16 were strong (> 0.5), apart from “choice of clothing” with “skin pain” and “burning” at baseline (both 0.49). All P-SIM scores were moderately to strongly correlated with other outcomes, demonstrating convergent validity, apart from ClinROs (PASI, IGA) at baseline that had low variability. P-SIM scores discriminated known groups at week 16, confirming known-groups validity. Changes from baseline to week 16 in P-SIM and other clinically relevant outcomes were strongly correlated (> 0.5; weaker with ClinROs), establishing sensitivity to change. Anchor-based RD analyses determined a four-point P-SIM item score decrease as indicative of marked clinically meaningful improvement. Conclusion P-SIM scores demonstrated good reliability, validity and sensitivity to change. A four-point RD threshold could be used to assess 16-week treatment effects. Trial Registration BE VIVID: NCT03370133; BE READY: NCT03410992. Supplementary Information The online version contains supplementary material available at 10.1007/s13555-021-00570-4.
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27
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Maddock A, Hevey D, D'Alton P, Kirby B. Examining Individual Differences in Wellbeing, Anxiety and Depression in Psoriasis Using a Clinically Modified Buddhist Psychological Model. J Clin Psychol Med Settings 2021; 27:842-858. [PMID: 31802330 DOI: 10.1007/s10880-019-09686-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Psoriasis patients can experience a range of psychosocial difficulties, which can lead to issues with wellbeing, anxiety and depression. Mindfulness-based interventions have positive impacts on these outcomes; however, there is a need to identify the mechanisms of action of such interventions. This study attempts to do so by examining individual differences in psoriasis patients' wellbeing, anxiety and depression using a clinically modified Buddhist psychological model (CBPM). Psoriasis patients (N = 285) and (N = 209) completed measures of each CBPM component at time 1 and 2. SEM analyses found that a direct and mediated effect of CBPM model was a good fit to the participant's data. This study suggests that non-attachment, aversion, acceptance and self-compassion could have a direct effect on the wellbeing, anxiety and depression of psoriasis patients and an indirect effect through reduced worry and rumination. This study provided preliminary evidence for the CBPM as being a useful explanatory framework of psoriasis patients' anxiety, depression and wellbeing.
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Affiliation(s)
- Alan Maddock
- School of Psychology, Trinity College, 49 Tamarisk Way, Kilnamanagh, Dublin 2, Ireland.
| | - David Hevey
- School of Psychology, Trinity College, 49 Tamarisk Way, Kilnamanagh, Dublin 2, Ireland
| | - Paul D'Alton
- St.Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Brian Kirby
- St.Vincent's University Hospital, Elm Park, Dublin 4, Ireland
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28
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Nawaz S, Tapley A, Davey AR, van Driel ML, Fielding A, Holliday EG, Ball J, Patsan I, Berrigan A, Morgan S, Spike NA, FitzGerald K, Magin P. Management of a Chronic Skin Disease in Primary Care: An Analysis of Early-Career General Practitioners' Consultations Involving Psoriasis. Dermatol Pract Concept 2021; 11:e2021055. [PMID: 34123559 DOI: 10.5826/dpc.1103a55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2020] [Indexed: 10/31/2022] Open
Abstract
Background The management of psoriasis by general practitioners (GPs) is vital, given its prevalence, chronicity, and associated physical and psychosocial co-morbidities. However, there is little information on how GPs (including early-career GPs) manage psoriasis. Objectives This study assessed the frequency with which Australian specialist GP vocational trainees ('registrars') provide psoriasis care and the associations of that clinical experience. Methods A cross-sectional analysis was done of data from the ReCEnT study, an ongoing multi-site cohort study of Australian GP registrars' experiences during vocational training. In ReCEnT, 60 consecutive consultations are recorded 3 times (6-monthly) during each registrar's training. The outcome factor for this analysis was a problem/diagnosis being psoriasis, and independent variables were related to registrar, patient, practice and consultation factors. This study analysed 17 rounds of data collection (2010-2017) using univariate and multivariable regression. Results Data from 1,741 registrars regarding 241,888 consultations and 377,980 problems/diagnoses were analysed. Psoriasis comprised 0.15% (n=550) of all problems/diagnoses (95% CI, 0.13-0.16). Significant patient multivariable associations of a problem/diagnosis being psoriasis included age, gender, being new to a practice or a registrar, and psoriasis being an existing problem rather than a new diagnosis. Significant registrar associations included seeking in-consultation information/assistance, not scheduling a follow-up appointment, prescribing medication, and generating learning goals. Conclusions Australian registrars have modest training exposure to psoriasis and may find psoriasis management challenging. Furthermore, continuity of care (essential for optimal chronic disease management) was modest. The findings have implications for GPs' approaches to the management of psoriasis more widely as well for general practice education and training policies.
