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Narbutt J, Jakubczak Z, Wasiewicz-Ciach P, Wojtania J, Krupa K, Sobolewska-Sztychny D, Ciążyńska M, Kołt-Kamińska M, Reich A, Skibińska M, Lesiak A. Effectiveness and Safety of Etanercept in Paediatric Patients with Plaque-Type Psoriasis: Real-World Evidence. J Clin Med 2024; 13:4858. [PMID: 39201000 PMCID: PMC11355138 DOI: 10.3390/jcm13164858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Revised: 08/07/2024] [Accepted: 08/15/2024] [Indexed: 09/02/2024] Open
Abstract
Background: Psoriasis is a chronic, multisystemic, inflammatory disease affecting approximately 1% of children and significantly reducing their health-related quality of life. Etanercept is a biologic fusion protein-blocking TNF-α and belongs to one of the biologics used among the children population. The purpose of this study was to assess the effectiveness and safety profile of etanercept in paediatric patients with plaque-type psoriasis. Material and methods: The outcome of the treatment was evaluated based on Psoriasis Area and Severity Index (PASI), Body Surface Area (BSA), and Children's Dermatology Life Quality Index (CDLQI). Achievement of at least PASI75 at week 16 was assessed as an adequate response to therapy, which was the primary endpoint. Results: Forty-three paediatric patients were included in the study, 24 females and 19 males. The average age at inclusion into our study was 13 years. At baseline, the mean PASI score, BSA, and CDLQI were 16.3 ± 6.5, 22.3 ± 12.2%, and 17.4 ± 5.3, respectively. At week 16, 90.7% of patients achieved PASI 50, 79.1% achieved PASI 75, and 46.5% attained PASI 90. There was also a decrease in mean BSA and CDLQI values to 3.5 ± 3.8 and 5.4 ± 5.7, respectively. Conclusions: Etanercept proved to be effective, safe, and well-tolerated among the paediatric population with psoriasis.
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Affiliation(s)
- Joanna Narbutt
- Department of Dermatology, Paediatric Dermatology and Oncology, Medical University of Lodz, 90-419 Lodz, Poland; (J.N.); (K.K.); (D.S.-S.); (M.S.)
| | - Zofia Jakubczak
- Students’ Scientific Association of Experimental, Clinical and Surgical Dermatology, Medical University of Lodz, 91-347 Lodz, Poland; (Z.J.); (P.W.-C.); (J.W.)
| | - Paulina Wasiewicz-Ciach
- Students’ Scientific Association of Experimental, Clinical and Surgical Dermatology, Medical University of Lodz, 91-347 Lodz, Poland; (Z.J.); (P.W.-C.); (J.W.)
| | - Joanna Wojtania
- Students’ Scientific Association of Experimental, Clinical and Surgical Dermatology, Medical University of Lodz, 91-347 Lodz, Poland; (Z.J.); (P.W.-C.); (J.W.)
| | - Katarzyna Krupa
- Department of Dermatology, Paediatric Dermatology and Oncology, Medical University of Lodz, 90-419 Lodz, Poland; (J.N.); (K.K.); (D.S.-S.); (M.S.)
| | - Dorota Sobolewska-Sztychny
- Department of Dermatology, Paediatric Dermatology and Oncology, Medical University of Lodz, 90-419 Lodz, Poland; (J.N.); (K.K.); (D.S.-S.); (M.S.)
- Laboratory of Autoinflammatory, Genetic and Rare Skin Disorders, Department of Dermatology, Pediatric Dermatology and Oncology, Medical University of Lodz, 91-347 Lodz, Poland;
| | - Magdalena Ciążyńska
- Laboratory of Autoinflammatory, Genetic and Rare Skin Disorders, Department of Dermatology, Pediatric Dermatology and Oncology, Medical University of Lodz, 91-347 Lodz, Poland;
| | - Marta Kołt-Kamińska
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-055 Rzeszow, Poland; (M.K.-K.); (A.R.)
| | - Adam Reich
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-055 Rzeszow, Poland; (M.K.-K.); (A.R.)
| | - Małgorzata Skibińska
- Department of Dermatology, Paediatric Dermatology and Oncology, Medical University of Lodz, 90-419 Lodz, Poland; (J.N.); (K.K.); (D.S.-S.); (M.S.)
| | - Aleksandra Lesiak
- Department of Dermatology, Paediatric Dermatology and Oncology, Medical University of Lodz, 90-419 Lodz, Poland; (J.N.); (K.K.); (D.S.-S.); (M.S.)
