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Medicina
Special Issues
Psoriasis and Related Conditions: Recent Advances and Controversies
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Psoriasis and Related Conditions: Recent Advances and Controversies

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Dermatology".

Deadline for manuscript submissions: 30 September 2026 | Viewed by 5121

Special Issue Editors

Prof. Dr. Alin Laurentiu Tatu

E-Mail Website
Guest Editor
1. Clinical Department, Dermatology, Faculty of Medicine and Pharmacy, Dunarea de Jos University, Galati, Romania
2. Dermatology Department, Saint Parascheva Clinical Hospital of Infectious Diseases, Galati, Romania
3. Multidisciplinary Integrative Center for Dermatological Interface Research, Galati, Romania
Interests: demodex; endosymbionts; cutaneous microbiome; integrative medicine; optical coherence tomography; dermoscopy; confocal microscopy; cutaneous comorbidities; skin cancer
Special Issues, Collections and Topics in MDPI journals
Dr. Elena Niculeţ

E-Mail Website
Guest Editor Assistant
Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800385 Galati, Romania
Interests: dermatopathology; clinical pathology; psoriasis; cytopathology; skin disorders

Special Issue Information

Dear Colleagues,

Psoriasis is a chronic, immune-mediated skin disorder that affects approximately 2–3% of the global population. Characterized by the hyperproliferation of keratinocytes and systemic inflammation, it presents with erythematous, scaly plaques and is often associated with comorbidities such as psoriatic arthritis, cardiovascular disease, and metabolic syndrome. Despite significant advances in understanding its pathophysiology, psoriasis remains a complex condition with unresolved questions regarding its triggers, treatment responses, and long-term management.

Recent breakthroughs in immunology have led to the development of targeted biologic therapies, including IL-17 and IL-23 inhibitors, which have revolutionized treatment outcomes. However, the long-term safety, cost, and accessibility of these therapies remain contentious. Additionally, emerging research on the gut–skin axis and the role of microbiota in psoriasis pathogenesis has sparked debate over potential non-traditional treatment avenues, such as probiotics and dietary modifications.

Beyond pharmacologic interventions, controversies persist regarding the impact of environmental factors, stress, and lifestyle on disease progression. Furthermore, disparities in healthcare access raise ethical concerns about treatment equity. This Special Issue aims to explore recent advances in psoriasis research while addressing ongoing controversies that influence clinical decision-making, patient care, and future therapeutic developments.

Prof. Dr. Alin Laurentiu Tatu
Guest Editor

Dr. Elena Niculeţ
Guest Editor Assistant

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • psoriasis
  • cytopathology
  • skin disorder
  • immunology
  • patient care

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Published Papers (5 papers)