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Affiliation(s)
- Sameerah Nawaz
- GP Synergy, Regional Training Organisation, Liverpool, NSW, Australia
| | - Amanda Tapley
- The University of Newcastle, School of Medicine and Public Health, Callaghan, NSW, Australia.,GP Synergy, Regional Training Organisation, NSW & ACT Research and Evaluation Unit, Mayfield West, NSW, Australia
| | - Andrew R Davey
- The University of Newcastle, School of Medicine and Public Health, Callaghan, NSW, Australia.,GP Synergy, Regional Training Organisation, NSW & ACT Research and Evaluation Unit, Mayfield West, NSW, Australia
| | - Mieke L van Driel
- The University of Queensland Faculty of Medicine, Primary Care Clinical Unit, Brisbane, QLD, Australia
| | - Alison Fielding
- The University of Newcastle, School of Medicine and Public Health, Callaghan, NSW, Australia.,GP Synergy, Regional Training Organisation, NSW & ACT Research and Evaluation Unit, Mayfield West, NSW, Australia
| | - Elizabeth G Holliday
- The University of Newcastle, School of Medicine and Public Health, Callaghan, NSW, Australia
| | - Jean Ball
- Hunter Medical Research Institute, Clinical Research Design, IT and Statistical Support Unit (CReDITSS), New Lambton, NSW, Australia
| | - Irena Patsan
- The University of Newcastle, School of Medicine and Public Health, Callaghan, NSW, Australia.,GP Synergy, Regional Training Organisation, NSW & ACT Research and Evaluation Unit, Mayfield West, NSW, Australia
| | - Alyse Berrigan
- GP Synergy, Regional Training Organisation, NSW & ACT Research and Evaluation Unit, Mayfield West, NSW, Australia
| | - Simon Morgan
- GP Synergy, Regional Training Organisation, Liverpool, NSW, Australia
| | - Neil A Spike
- Eastern Victoria GP Training, General Practice Training Organisation, Melbourne, Australia.,The University of Melbourne, Department of General Practice, Melbourne, VIC, Australia
| | - Kristen FitzGerald
- University of Tasmania, School of Medicine, Hobart, TAS, Australia.,General Practice Training Tasmania (GPTT), Regional Training Organisation, Hobart, TAS, Australia
| | - Parker Magin
- The University of Newcastle, School of Medicine and Public Health, Callaghan, NSW, Australia.,GP Synergy, Regional Training Organisation, NSW & ACT Research and Evaluation Unit, Mayfield West, NSW, Australia
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Gago-López N, Lagunas Arnal C, Perez JJ, Wagner EF. Topical application of an amygdalin analogue reduces inflammation and keratinocyte proliferation in a psoriasis mouse model. Exp Dermatol 2021; 30:1662-1674. [PMID: 33998705 PMCID: PMC8597152 DOI: 10.1111/exd.14390] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/25/2021] [Accepted: 04/28/2021] [Indexed: 02/06/2023]
Abstract
Psoriasis is a chronic inflammatory skin disease without cure. Systemic and biological therapies are the most effective treatments for patients with severe psoriasis. However, these drugs can cause serious side effects from extended use. Safe and effective topical drugs are needed to decrease psoriatic plaques and reduce the risk of adverse effects. Amygdalin analogues are stable small molecules that showed benefits in psoriasis xenografts to immune‐deficient mice by systemic application. However, whether topical application of these amygdalin analogues could reduce the progression of the psoriatic phenotype in an immune‐competent organism is unknown. Here, we analyse the efficiency of topical application of an amygdalin analogue cream on a well‐established genetic and immune‐competent mouse model of psoriasis. Topical application of an amygdalin analogue cream ameliorates psoriasis‐like disease in mice, reduces epidermal hyperplasia and skin inflammation. Amygdalin analogue treatment leads to reduced expression of local pro‐inflammatory cytokines, but systemic pro‐inflammatory cytokines that are highly expressed in psoriasis patients such as IL‐17A, IL6 or G‐CSF are also decreased. Furthermore, expression of important mediators of psoriasis initiation and epidermal hyperplasia, such as TNFa, S100A9 and TSLP, is decreased in lesional epidermis after amygdalin analogue treatment. In conclusion, we show that amygdalin analogue reduces the proliferative capacity of psoriasis‐like stimulated keratinocytes and their inflammatory response in vivo and in vitro. These results suggest that topical application of amygdalin analogues may represent a safe and effective treatment for psoriasis.
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Affiliation(s)
- Nuria Gago-López
- Genes, Development and Disease group, Cancer Cell Biology Programme, Centro Nacional de Investigaciones Oncológicas (CNIO, Madrid, Spain.,Melanoma group, Molecular Oncology Programme, Centro Nacional de Investigaciones Oncológicas (CNIO, Madrid, Spain
| | - Carmen Lagunas Arnal
- Ferrer Advanced Biotherapeutics, Grupo Ferrer Internacional S.A, Barcelona, Spain
| | - Juan J Perez
- Department of Chemical Engineering, Universitat Politecnica de Catalunya, Barcelona, Spain
| | - Erwin F Wagner
- Department of Dermatology and Department of Laboratory Medicine, Medical University of Vienna (MUW, Vienna, Austria
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Lambert J, Hansen JB, Sohrt A, Puig L. Dermatology Life Quality Index in Patients with Moderate-to-Severe Plaque Psoriasis Treated with Brodalumab or Ustekinumab. Dermatol Ther (Heidelb) 2021; 11:1265-1275. [PMID: 33988818 PMCID: PMC8322208 DOI: 10.1007/s13555-021-00545-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/29/2021] [Indexed: 12/01/2022] Open
Abstract
Introduction Targeted biological therapies for psoriasis have resulted in significant benefits, with therapeutic goals such as clear or almost clear skin accompanied by improvements in health-related quality of life (HRQoL). The objective of this study was to compare the effects of 52 weeks of treatment with brodalumab or ustekinumab on HRQoL in patients with moderate-to-severe plaque psoriasis. Methods Data were pooled from two randomised controlled phase 3 trials (AMAGINE-2 and -3) which included patients with moderate-to-severe plaque psoriasis treated with brodalumab 210 mg or ustekinumab 45 or 90 mg for 52 weeks. HRQoL outcomes were measured using the Dermatology Life Quality Index (DLQI) as well as the DLQI-Relevant (DLQI-R) version which excludes ‘not relevant’ responses. Results A total of 929 patients were included, 339 in the brodalumab group and 590 in the ustekinumab group. A significantly greater reduction (improvement) in DLQI score from baseline was observed in the brodalumab group compared with the ustekinumab group at weeks 4 [least-squares (LS) mean difference − 2.9, 95% confidence interval [CI] − 3.6 to − 2.2; p < 0.001), 12 (LS mean difference − 0.85, 95% CI − 1.5 to − 0.2; p = 0.01) and 52 (LS mean difference − 0.94, 95% CI − 1.6 to − 0.2; p = 0.009)]. Significantly greater proportions of patients treated with brodalumab achieved a DLQI score of 0 at weeks 4 (15.0 vs. 5.4%; p < 0.0001), 12 (37.5 vs. 28.0%; p = 0.0140) and 52 (46.3 vs. 30.3%; p < 0.0001), or of ≤ 1 [DLQI (0/1): 33.9 vs. 15.4%, 59.9 vs. 45.6% and 54.9 vs. 39.8%, respectively; all p < 0.0001]. Similar results were observed using the DLQI-R scoring system. Significantly more patients achieved a ≥ 4 or ≥ 5 improvement in DLQI with brodalumab compared to ustekinumab at weeks 4 and 52. Treatment with brodalumab was associated with significantly more patients achieving a DLQI of 0 compared to ustekinumab for all domains after 4 and 52 weeks. Conclusion Brodalumab was associated with a significantly greater improvement in HRQoL compared to ustekinumab in patients with moderate-to-severe psoriasis.