- Laboratory of Autoinflammatory, Genetic and Rare Skin Disorders, Department of Dermatology, Pediatric Dermatology and Oncology, Medical University of Lodz, 91-347 Lodz, Poland;
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Yi RC, Moran SK, Gantz HY, Strowd LC, Feldman SR. Biologics and Small Molecule Targeted Therapies for Pediatric Alopecia Areata, Psoriasis, Atopic Dermatitis, and Hidradenitis Suppurativa in the US: A Narrative Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:892. [PMID: 39201826 PMCID: PMC11352834 DOI: 10.3390/children11080892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2024] [Revised: 07/23/2024] [Accepted: 07/23/2024] [Indexed: 09/03/2024]
Abstract
BACKGROUND The management of pediatric dermatological conditions such as alopecia areata (AA), psoriasis, atopic dermatitis (AD), and hidradenitis suppurativa (HS) has significantly evolved with the introduction of biologics and small molecule targeted therapies. The advancement in understanding the immunopathogenesis of these chronic skin conditions has led to the development and approval of novel biologics and small molecule therapies. Initially approved by the United States Food and Drug Administration (FDA) for adults, most of these therapies are now being evaluated in clinical trials for safety and efficacy in adolescents and children, expanding new treatment options for pediatric patients. The role of the FDA in drug approval is multifaceted from drug inception, ensuring that research, data, and evidence show that the proposed drug is effective and safe for the intended use. OBJECTIVE The goal of this review article is to provide an overview of the recently FDA-approved and potential biologic and oral small molecule therapies in clinical trials for AA, psoriasis, AD, and HS in pediatric patients. METHODS The search for this review included keywords in ClinicalTrials.gov, PubMed, and Google Scholar for the latest research and clinical trials relevant to these conditions and treatments without the PRISMA methodology. RESULTS For pediatric AA, ritlecitinib is FDA-approved, while baricitinib and updacitinib are in phase 3 clinical trials for pediatric approval. The FDA-approved drugs for pediatric psoriasis include secukinumab, ustekinumab, ixekizumab, etanercept, and apremilast. Other phase 3 clinical trials for pediatric psoriasis include risankizumab, guselkumab, tildrakizumab, brodalumab, and deucravacitinib. For pediatric AD, the FDA-approved drugs are dupilumab, tralokinumab, abrocitinib, and upadacitinib, with many other drugs in phase 3 trials. Adalimumab is an FDA-approved biologic for pediatric HS, with various clinical trials ongoing for adults. The approved biologics and small molecule therapies had higher efficacy and improved safety profiles compared to traditional medications. CONCLUSIONS With numerous ongoing trials, the success of these clinical trials could lead to their inclusion in treatment guidelines for these chronic skin conditions. Biologics and small molecule therapies offer new avenues for effective disease management, enabling personalized therapeutic interventions and improving pediatric health outcomes.
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Affiliation(s)
- Robin C. Yi
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA; (S.K.M.); (H.Y.G.); (L.C.S.); (S.R.F.)
| | - Shannon K. Moran
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA; (S.K.M.); (H.Y.G.); (L.C.S.); (S.R.F.)
| | - Hannah Y. Gantz
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA; (S.K.M.); (H.Y.G.); (L.C.S.); (S.R.F.)
| | - Lindsay C. Strowd
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA; (S.K.M.); (H.Y.G.); (L.C.S.); (S.R.F.)
| | - Steven R. Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA; (S.K.M.); (H.Y.G.); (L.C.S.); (S.R.F.)