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Research

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10 pages, 261 KB  
Article
Real-World Use of Biologic Therapy in Elderly Patients with Moderate-to-Severe Psoriasis: A Retrospective Single-Center Study
by Vanda Bondare-Ansberga and Aleksandra Grigorjeva
Medicina 2026, 62(5), 911; https://doi.org/10.3390/medicina62050911 - 8 May 2026
Viewed by 313
Abstract
Background and Objectives: Psoriasis patients aged over 65 years, especially those with chronic comorbidities, constitute an increasingly important patient population. In this group, the selection of therapy, along with its efficacy and safety, is of relevance. Materials and Methods: A single-center [...] Read more.
Background and Objectives: Psoriasis patients aged over 65 years, especially those with chronic comorbidities, constitute an increasingly important patient population. In this group, the selection of therapy, along with its efficacy and safety, is of relevance. Materials and Methods: A single-center retrospective analysis of clinical records of patients aged ≥ 65 years with moderate to severe plaque psoriasis, treated with biologic therapies. The study covered the period 2019–2025. Results: A total of 38 patients were included. Biologic switching occurred in 15 patients (39.5%). The primary reason for switching was loss of efficacy (86.7%), while adverse events accounted for 13.3% of cases. The mean duration from initiation of adalimumab (the mandatory first-line biologic therapy) to switching was 325 ± 191 days. Baseline PASI did not differ significantly between groups (p = 0.139). Psoriatic arthritis was significantly less frequent among patients who switched therapy (13.3% vs. 56.5%, p = 0.008). No significant associations were observed between switching and comorbidities or overall comorbidity burden (p > 0.05). Clinically relevant adverse events included infections, cardiovascular events, malignancies, and autoimmune laboratory abnormalities. Conclusions: Biologic therapy in elderly psoriasis patients appears to be generally well tolerated, based on descriptive real-world data. Treatment switching was primarily driven by loss of efficacy rather than comorbidities. Full article
(This article belongs to the Special Issue Psoriasis and Related Conditions: Recent Advances and Controversies)
17 pages, 1046 KB  
Article
Exploratory Retrospective Assessment of Patients with Psoriasis Receiving Biological Therapy
by Andrada-Luciana Lazar, Sorana D. Bolboacă, Adrian-Lucian Baican, Corina-Iulia Baican, Sorina Dănescu, Elisabeta Candrea, Diana Valentina Câmpean, Paula Iluț, Ioana Semenescu, Adela-Viviana Sitar-Tăut, Romana Vulturar, Olga Hilda Orășan and Angela Cozma
Medicina 2026, 62(2), 257; https://doi.org/10.3390/medicina62020257 - 26 Jan 2026
Cited by 1 | Viewed by 911
Abstract
Background and Objectives: Biological therapies improve disease severity and quality of life in patients with psoriasis, but data on Romanian patients remain limited. Our study aimed to characterize patients with psoriasis from Transylvania and to evaluate the impact of biologics on disease [...] Read more.
Background and Objectives: Biological therapies improve disease severity and quality of life in patients with psoriasis, but data on Romanian patients remain limited. Our study aimed to characterize patients with psoriasis from Transylvania and to evaluate the impact of biologics on disease severity, treatment switching, affected special areas response, quality of life, and laboratory biomarkers. Materials and Methods: We conducted a retrospective exploratory study at two centers in Cluj-Napoca, Romania, using routinely collected medical data. Results: One-hundred and fifteen patients (aged 2–72 years) were evaluated; 45 patients received anti-TNF, 43 received anti-IL-17, and 27 received anti-IL-23. Patients treated with anti-IL-17 or anti-IL-23 were older at diagnosis than those treated with anti-TNF (p = 0.0001). Psoriatic lesions were prevalent in the scalp (58.3%) and nails (36.5%). Methotrexate was the most common prior systemic therapy (87.8%), with no difference between the groups (p = 0.7668). Patients receiving anti-TNF therapy (46.7%) or anti-IL-17 therapy (20.9%) also most frequently received prior treatment with systemic retinoids. Cardiometabolic comorbidities, including hypertension (40.9%) and diabetes mellitus (20.9%), were prevalent. Anti-IL-17 therapies were used more frequently in patients with hypertension (46.5%), diabetes mellitus (34.9%), and psoriatic arthritis (34.9%). Baseline severity scores were comparable across the groups (p > 0.10). A therapeutic switch occurred in approximately one-quarter of the patients, most frequently in the anti-TNF group (57.8%), which also showed higher PASI and DLQI scores at switching (p < 0.0001). At 36 weeks, anti-IL-17 and anti-IL-23 therapies demonstrated superior outcomes compared to anti-TNF therapy (p = 0.045). All patients receiving anti-IL-23 therapy achieved a PASI 100 at the 60-week follow-up. Significant improvements in PASI and DLQI were observed for all biologics (p < 0.0001). Conclusions: Biological therapies were associated with significant improvements in disease severity and quality of life. Anti-TNF therapies were switched more frequently due to reduced efficacy, while clinical improvement was observed regardless of lesion localization. Full article
(This article belongs to the Special Issue Psoriasis and Related Conditions: Recent Advances and Controversies)
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14 pages, 522 KB  
Article
Depression, Anxiety and Quality of Life in Patients with Atopic Dermatitis and Psoriasis
by Arina Arnīte, Vanda Bondare-Ansberga, Lelde Reinberga, Ilona Hartmane and Ingmārs Mikažāns
Medicina 2026, 62(1), 164; https://doi.org/10.3390/medicina62010164 - 14 Jan 2026
Cited by 1 | Viewed by 1020
Abstract
Background and Objectives: Atopic dermatitis and psoriasis are life-long inflammatory diseases affecting more than just the skin. Although their link with mental comorbidities has been established, the role of using self-assessment questionnaires is still debated. The aim of our study was to [...] Read more.
Background and Objectives: Atopic dermatitis and psoriasis are life-long inflammatory diseases affecting more than just the skin. Although their link with mental comorbidities has been established, the role of using self-assessment questionnaires is still debated. The aim of our study was to evaluate differences in the quality of life (DLQI) as well as depression (PHQ-9) and anxiety (GAD-7) questionnaire data and determine their link with individual patient and skin disease factors. Materials and Methods: Demographic, clinical and questionnaire data were collected from Riga 1st hospitals archive. For statistical evaluation, the Mann–Whitney U test and Spearman’s rank correlation coefficient were used. Results: The median DLQI for atopic dermatitis and psoriasis was 10.5 and 10, respectively. The prevalence among women with atopic dermatitis who had a PHQ-9 ≥ 10 was 42.9%, compared to 50.0% in men, and GAD-7 ≥ 10 prevalence was 14.3% and 20.0%, respectively. Psoriatic women had a PHQ-9 ≥ 10 prevalence of 25.0% compared with 28.9% in men. The prevalence of GAD-7 ≥ 10 was 20.0% in females and 15.8% in males. GAD-7 score was elevated in patients with psoriatic genital involvement. Multiple positive correlations were noted between PHQ-9, GAD-7 and DLQI scores. Conclusions: Patient quality of life and prevalence of anxiety and depression symptoms are impacted by psoriasis and atopic dermatitis, with similar patterns observed across genders and comorbidities. Genital involvement could be associated with more severe anxiety symptoms. The correlations between PHQ-9, GAD-7 and DLQI scores indicate that further evaluation might be necessary if quality of life is impaired. Full article
(This article belongs to the Special Issue Psoriasis and Related Conditions: Recent Advances and Controversies)
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10 pages, 636 KB  
Article
Effects of Immunomodulatory Therapy on the Skin Barrier Function in Patients with Psoriasis Vulgaris
by Anete Mālkalne, Vanda Bondare-Ansberga, Ilona Hartmane, Ingmārs Mikažāns and Lelde Reinberga
Medicina 2025, 61(11), 2070; https://doi.org/10.3390/medicina61112070 - 20 Nov 2025
Viewed by 752
Abstract
Background and Objectives: Psoriasis vulgaris features epidermal barrier dysfunction. Materials and Methods: Barrier function changes were prospectively evaluated over 12 weeks during TNF-α inhibition with adalimumab, along with concurrent changes in disease severity and quality of life. Adults with moderate-to-severe plaque [...] Read more.
Background and Objectives: Psoriasis vulgaris features epidermal barrier dysfunction. Materials and Methods: Barrier function changes were prospectively evaluated over 12 weeks during TNF-α inhibition with adalimumab, along with concurrent changes in disease severity and quality of life. Adults with moderate-to-severe plaque psoriasis initiating adalimumab (80 mg loading on day 1; 40 mg every other week thereafter, starting day 8) underwent assessments at baseline and at week 12 (n = 9; mean age 44.1 ± 14.9 years, range 20–61). Transepidermal water loss (TEWL; g/m2/h) and skin pH were measured at the elbow, lower leg, abdomen, back, and scalp; PASI, BSA, and DLQI were recorded. The measurements were standardized, though room temperature/humidity were not identical between visits. Results: The clinical indices improved markedly and TEWL also decreased at all sites—the elbow, lower leg, abdomen, back, and scalp—indicating barrier recovery; in contrast, the pH remained within a mildly acidic range at all sites. Lesion-to-non-lesion conversion occurred, and no site worsened. Conclusions: In summary, 12 weeks of adalimumab were associated with a notable clinical improvement and consistent, site-spanning reductions in TEWL, whereas skin surface pH showed no material change. TEWL appears to be a sensitive objective adjunct to clinical indices for monitoring response. Full article
(This article belongs to the Special Issue Psoriasis and Related Conditions: Recent Advances and Controversies)
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Review