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Affiliation(s)
- Jo Lambert
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
| | | | | | - Luis Puig
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau-Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
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Blauvelt A, Gordon KB, Lee P, Bagel J, Sofen H, Lockshin B, Soliman AM, Geng Z, Zhan T, Alperovich G, Stein Gold L. Efficacy, safety, usability, and acceptability of risankizumab 150 mg formulation administered by prefilled syringe or by an autoinjector for moderate to severe plaque psoriasis. J DERMATOL TREAT 2021; 33:2085-2093. [PMID: 33947295 DOI: 10.1080/09546634.2021.1914812] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Risankizumab is approved for treatment of moderate to severe plaque psoriasis. Availability of a patient-controlled single self-injection of risankizumab may improve adherence and long-term management of psoriasis. OBJECTIVE To investigate efficacy, safety, and usability of a new risankizumab 150 mg/mL formulation administered as a single subcutaneous injection via prefilled syringe (PFS) or autoinjector (AI). METHODS Efficacy, safety, usability, and acceptability of risankizumab 150 mg/mL PFS or AI were investigated in adults with moderate to severe psoriasis in two phase 3 studies. Study 1 was a multicenter, randomized, double-blinded, placebo-controlled study that investigated 150 mg/mL risankizumab PFS; study 2 was a multicenter, single-arm, open-label study that investigated 150 mg/mL risankizumab AI. RESULTS At week 16, risankizumab 150 mg/mL demonstrated efficacy vs. placebo (Psoriasis Area and Severity Index ≥90% improvement (PASI 90), 62.9% vs. 3.8%; static Physician Global Assessment (sPGA) 0/1, 78.1% vs. 9.6%; both p< .001) in study 1; in study 2, PASI 90 and sPGA 0/1 were 66.7%, and 81.5%, respectively. All patients successfully self-administered study treatments via PFS or AI. Acceptability of self-injection was high in both studies. Efficacy and safety of risankizumab 150 mg/mL were comparable with results from previous risankizumab phase 3 studies using the 90 mg/mL formulation. CONCLUSIONS The efficacy, safety, and usability of 150 mg/mL risankizumab delivered as a single PFS or AI injection support use of this new formulation in patients with moderate to severe plaque psoriasis. CLINICAL TRIALS NCT03875482 and NCT0387508.
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Affiliation(s)
| | - Kenneth B Gordon
- Department of Dermatology, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Jerry Bagel
- Psoriasis Treatment Center of Central New Jersey, East Windsor, NJ, USA
| | - Howard Sofen
- Department of Medicine/Dermatology, UCLA School of Medicine, Los Angeles, CA, USA
| | - Benjamin Lockshin
- DermAssociates, Silver Spring, MD, USA.,Department of Dermatology, Georgetown University, Washington, DC, USA.,Department of Dermatology, Johns Hopkins University, Baltimore, MD, USA
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Yazdanpanah MJ, Vahabi-Amlashi S, Pishgouy M, Imani M, Banihashemi M, Mohammadpoor AH, Khajedaluee M, Bahrami-Taghanaki H, Azizi H. Comparing the topical preparations of Indigo naturalis from Chinese and Iranian origin in the treatment of plaque-type psoriasis: A preliminary randomized double-blind pilot study. Eur J Integr Med 2021. [DOI: 10.1016/j.eujim.2021.101310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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33
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Mahe E, Moumane SH, Foist M. Topical medications for chronic plaque psoriasis: A 3-year longitudinal study in France. Dermatol Ther 2021; 34:e14781. [PMID: 33455063 DOI: 10.1111/dth.14781] [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: 09/28/2020] [Revised: 11/24/2020] [Accepted: 12/21/2020] [Indexed: 11/28/2022]
Abstract
Topical treatments are first-line therapies, prescribed to most patients with chronic plaque psoriasis. This non-interventional, longitudinal study examined data regarding the treatment pathways of French patients with psoriasis vulgaris using a pharmacy database. From this database, patients with an initial prescription of a topical treatment of interest (ie, calcipotriol alone and/or calcipotriol/betamethasone) between March and October 2013 were included in the study. The primary objective was to capture the switch from a topical treatment, from treatment initiation to receipt of a systemic therapy over a period of 3 years. A total of 26 605 patients were included in the study. The mean age was 58.5 years. The majority of patients (94.7%) maintained topical treatment during the 3 years, receiving a mean of 1.1 different therapies. Of 1400 patients who switched to a systemic therapy, 93.1% switched to a non-biological (mean time to switching >400 days), maintaining this for the remainder of the follow-up period. The most commonly prescribed first non-biological systemic therapy was methotrexate (37%). Less than 1% of patients switched to a biological therapy during follow up. Cohort analyses suggest that patients progressing to use of a systemic therapy within 12 months were those with more severe disease. There was a low rate of transition from topical to systemic therapies in patients with chronic plaque psoriasis during the first 3 years of treatment, suggesting stability of disease severity over time with topical therapy alone, potentially due to good patient adherence.