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
- Department of Social Sciences & Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
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Kontzias C, Chandy R, Feldman SR. Choosing Systemic Agents for Psoriasis. Ann Pharmacother 2024; 58:333-337. [PMID: 37341171 DOI: 10.1177/10600280231170031] [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] [Indexed: 06/22/2023] Open
Abstract
Treatment options for moderate-to-severe psoriasis depend on drug efficacy and safety, patient preferences, comorbidities, and cost-no drug dominates across all dimensions. Interleukin (IL)-17 inhibitors may be preferred for fast-acting treatment, while the 3-month schedule of risankizumab, ustekinumab, or tildrakizumab may be attractive for patients who prioritize fewer injections. Phototherapy is suitable for patients who wish to avoid systemic agents or when cost is a concern. For patients with poor adherence, infliximab or tildrakizumab may be well suited as they require in-office administration. Dermatologists can educate patients on available therapies to find a regimen best suited to their needs.
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Affiliation(s)
- Christina Kontzias
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Rithi Chandy
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Steven R Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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Hwang JK, Grover C, Iorizzo M, Lebwohl MG, Piraccini BM, Rigopoulos DG, Lipner SR. Nail psoriasis and nail lichen planus: Updates on diagnosis and management. J Am Acad Dermatol 2024; 90:585-596. [PMID: 38007038 DOI: 10.1016/j.jaad.2023.11.024] [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: 07/23/2023] [Revised: 10/30/2023] [Accepted: 11/17/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND Inflammatory diseases of the nail, including nail psoriasis and nail lichen planus, are associated with significant disease burden and have a negative impact on quality of life. Diagnosis is often delayed, especially when patients present without cutaneous findings. Therefore, recognizing clinical signs and symptoms of inflammatory nail diseases, and initiating timely and appropriate treatment, is of utmost importance. OBJECTIVE We review recent studies on diagnostic techniques, discuss severity grading and scoring systems, and describe consensus treatment recommendations for nail psoriasis and nail lichen planus. METHODS An updated literature review was performed using the PubMed database on studies assessing diagnostic techniques or treatment modalities for nail psoriasis and nail lichen planus. RESULTS Recent studies on diagnostic techniques for inflammatory nail disease have focused on use of dermoscopy, capillaroscopy, and ultrasound modalities. Treatment of these conditions is dichotomized into involvement of few (≤3) or many (>3) nails. Recent psoriatic therapeutics studied for nail outcomes include brodalumab, tildrakizumab, risankizumab, deucravacitinib, and bimekizumab, while emerging treatments for nail lichen planus include JAK inhibitors and intralesional platelet rich plasma injections. CONCLUSIONS We emphasize the need for increased awareness and expanded management strategies for inflammatory nail diseases to improve patient outcomes.
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Affiliation(s)
- Jonathan K Hwang
- Department of Dermatology, Weill Cornell Medicine, New York, New York
| | - Chander Grover
- Department of Dermatology, University College of Medical Sciences, New Delhi, India
| | | | - Mark G Lebwohl
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Bianca M Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Dimitris G Rigopoulos
- 1st Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Athens, Greece
| | - Shari R Lipner
- Department of Dermatology, Weill Cornell Medicine, New York, New York.
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George A, Lansang RP, Lansang P, Gooderham M. A Practical Guide to Using Biologics in Pediatric Dermatology. J Cutan Med Surg 2024; 28:59-67. [PMID: 38229411 PMCID: PMC10908204 DOI: 10.1177/12034754231222415] [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] [Indexed: 01/18/2024]
Abstract
Psoriasis, hidradenitis suppurativa (HS), atopic dermatitis (AD), and chronic spontaneous urticaria (CSU), are common, immune-mediated, chronic, inflammatory skin diseases that can affect the pediatric population. While there is adequate evidence supporting the use of biologics in pediatric patients, concerns regarding safety and efficacy amongst healthcare providers are not uncommon. However, new emerging evidence in this population highlights the safety of biologic therapy, making it crucial to review and establish a practical guide for their use. This article describes a methodological framework for initiating biologics in the management of pediatric psoriasis, HS, AD, and CSU, with a special focus on baseline work-up, monitoring, dosing, and considerations in this population.