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16 pages, 2108 KB  
Review
The Role of Dermoscopy and High-Frequency Ultrasonography in the Diagnosis and Monitoring of Psoriasis Vulgaris
by Ioana-Alina Halip, Dan Vata, Adriana Ionela Patrascu, Doinita Temelie Olinici, Ioana-Adriana Popescu, Madalina Mocanu, Dumitrita Lenuta Gugulus, Valentin-Tudor Popa, Dragos Gheuca-Solovastru and Laura Gheuca-Solovastru
Medicina 2025, 61(11), 1978; https://doi.org/10.3390/medicina61111978 - 4 Nov 2025
Viewed by 1225
Abstract
Psoriasis vulgaris is a polygenic, immunomediated dermatological condition, characterized pathophysiologically by abnormal proliferation of the epidermis and immune response disorders, evidenced by the presence of a dermal inflammatory infiltrate accompanied by exocytosis. The prevalence of this disease is continuously increasing, and the significant [...] Read more.
Psoriasis vulgaris is a polygenic, immunomediated dermatological condition, characterized pathophysiologically by abnormal proliferation of the epidermis and immune response disorders, evidenced by the presence of a dermal inflammatory infiltrate accompanied by exocytosis. The prevalence of this disease is continuously increasing, and the significant impact on quality of life is determined by both the severity of the skin manifestations and the associated comorbidities, which underlines the importance of early diagnosis. Among the imaging methods useful in the diagnosis and monitoring of psoriasis vulgaris are dermatoscopy and high-frequency cutaneous ultrasonography (HFUS). Dermatoscopy is a valuable complementary imaging tool in assessing the therapeutic response in patients with psoriasis vulgaris. Although clinical lesions may show partial or complete remission, the persistence of the specific vascular architecture—characterized by dilated and branched capillaries—suggests the maintenance of disease activity and justifies the need for continued treatment. HFUS allows the identification of characteristic changes in psoriatic plaques, such as homogeneous thickening of the epidermis, visible as a hyperechoic band, the presence of a hypoechoic subepidermal band, and thickening of the dermis. Evaluation with 20 MHz probes can significantly contribute to monitoring therapeutic efficacy, since the first observable changes under topical and/or systemic treatment include a reduction in the thickness of the epidermis, dermis, and hypoechoic subepidermal band. The integration of dermatoscopy and HFUS within the clinical evaluation allows for a complex and precise approach to the management of patients with psoriasis vulgaris, facilitating objective monitoring of disease progression and appropriate adjustment of therapy. Full article
(This article belongs to the Special Issue Psoriasis and Related Conditions: Recent Advances and Controversies)
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