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Affiliation(s)
- Emmanuel Mahe
- Department of Dermatology, Victor Dupouy Hospital, Paris, France
| | | | - Murielle Foist
- Medical Department, LEO Pharma, Voisins-Le-Bretonneux, France
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34
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Bruins FM, Bronckers IMGJ, Groenewoud HMM, van de Kerkhof PCM, de Jong EMGJ, Seyger MMB. Association Between Quality of Life and Improvement in Psoriasis Severity and Extent in Pediatric Patients. JAMA Dermatol 2020; 156:72-78. [PMID: 31774449 DOI: 10.1001/jamadermatol.2019.3717] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Treatment of psoriasis is associated with improved quality of life (QOL) in those with the disease. However, in daily clinical practice, the association between the degree of psoriasis clearance and QOL has not been studied to date, especially in the pediatric population. Objectives To identify the association between the degree of psoriasis improvement (as measured by the Psoriasis Area Severity Index [PASI] and body surface area [BSA] response) and QOL (as measured by the Children's Dermatology Life Quality Index [CDLQI]) in pediatric psoriasis, and to assess the association of treatment type with QOL, independent of psoriasis improvement. Design, Setting, and Participants Data used in this single-center cohort study were extracted from the Child-CAPTURE (Continuous Assessment of Psoriasis Treatment Use Registry), a prospective, observational, daily clinical practice cohort of all children (aged <18 years) with a psoriasis diagnosis who attended the outpatient clinic of the Department of Dermatology at the Radboud University Medical Center in Nijmegen, the Netherlands, between September 3, 2008, and May 4, 2018. All records of treatment episodes with CDLQI, PASI, and BSA scores were included in the analysis. Exposures Patients were treated according to daily clinical care. Treatments were clustered into topical, dithranol, conventional systemic, and biological treatments. Because of low numbers of UV-B phototherapy, this treatment was not assessed. Main Outcomes and Measures Primary outcomes were mean change of CDLQI scores per PASI and BSA response categories (0 to <50, 50 to <75, 75 to <90, and ≥90) and mean CDLQI change per treatment categories. Results In total, 319 patients (median [interquartile range] age, 10.0 [7.0] years; 183 female [57.4%]) were analyzed for PASI score improvement (399 treatment episodes) and improvement in BSA involvement (366 treatment episodes). The greatest improvements in CDLQI scores were seen in the PASI ≥90 response category, with an estimated marginal mean change in CDLQI score of -6.6 (95% CI, -7.5 to -5.7). The greatest improvements in CDLQI scores were also observed in the BSA ≥90 response category, with an estimated marginal mean change in CDLQI score of -6.8 (95% CI, -7.5 to -6.1). Systemic treatment demonstrated a greater degree of improvement of CDLQI compared with topical treatment, independent of PASI response categories. Conclusions and Relevance This cohort study in a real-world setting found that the greatest improvements in QOL were associated with PASI 90 or greater, a decrease in BSA involvement of 90% or greater, and systemic treatments. These findings suggest that reaching PASI 90 or greater and decreasing BSA involvement by at least 90% may be clinically meaningful treatment goals that will help pediatric patients with psoriasis reach optimal QOL.
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Affiliation(s)
- Finola M Bruins
- Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Inge M G J Bronckers
- Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Hans M M Groenewoud
- Department for Health Evidence, Radboud University, Nijmegen, the Netherlands
| | | | - Elke M G J de Jong
- Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marieke M B Seyger
- Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands
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35
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Iani L, Quinto RM, Porcelli P, Angeramo AR, Schiralli A, Abeni D. Positive Psychological Factors Are Associated With Better Spiritual Well-Being and Lower Distress in Individuals With Skin Diseases. Front Psychol 2020; 11:552764. [PMID: 33123038 PMCID: PMC7573544 DOI: 10.3389/fpsyg.2020.552764] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 09/11/2020] [Indexed: 12/30/2022] Open
Abstract
In this study we examined whether aspects of positive functioning [reappraisal, sense of coherence (SOC), and positivity] were associated with spiritual well-being and psychological distress after controlling for negative functioning (skin-related symptoms, type of disease, and expressive suppression) in individuals with skin diseases. We also examined whether negative functioning aspects were linked to spiritual well-being and distress when controlling for aspects of positive functioning. The study used a cross-sectional design with a sample of 192 individuals with psoriasis and systemic sclerosis (SSc) (M age = 51.6 years, SD = 16.5). Two hierarchical multiple regressions were conducted to determine whether spiritual well-being and psychological distress were accounted for by skin-related symptoms, type of disease, emotion regulation strategies, SOC, and positivity. Positivity was the most important contributor to better spiritual well-being, followed by both the comprehensibility/manageability and meaningfulness SOC subscales, after controlling for the other variables. High skin-related symptoms and expressive suppression were associated with lower psychological distress, whereas high SOC and reappraisal correlated with higher psychological distress. The findings of this study pave the way for further research on how SOC and positivity may reduce the effects of both skin-related symptoms and emotion dysregulation and facilitate spiritual well-being of individuals with skin diseases. Interventions aimed to enhance inner resources of these individuals and help them to find a meaning in their experience of skin disease might reduce psychological distress and improve spiritual well-being. Our findings suggest that healthcare professionals should consider positive functioning aspects in future interventions for individuals with skin diseases.