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Affiliation(s)
- Annie George
- Temerty School of Medicine, University of Toronto, Toronto, ON, Canada
| | - Rafael Paolo Lansang
- Michael G. Degroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Perla Lansang
- Temerty School of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Melinda Gooderham
- SKiN Centre for Dermatology, Peterborough, ON, Canada
- Probity Medical Research, Waterloo, ON, Canada
- Department of Medicine, Queen’s University, Kingston, ON, Canada
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Nikolaishvili M, Di Lernia V. Biological therapies for the treatment of psoriasis in pediatrics. Expert Opin Biol Ther 2023; 23:1219-1226. [PMID: 37936485 DOI: 10.1080/14712598.2023.2281496] [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: 10/03/2023] [Accepted: 11/06/2023] [Indexed: 11/09/2023]
Abstract
INTRODUCTION Psoriasis is a multifactorial, immune-mediated condition with predominant skin involvement. It may develop at any age. In one-third of patients, the first symptoms of psoriasis start during childhood or adolescence. A marked impairment of the quality of life of patients and their caregivers is often associated. AREAS COVERED Databases including PubMed and Clinicaltrials.gov were used to identify clinical studies involving pediatric patients with psoriasis. In the last few years, the implementation of therapy with drugs targeting cytokines like interleukin (IL)-12/23 and IL-17A has expanded the number of available therapeutic options in pediatric psoriasis. This review focuses on the latest evidence on the clinical efficacy and safety profile of drugs licensed for severe pediatric psoriasis. EXPERT OPINION Increasing knowledge about the pathogenetic mechanisms underlying pediatric psoriasis is leading to an improvement in disease management. Effective treatment is crucial in patients affected with moderate to severe disease to reduce the burden of the disease and avoid stigmatization. The treatment of pediatric psoriasis remains challenging for specific clinical subtypes, when difficult areas are involved, after resistance to multiple treatments, and when psoriatic arthritis is associated. A personalized approach and a thorough understanding of the disease are required to advance pediatric psoriasis care.
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Affiliation(s)
- Mariam Nikolaishvili
- Faculty of Medicine, Ivane Javakhishvili, Tbilisi State University, Tbilisi, Georgia
| | - Vito Di Lernia
- Dermatology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Axler EN, Lipner SR. Nail lichen planus treatment safety. Expert Opin Drug Saf 2023; 22:1157-1168. [PMID: 38014463 DOI: 10.1080/14740338.2023.2288902] [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: 08/10/2023] [Accepted: 11/24/2023] [Indexed: 11/29/2023]
Abstract
AREAS COVERED Topical therapies for nail lichen planus (clobetasol propionate, topical tacrolimus, bath-PUVA), intralesional treatment (triamcinolone), and systemic treatment (corticosteroids, retinoids, small molecule inhibitors (jak/stat inhibitors)), TNF-alpha inhibitors (etanercept), systemic immunomodulators (oral calcineurin inhibitors, mycophenolate mophetil), and antimalarials (chloroquine), each with unique safety profiles and considerations. Herein, we discuss common and uncommon adverse events, as well as utilization for special populations, including pregnant and pediatric patients.
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Affiliation(s)
- Eden N Axler
- Albert Einstein College of Medicine, Bronx, New York, USA
| | - Shari R Lipner
- Weill Cornell Medicine, Department of Dermatology, New York, NY, USA
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Krajewski PK, Szepietowski JC. Secukinumab for the treatment of moderate-to-severe plaque psoriasis in pediatric patients aged six years and older. Expert Rev Clin Immunol 2023:1-6. [PMID: 37191153 DOI: 10.1080/1744666x.2023.2214365] [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: 05/17/2023]
Abstract
INTRODUCTION Psoriasis (PSO) is a chronic, recurrent, inflammatory skin disorder that significantly influences patients' quality of life. The prevalence of PSO among children varies depending on the age and ranges from 0.12% at one year to 2% at 18 years. Due to systemic inflammation, PSO is associated with obesity, hypertension, inflammatory bowel disease, and cardiovascular incidences.Secukinumab is a fully human monoclonal antibody selectively targeting IL-17A. The drug has been approved for children aged 6-18 with moderate to severe plaque psoriasis. Nevertheless, only a few reports thoroughly describe its efficacy and safety in the pediatric population. AREAS COVERED This review aims to describe the efficacy and safety of secukinumab for the treatment of moderate-to-severe plaque PSO in pediatric patients aged six years and older. EXPERT OPINION Although there are only two clinical trials assessing the efficacy and safety of secukinumab in the pediatric population with plaque PSO, this therapy seems to be a significant advancement in managing those patients. Both dose regimens (depending on the weight, low-dose, 75/75/150 mg, and high-dose 75/150/300 mg) of secukinumab were more effective in achieving significant clinical improvement (PASI 75/90 and IGA response) than placebo or active-comparator. Both regimens showed good safety and tolerability profiles, with mostly mild AEs and no SAEs observed.