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Affiliation(s)
- Luca Iani
- Department of Human Sciences, European University of Rome, Rome, Italy
| | | | - Piero Porcelli
- Department of Psychological, Health and Territorial Sciences, University of “G. d’Annunzio” Chieti–Pescara, Chieti, Italy
| | | | - Andrea Schiralli
- Department of Human Sciences, European University of Rome, Rome, Italy
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36
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Augustin M, Dauden E, Mrowietz U, Konstantinou M, Gerdes S, Kingo K, Szepietowski J, Perrot J, Cuccia A, Rissler M, Gathmann S, Sieder C, Orsenigo R, Jagiello P, Bachhuber T. Secukinumab treatment leads to normalization of quality of life and disease symptoms in psoriasis patients with or without prior systemic psoriasis therapy: the PROSE study results. J Eur Acad Dermatol Venereol 2020; 35:431-440. [DOI: 10.1111/jdv.16632] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 05/05/2020] [Indexed: 12/19/2022]
Affiliation(s)
- M. Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Centre Hamburg‐Eppendorf Hamburg Germany
| | - E. Dauden
- Department of Dermatology Hospital Universitario de la Princesa Madrid Spain
| | - U. Mrowietz
- Psoriasis‐Center Department of Dermatology University Medical Center Schleswig‐Holstein, Campus Kiel Kiel Germany
| | | | - S. Gerdes
- Psoriasis‐Center Department of Dermatology University Medical Center Schleswig‐Holstein, Campus Kiel Kiel Germany
| | - K. Kingo
- Dermatology Clinic, Tartu University Hospital Department of Dermatology, University of Tartu Tartu Estonia
| | - J.C. Szepietowski
- Department of Dermatology, Venereology and Allergology Wroclaw Medical University Wroclaw Poland
| | - J.L. Perrot
- Department of Dermatology Venereology and Allergology Jacques Lisfranc University Saint‐Etienne France
| | - A. Cuccia
- Unit of Dermatology San Donato Hospital Arezzo Italy
| | | | | | - C. Sieder
- Novartis Pharma GmbH Nuernberg Germany
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37
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Augustin M, Dauden E, Mrowietz U, Konstantinou M, Gerdes S, Rissler M, Gathmann S, Sieder C, Baeumer D, Orsenigo R. Baseline characteristics of patients with moderate‐to‐severe psoriasis according to previous systemic treatment exposure: the PROSE study population. J Eur Acad Dermatol Venereol 2020; 34:2548-2556. [DOI: 10.1111/jdv.16400] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 03/10/2020] [Indexed: 12/18/2022]
Affiliation(s)
- M. Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - E. Dauden
- Department of Dermatology Instituto de Investigación Sanitaria la Princesa (IIS‐IP)Hospital Universitario la Princesa Madrid Spain
| | - U. Mrowietz
- Department of Dermatology Psoriasis‐Center University Medical Center Schleswig‐Holstein Kiel Germany
| | | | - S. Gerdes
- Department of Dermatology Psoriasis‐Center University Medical Center Schleswig‐Holstein Kiel Germany
| | | | | | - C. Sieder
- Novartis Pharma AG Basel Switzerland
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38
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Halioua B, Maccari F, Fougerousse AC, Parier J, Reguiai Z, Taieb C, Esteve E. Impact of patient psoriasis on partner quality of life, sexuality and empathy feelings: a study in 183 couples. J Eur Acad Dermatol Venereol 2020; 34:2044-2050. [PMID: 32173921 DOI: 10.1111/jdv.16270] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 01/13/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND The impact of psoriasis on quality of life (QoL), sexuality and empathy requires better understanding in patient-partner relationships. OBJECTIVES To evaluate the influence of psoriasis on partner QoL, presence of sexual dysfunction (SDy) in couples and empathy in partners of psoriasis patients. METHODS A total of 183 adult psoriasis patients and their partners participated in this observational, cross-sectional and non-comparative study. Severity of psoriasis was measured using the Psoriasis Area and Severity Index. Patient QoL was assessed using the Dermatology Life Quality Index and the Short Form-12 (SF12). The impact of psoriasis on partner QoL was measured with the Family Pso and the SF12. Presence of SDy and empathy in partners were assessed using the Family Pso. RESULTS Overall, 49.7% of the patients had moderate-to-severe psoriasis. Patient psoriasis severity and patient QoL were correlated with partner psychological distress. The largest QoL impairment was observed in female patients with moderate-to-severe psoriasis. The stronger QoL alteration observed in female psoriasis patients, compared to their partners, was not observed in male psoriasis patients vs. their partners. There was no relationship between partner QoL and patient age and duration of psoriasis. Most patients, but less than half of the partners, reported SDy with age being a being a significantly more important impacting factor than disease severity. Both psoriasis clinical severity and/or a significant impact on QoL were associated factors for SDy in male partners of psoriasis women, but not in female partners of psoriatic men. Reporting empathy was higher among young male partners of psoriasis patients. In both male and female partners, patient psoriasis clinical severity was not associated with empathy. CONCLUSIONS Psoriasis impact on patient-partner QoL, sexuality and empathy should be considered more thoroughly by dermatologists when formulating treatment plans and making treatment decisions.
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Affiliation(s)
- B Halioua
- GEM Resopso, Dermatology Center, Paris, France
| | - F Maccari
- Service de Dermatologie, Hopital d'Instruction des Armees Begin, Saint-Maur-des-Fossés, France
| | | | - J Parier
- Private Practice, Saint-Maur-des-Fossés, France
| | | | - C Taieb
- Necker Enfants Malades Hospital, Paris, France
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Gao L, Dou J, Zhang B, Zeng J, Cheng Q, Lei L, Tan L, Zeng Q, Ding S, Guo A, Cheng H, Yang C, Luo Z, Lu J. Ozone therapy promotes the differentiation of basal keratinocytes via increasing Tp63-mediated transcription of KRT10 to improve psoriasis. J Cell Mol Med 2020; 24:4819-4829. [PMID: 32168425 PMCID: PMC7176851 DOI: 10.1111/jcmm.15160] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 02/20/2020] [Accepted: 02/25/2020] [Indexed: 12/16/2022] Open
Abstract
Psoriasis is a chronic immune‐mediated inflammatory dermatosis. Recently, ozone therapy has been applicated to psoriasis treatment; however, the mechanism by which ozone therapy improves psoriasis remains unclear. The excessive proliferation and the differentiation of basal keratinocytes have been considered critical issues during pathological psoriasis process, in which keratin 6 (KRT6) and KRT10 might be involved. In the present study, KRT6, IL‐17 and IL‐22 protein within psoriasis lesions was decreased, while KRT10 and Tp63 protein in psoriasis lesions was increased by ozone treatment in both patient and IMQ mice psoriatic tissues. In the meantime, ozone treatment down‐regulated KRT6 mRNA and protein expression while up‐regulated KRT10 mRNA and protein expression within IL‐22 treated primary KCs; the cell viability of KCs was suppressed by ozone treatment. Moreover, Tp63 bound to KRT10 promoter region to activate its transcription in basal keratinocytes; the promotive effects of ozone on Tp63 and KRT10 were significantly reversed by Tp63 silence. Both TP63 and KRT10 mRNA expression were significantly increased by ozone treatment in psoriasis lesions; there was a positive correlation between Tp63 and KRT10 expression within tissue samples, suggesting that ozone induces the expression of Tp63 to enhance the expression of KRT10 and the differentiation of keratinocytes, therefore improving the psoriasis. In conclusion, the application of ozonated oil could be an efficient and safe treatment for psoriasis; ozone promotes the differentiation of keratinocytes via increasing Tp63‐mediated transcription of KRT10, therefore improving psoriasis.