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Affiliation(s)
- Piotr K Krajewski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wrocław, Poland
| | - Jacek C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wrocław, Poland
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Hamm H, Höger PH. [Psoriasis in children and adolescents : Short update and guideline-based treatment]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2023; 74:340-349. [PMID: 36976302 PMCID: PMC10043838 DOI: 10.1007/s00105-023-05132-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 02/14/2023] [Indexed: 03/29/2023]
Abstract
Psoriasis is nowadays regarded as a multifactorial, inflammatory, immune-mediated systemic condition with predominant involvement of the skin. It starts in about one third of cases in childhood and adolescence and is often accompanied by marked impairment of the quality of life of sufferers and their parents. Aside from genetic disposition, trigger factors such as streptococcal infections are notably involved in manifestation and in exacerbations. The harmful role of comorbidities even in the young, particularly of obesity, has been well documented. Treatment options have considerably improved following the approval of five biologic agents in childhood but are still insufficiently used. The present article gives a short overview of current knowledge and the recommendations of the updated German guideline. Besides frequent types, unusual presentations such as pustular psoriasis, psoriasis dermatitis, and paradoxical psoriasis induced by tumor necrosis factor alpha (TNF-α) inhibitors are addressed.
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Affiliation(s)
- Henning Hamm
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Deutschland.
| | - Peter H Höger
- Abteilungen für Pädiatrie und Pädiatrische Dermatologie/Allergologie, Katholisches Kinderkrankenhaus Wilhelmstift, Hamburg, Deutschland
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Hamm H, Höger PH. [Psoriasis in children and adolescents]. Monatsschr Kinderheilkd 2023; 171:420-429. [PMID: 37143470 PMCID: PMC10090738 DOI: 10.1007/s00112-023-01764-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Psoriasis is nowadays regarded as a multifactorial, inflammatory, immune-mediated systemic condition with predominant involvement of the skin. It starts in about one third of cases in childhood and adolescence and is often accompanied by marked impairment of the quality of life of sufferers and their parents. Aside from genetic disposition, trigger factors such as streptococcal infections are notably involved in manifestation and in exacerbations. The harmful role of comorbidities even in the young, particularly of obesity, has been well documented. Treatment options have considerably improved following the approval of five biologic agents in childhood but are still insufficiently used. The present article gives a short overview of current knowledge and the recommendations of the updated German guideline. Besides frequent types, unusual presentations such as pustular psoriasis, psoriasis dermatitis, and paradoxical psoriasis induced by tumor necrosis factor alpha (TNF-α) inhibitors are addressed.
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Affiliation(s)
- Henning Hamm
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg, Josef-Schneider-Str. 2, 97080 Würzburg, Deutschland
| | - Peter H. Höger
- Abteilungen für Pädiatrie und Pädiatrische Dermatologie/Allergologie, Katholisches Kinderkrankenhaus Wilhelmstift, Hamburg, Deutschland
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11
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Narbutt J, Niedźwiedź M, Lesiak A, Ceryn J, Skibińska M. Secukinumab for the Treatment of Psoriasis in Pediatrics: Patient Selection and Acceptability. Patient Prefer Adherence 2023; 17:421-431. [PMID: 36815128 PMCID: PMC9940655 DOI: 10.2147/ppa.s350753] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 02/11/2023] [Indexed: 02/17/2023] Open
Abstract
Psoriasis (PsO) is a chronic, systemic, immune-mediated inflammatory skin disease affecting 1% to 5% population worldwide. In one-third of patients, the first symptoms of PsO manifest in childhood, with a mean age of nine years. Psoriasis in children under 16 years of age constitutes 4% of dermatological problems in this age group. Chronic inflammation of the skin observed in PsO is associated with a development of potentially serious comorbidities, including psoriatic arthritis, hypertension, metabolic syndrome, cardiovascular diseases, inflammatory bowel disease, depression and anxiety. It is reported that among children with psoriasis between 5 and 16 years of age health-related quality of life is reduced by 30.5%. Early diagnosis and effective treatment are crucial in pediatric psoriatic patients to avoid future complications and stigmatization. Treatment for psoriasis consists of a range of topical medications, phototherapy and non-biologic and biologic systemic therapies. Approved biologics for PsO in pediatric patients include etanercept, adalimumab, ustekinumab, ixekizumab and secukinumab. Secukinumab, a recombinant, fully human monoclonal antibody targeting IL-17A, was approved by the EMA (2020) and FDA (2021) in pediatric patients above 6 years of age for the treatment of moderate to severe plaque psoriasis who are candidates for systemic therapy. This review discusses the selection and acceptability of secukinumab in children with psoriasis.