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Affiliation(s)
- Lihua Gao
- Department of Physiology, College of Basic Medicine, Central South University, Changsha, China.,Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jianhua Dou
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Bo Zhang
- Department of Stomatology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jinrong Zeng
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Qingmei Cheng
- Department of Physiology, College of Basic Medicine, Central South University, Changsha, China
| | - Li Lei
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Lina Tan
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Qinghai Zeng
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Shu Ding
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Aiyuan Guo
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Haipeng Cheng
- Department of Physiology, College of Basic Medicine, Central South University, Changsha, China
| | - Caifeng Yang
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Ziqiang Luo
- Department of Physiology, College of Basic Medicine, Central South University, Changsha, China
| | - Jianyun Lu
- Department of Dermatology, The Third Xiangya Hospital, Central South University, Changsha, China
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Gerdes S, Velasco M, Wu JJ, Hubo M, Veverka KA. Calcipotriol/betamethasone dipropionate aerosol foam for the treatment of psoriasis vulgaris: a review of real-world evidence (RWE). J DERMATOL TREAT 2020; 32:883-893. [PMID: 31986945 DOI: 10.1080/09546634.2020.1717417] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background: Randomized controlled trials (RCTs) demonstrated the advantages of an aerosol foam formulation of calcipotriol/betamethasone dipropionate (Cal/BD) in patients with psoriasis. In this review, we investigated whether such benefits could also be obtained in real-world clinical practice.Methods: PubMed was searched for studies reporting real-world data in patients with psoriasis treated with Cal/BD aerosol foam.Results: Three large real-world studies with Cal/BD aerosol foam were identified: a prospective non-interventional study from Germany, a medical chart review from the US, and a retrospective non-interventional study from Spain. Some key findings included the following: high levels of adherence to treatment (82-93%); after 4 weeks, about 50% of patients achieved complete/almost complete responses; at final assessment, 85-95% of patients were extremely satisfied/very satisfied/satisfied with Cal/BD aerosol foam; all healthcare providers were satisfied or somewhat satisfied with the efficacy of Cal/BD foam and they reported similar findings for symptom improvements (itch, pain, erythema/redness, flaking, and plaque thickness). Global ratings by investigators/healthcare providers for symptom control, overall efficacy and the emotional status of patients were also very high (75-100%).Conclusion: The results from real-world studies undertaken in diverse healthcare systems reinforce the positive findings reported in RCTs with Cal/BD aerosol foam in patients with psoriasis.
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Affiliation(s)
- Sascha Gerdes
- Psoriasis Center, Department of Dermatology, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | | | - Jashin J Wu
- Dermatology Research and Education Foundation, Irvine, CA, USA
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Reich K, Warren R, Coates L, Di Comite G. Long‐term efficacy and safety of secukinumab in the treatment of the multiple manifestations of psoriatic disease. J Eur Acad Dermatol Venereol 2020; 34:1161-1173. [DOI: 10.1111/jdv.16124] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Accepted: 11/19/2019] [Indexed: 12/12/2022]
Affiliation(s)
- K. Reich
- Translational Research in Inflammatory Skin Diseases Institute for Health Services Research in Dermatology and Nursing University Medical Center Hamburg‐Eppendorf Hamburg Germany
- Skinflammation® Center Hamburg Germany
- Dermatologikum Berlin Berlin Germany
| | - R.B. Warren
- Dermatology Centre Salford Royal NHS Foundation Trust Manchester NIHR Biomedical Research Centre Manchester Academic Health Science Centre The University of Manchester Manchester UK
| | - L.C. Coates
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford Oxford UK
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Galimberti ML, Vacas AS, Hernández BA, Bollea Garlatti ML, Cura MJ, Galimberti RL. Medical resource consumption of moderate/severe psoriasis in a private health organization of Buenos Aires, Argentina. An Bras Dermatol 2019; 95:20-24. [PMID: 31899062 PMCID: PMC7058848 DOI: 10.1016/j.abd.2019.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 04/19/2019] [Indexed: 11/25/2022] Open
Abstract
Background Despite the economic burden of psoriasis for patients and societies, scant information exists regarding the impact and burden of the disease in Argentina. Objective The objective of this study was to estimate medical resource consumption and direct health care costs for patients with moderate/severe psoriasis in Buenos Aires, Argentina from the perspective of the payer. Methods Adults with moderate/severe psoriasis (severity was defined as receiving systemic treatment), during January 2010–January 2014, aged 18 years and older, members of the Italian Hospital Medical Care Program with at least 18 months of follow-up were included. All data on hospitalizations, drug prescription, outpatient episodes, consultations, and investigations/tests in the 12 months before inclusion in the study were considered for the estimation of medical resource consumption and direct health care costs. First-quarter 2018 costs were obtained from the IHMCP and converted into US dollars (using the January 2018 exchange rate). Results A total of 791 patients were included. The mean age at diagnosis was 34 ± 12 years. Almost 65% of the patients had a dermatologist as their usual source of care, 43% had internists, and 14% had rheumatologists. The average yearly direct cost was US$ 5326 (95% CI: 4125–7896) per patient per year. Study limitation The single center design and the retrospective nature are the main limitations. Conclusion This is the first Argentine study that evaluated the costs of moderate/severe psoriasis by taking into consideration the direct medical costs of the disease.
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Affiliation(s)
| | - Aldana S Vacas
- Dermatology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Barbara A Hernández
- Dermatology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - María J Cura
- Dermatology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Ricardo L Galimberti
- Dermatology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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Caroppo F, Zacchino M, Milazzo E, Fontana E, Nobile F, Marogna C, Ventura L, Belloni Fortina A. Quality of life in children with psoriasis: results from a monocentric study. Ital J Dermatol Venerol 2019; 156:374-377. [PMID: 31797650 DOI: 10.23736/s2784-8671.19.06368-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Psoriasis is a chronic inflammatory disease that can impair quality of life and psychological status not only in adult patients, but also in children. Few data about quality of life in children with psoriasis are available in literature. The aim of this study was to investigate the impact on the quality of life in children with psoriasis and the relationship with severity, localization, age at onset, duration and family history of psoriasis. METHODS Health-related quality of life was assessed in 110 children and adolescents with psoriasis using a validated Italian version of the Children's Dermatology Life Quality Index. Clinical and anamnestic data were collected in all patients. RESULTS The mean value of Children's Dermatology Life Quality Index was 4.20±3.73. Multivariate analysis showed a statistically significant correlation of the Children's Dermatology Life Quality Index with the severity of psoriasis (P<0.001) and with the presence of psoriasis in visible areas (P<0.001) independently from the severity. CONCLUSIONS Psoriasis has a remarkable social and psychological impact on life, also in children. Quality of life should be assessed in children with psoriasis also when psoriasis is mild but localized in visible areas.
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Affiliation(s)
- Francesca Caroppo
- Unit of Pediatric Dermatology, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Matteo Zacchino
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padua, Italy
| | | | - Elena Fontana
- Unit of Pediatric Dermatology, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Francesca Nobile
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padua, Italy
| | - Cristina Marogna
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padua, Italy
| | - Laura Ventura
- Department of Statistics, University of Padua, Padua, Italy
| | - Anna Belloni Fortina
- Unit of Pediatric Dermatology, Department of Medicine (DIMED), University of Padua, Padua, Italy -
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Termeer C, Reinhold U, Dirschka T, von Kiedrowski R, Kurzen H. Long-term use of fumaric acid esters for the treatment of psoriasis in daily practice. J DERMATOL TREAT 2019; 32:610-616. [PMID: 31682772 DOI: 10.1080/09546634.2019.1688234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Fumaric acid ester (FAE) is the most commonly prescribed first-line systemic therapy for the treatment of psoriasis in Germany. Although developed in the 1990s, only limited long-term data are available. METHODS Data of 200 adult psoriatic patients from 10 study centers were collected in a noninterventional, multicenter, retrospective analysis. The inclusion criteria was treatment with FAE in 2015. RESULTS Eighty-two percent of the patients were naive to systemic treatment. Ten percent of all patients had FAE-treatment for 10 years or longer with an average drug survival of 4.32 years. The maintenance dose was ranging from 1-4 120 mg tablets for 87.5% of the patients. In our population, 14% of the patients stopped therapy during the first six month mainly due to gastro-intestinal side effects. No serious side effects were reported. Seventy-eight percent of the patients responded to FAE therapy with improvement of their psoriasis to mild (61%) or clear (17%). The PASI 75 response was achieved in 44% of the patient during long-term treatment without remarkable differences between moderate or severe plaque psoriasis. CONCLUSION Our study confirms FAE therapy as a long-term, first-line treatment for moderate-to-severe plaque psoriasis.
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Affiliation(s)
- Christian Termeer
- Dermatology Practice, Stuttgart and Department of Dermatology, University of Freiburg, Freiburg, Germany
| | - Uwe Reinhold
- Department of Dermatology, Medical Center Bonn Friedensplatz, Bonn, Germany
| | - Thomas Dirschka
- CentroDerm Clinic Wuppertal, Germany and Faculty of Health, University Witten-Herdecke, Witten, Germany
| | | | - Hjalmar Kurzen
- Dermatology Practice, Freising and Department of Dermatology, Venereology and Allergy, University Medical Center Mannheim, Ruprecht-Karls University of Heidelberg, Mannheim, Germany
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Psoriasis in family members of patients with multiple sclerosis. Mult Scler Relat Disord 2019; 36:101421. [PMID: 31610402 DOI: 10.1016/j.msard.2019.101421] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 09/28/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND It has been noted both anecdotally and in a selection of studies that the incidence of multiple sclerosis (MS) and psoriasis may be related, however the nature of that association is unclear. Clustering among families of multiple autoimmune diseases may be linked to genetic factors. Whether family members of those with MS are at increased risk of psoriasis is not well established. METHODS A systematic review and meta-analysis was performed according to recommended PRISMA guidelines. Data from studies assessing the proportion or effect size of psoriasis cases reported for families or relatives of MS cases versus families or relatives of control cases without MS were extracted and meta-analysed. RESULTS From a pooled unadjusted meta-analysis of 5 studies that met criteria, we found that family members of MS patients were at increased risk of psoriasis (OR 1.45 95% CI 1.07, 1.97). CONCLUSION Family members of those with MS may be at greater risk of developing psoriasis.