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Affiliation(s)
- Joanna Narbutt
- Department of Dermatology, Pediatric Dermatology and Dermatological Oncology, Medical University of Lodz, Lodz, Poland
| | - Michał Niedźwiedź
- Department of Dermatology, Pediatric Dermatology and Dermatological Oncology, Medical University of Lodz, Lodz, Poland
- Correspondence: Michał Niedźwiedź, Department of Dermatology, Pediatric Dermatology and Oncology, Medical University of Lodz, gen. Karola Kniaziewicza 1/5, Lodz, 91-347, Poland, Tel +48 690 529 430, Email
| | - Aleksandra Lesiak
- Department of Dermatology, Pediatric Dermatology and Dermatological Oncology, Medical University of Lodz, Lodz, Poland
| | - Justyna Ceryn
- Department of Dermatology, Pediatric Dermatology and Dermatological Oncology, Medical University of Lodz, Lodz, Poland
- International Doctoral School of the Medical University of Lodz, Lodz, Poland
| | - Małgorzata Skibińska
- Department of Dermatology, Pediatric Dermatology and Dermatological Oncology, Medical University of Lodz, Lodz, Poland
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Caroppo F, Gnesotto L, Ludovica Deotto M, Salmaso R, Fortina AB. A Case of Lip Psoriasis in a 14-Year-Old Boy Successfully Treated with Adalimumab. Case Rep Dermatol 2023; 15:142-146. [PMID: 37933229 PMCID: PMC10625818 DOI: 10.1159/000532103] [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: 02/23/2023] [Accepted: 06/29/2023] [Indexed: 11/08/2023] Open
Abstract
Psoriasis is a common chronic skin disease mainly located in areas of friction. Psoriasis of the lips as an exclusive presentation is rare and often misdiagnosed. Different anti-psoriatic therapies have been proposed, but the literature is limited to case studies with partial results. Biologic therapies have revolutionized the management of many dermatologic conditions, including psoriasis, and they are approved for pediatric use. We report the case of a 14-year-old boy with a 2-year history of white-yellowish scaling lesions on his lips, without intraoral involvement. Lip biopsy showed a psoriasiform pattern. Treatment with adalimumab 40 mg every other week was started, and after 6 months of therapy, we obtained a complete remission of the patient's lip psoriasis.
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Affiliation(s)
- Francesca Caroppo
- Department of Medicine DIMED & Department of Women’s and Children’s Health SDB, Pediatric Dermatology Regional Center, University of Padova, Padova, Italy
| | - Laura Gnesotto
- Department of Medicine DIMED & Department of Women’s and Children’s Health SDB, Pediatric Dermatology Regional Center, University of Padova, Padova, Italy
| | - Maria Ludovica Deotto
- Department of Medicine DIMED & Department of Women’s and Children’s Health SDB, Pediatric Dermatology Regional Center, University of Padova, Padova, Italy
| | - Roberto Salmaso
- Department of Medicine DIMED, Surgical Pathology and Cytopathology Unit, University of Padova, Padova, Italy
| | - Anna Belloni Fortina
- Department of Medicine DIMED & Department of Women’s and Children’s Health SDB, Pediatric Dermatology Regional Center, University of Padova, Padova, Italy
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