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Sampogna F, Mastroeni S, Pallotta S, Fusari R, Uras C, Napolitano M, Abeni D. Use of the SF‐12 questionnaire to assess physical and mental health status in patients with psoriasis. J Dermatol 2019; 46:1153-1159. [DOI: 10.1111/1346-8138.15074] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 08/12/2019] [Indexed: 11/29/2022]
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Association of Multiple Sclerosis with Psoriasis: A Systematic Review and Meta-Analysis of Observational Studies. Am J Clin Dermatol 2019; 20:201-208. [PMID: 30361954 DOI: 10.1007/s40257-018-0399-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Previous studies have reported the occurrence of psoriasis together with multiple sclerosis (MS). Although similar predisposing genes and pathomechanisms have been hypothesized, the relationship between the two remains obscure. OBJECTIVE The aim of this systematic review and meta-analysis was to investigate the association between psoriasis and MS. METHODS We searched MEDLINE, Embase, and CENTRAL in July 2018 for case-control, cross-sectional, or cohort studies that examined either the odds or risk of psoriasis in subjects with multiple sclerosis. The risk of bias of included studies was assessed using the Newcastle-Ottawa Scale. A random-effects model meta-analysis was used to calculate the odds ratio (OR) for case-control/cross-sectional studies and hazard ratio (HR) for cohort studies. RESULTS We included 10 publications that reported a total of 11 studies (5 case-control, 4 cross-sectional and 2 cohort studies). The case-control and cross-sectional studies included 18,456 MS patients and 870,149 controls, while the two cohort studies involved 25,187 MS patients and 227,225 controls in total. Three studies were rated with a high risk of bias in comparability, non-response rate, and selection of controls. MS was associated with increased odds (OR 1.29; 95% confidence interval [CI] 1.14-1.45) and risk for psoriasis (HR 1.92; 95% CI 1.32-2.80). CONCLUSION Patients with MS display both increased prevalence and incidence of psoriasis.
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Wu JJ, Veverka KA, Lu M, Armstrong AW. Real-world experience of calcipotriene and betamethasone dipropionate foam 0.005%/0.064% in the treatment of adults with psoriasis in the United States. J DERMATOL TREAT 2019; 30:454-460. [DOI: 10.1080/09546634.2018.1535689] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Jashin J. Wu
- Dermatology Research and Education Foundation, Irvine, CA, USA
| | | | - Minyi Lu
- LEO Pharma Inc., Madison, NJ, USA
| | - April W. Armstrong
- Keck School of Medicine at USC, University of Southern California, Los Angeles, CA, USA
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Lai R, Xian D, Xiong X, Yang L, Song J, Zhong J. Proanthocyanidins: novel treatment for psoriasis that reduces oxidative stress and modulates Th17 and Treg cells. Redox Rep 2018; 23:130-135. [PMID: 29630472 PMCID: PMC6748681 DOI: 10.1080/13510002.2018.1462027] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Psoriasis is a common, chronic, inflammatory skin disease that affects 2%-4% of the global population. Recent studies have shown that increased oxidative stress (OS) and T-cell abnormalities are central to the pathogenesis of this disease. The resulting reactive oxygen species (ROS) induces proliferation and differentiation of Th17/Th1/Th22 cells and inhibits the anti-inflammatory activities of regulatory T lymphocytes (Treg). Subsequent secretions of inflammatory cytokines, such as interleukin (IL)-17, IL-22, tumor necrosis factor alpha (TNF-α), and interferon-gamma (IFN-γ), and vascular endothelial growth factor (VEGF), stimulate keratinocyte proliferation and angiogenesis. Proanthocyanidins are a class of flavonoids from plants and fruits, and have various antioxidant, anti-inflammatory, and anti-angiogenic properties. Numerous reports have demonstrated therapeutic effects of proanthocyanidins for various diseases. Among clinical activities, proanthocyanidins suppress cell proliferation, prevent OS, and regulate Th17/Treg cells. Because the pathogenesis of psoriasis involves OS and T cells dysregulation, we reviewed the effects of proanthocyanidins on OS, Th17 and Treg cell activities, and keratinocyte proliferation and angiogenesis. Data from multiple previous studies warrant consideration of proanthocyanidins as a promising strategy for the treatment of psoriasis.
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Affiliation(s)
- Rui Lai
- Department of Dermatology, the Affiliated
Hospital of Southwest Medical University, Luzhou,
People's Republic of China
| | - Dehai Xian
- Department of Anatomy, Southwest Medical
University, Luzhou, People's Republic of
China
| | - Xia Xiong
- Department of Dermatology, the Affiliated
Hospital of Southwest Medical University, Luzhou,
People's Republic of China
| | - Lingyu Yang
- Department of Dermatology, the Affiliated
Hospital of Southwest Medical University, Luzhou,
People's Republic of China
| | - Jing Song
- Department of Dermatology, the Affiliated
Hospital of Southwest Medical University, Luzhou,
People's Republic of China
| | - Jianqiao Zhong
- Department of Dermatology, the Affiliated
Hospital of Southwest Medical University, Luzhou,
People's Republic of China
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Hu S, Lin C, Tu H. Association between psoriasis, psoriatic arthritis and gout: a nationwide population‐based study. J Eur Acad Dermatol Venereol 2018; 33:560-567. [DOI: 10.1111/jdv.15290] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 09/27/2018] [Indexed: 02/06/2023]
Affiliation(s)
- S.C.‐S. Hu
- Department of Dermatology College of Medicine Kaohsiung Medical University Kaohsiung Taiwan
- Department of Dermatology Kaohsiung Medical University Hospital Kaohsiung Taiwan
- Department of Medical Research Kaohsiung Medical University Hospital Kaohsiung Taiwan
- Translational Research Center Kaohsiung Medical University Hospital Kaohsiung Medical University Kaohsiung Taiwan
| | - C.‐L. Lin
- Department of Dermatology Kaohsiung Medical University Hospital Kaohsiung Taiwan
- Department of Dermatology Kaohsiung Municipal Hsiao‐Kang Hospital Kaohsiung Taiwan
| | - H.‐P. Tu
- Department of Public Health and Environmental Medicine School of Medicine College of Medicine Kaohsiung Medical University Kaohsiung Taiwan
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