Search Results (203)

A psoriasis vulgaris flare is characterized by a rapid intensification of symptoms, which is often triggered by various factors that can worsen the condition. The risk factors for these exacerbations are numerous and include obesity, antihypertensive drugs, and psychological stress. Moreover, links have been documented between type II diabetes, hypertension, and psoriasis vulgaris. The present case report describes a 52-year-old female patient who presented at the clinic with disseminated erythematous-squamous plaques and patches covered by thick, white-pearly, easily detachable scales, along with stress, fatigue, anxiety, severe pruritus, irritability, insomnia, and decreased self-esteem. Her past medical regimen included various conventional topical options, including calcipotriol combined with betamethasone, clobetasol, betamethasone combined with salicylic acid, and betamethasone combined with gentamicin, yet the condition remained refractory, with periodic flare-ups. The integrated and personalized therapeutic approach aimed to target both the dermatological issues and the associated systemic and psychological factors contributing to the condition. The therapeutic strategy implemented in this case combined psychological counseling sessions, a very low-calorie ketogenic diet, oral supplementation with anti-inflammatory and antioxidant vitamins and minerals, topical treatments utilizing urea and Dead Sea-mineral-based formulations, and rosemary extract-based scalp care, without requiring additional conventional treatment. This comprehensive approach led to significant improvement, ultimately achieving complete remission of the patient’s psoriasis. The associated comorbidities were well controlled with the specified medication, without any further complications. Thus, the importance of alternative options was emphasized, particularly in the context of an incurable disease, along with the need for continued research to improve the ongoing therapeutic management of psoriasis vulgaris. Such approaches are essential to reducing the risk of flare-ups and to achieving better management of associated risk factors. Full article

Background: Psoriasis is a chronic inflammatory skin disease linked to systemic comorbidities, including metabolic, cardiovascular, and autoimmune disorders. Thyroid dysfunction, particularly hypothyroidism, has been observed in patients with moderate-to-severe psoriasis, suggesting possible shared inflammatory pathways. Objectives: This study aims to explore the relationship between psoriasis and thyroid dysfunction in adults with moderate-to-severe psoriasis undergoing biologic therapy to determine whether psoriasis predisposes individuals to thyroid disorders and to identify demographic or clinical factors influencing this association. Materials and Methods: A cross-sectional study included adult patients with moderate-to-severe psoriasis receiving biologic therapy, recruited from the Psoriasis Unit at the Dermatology Department of Hospital Universitario San Cecilio in Granada, Spain, from 2017 to 2023. Patients with mild psoriasis or those treated with conventional systemic therapies were excluded. The data collected included demographics and clinical characteristics, such as age, sex, BMI (body mass index), and psoriasis severity (psoriasis severity was evaluated using the Psoriasis Area Severity Index (PASI), body surface area (BSA) involvement, Investigator’s Global Assessment (IGA), pruritus severity using the Numerical Rating Scale (NRS), and impact on quality of life through the Dermatology Life Quality Index (DLQI)). Thyroid dysfunction, including hypothyroidism and subclinical hypothyroidism, was assessed based on records from the Endocrinology Department. Results: Thyroid dysfunction was found in 4.2% of patients, all classified as hypothyroidism, primarily subclinical. The affected patients were generally older, with a mean age of 57.4 years. No significant differences in psoriasis severity (PASI, BSA) or treatment response were observed between patients with and without thyroid dysfunction. Conclusion: Our findings suggest hypothyroidism is the main thyroid dysfunction in psoriatic patients, independent of psoriasis severity. The lack of impact on psoriasis severity suggests hypothyroidism may be an independent comorbidity, warranting further research into shared inflammatory mechanisms. Full article

Psoriasis is a chronic inflammatory autoimmune disease that causes significant deterioration of the quality of life, and due to its multifactorial causes, it is often difficult to manage. Apart from genetic and environmental components, an important part of its pathophysiology comprises an oxidative stress induction that the standard antioxidative mechanisms of the human body cannot compensate for. Moreover, in many psoriatic patients, there is a documented imbalance between antioxidant and pro-oxidative factors. Usually, psoriasis is evaluated using the Psoriasis Area and Severity Index (PASI) score. It has been demonstrated that dietary choices can lead to significant modification of PASI scores. Hypocaloric diets that are rich in antioxidants are highly effective in this regard, especially when focusing on vegetables and restricting consumption of animal-derived protein. Specific dietary regimens, namely the Mediterranean diet and potentially the ketogenic diet, are very beneficial, in the former case owing in large part to the omega-three fatty acids it provides and its ability to alter gut microbiome, a factor which seems to play a notable role in the pathogenesis of the disease. Another option is the topical application of vitamin D and its analogues, combined with corticosteroids, which can ameliorate the manifestations of psoriasis at the level of the skin. Finally, oral vitamin D supplementation has a positive impact on psoriatic arthritis and can mitigate the risk of associated comorbidities. Full article

Approximately 3–13% of patients with psoriasis are first affected after age 60 years. Numerous studies have investigated the use of biologic agents for the treatment of psoriasis, but the routine exclusion of elderly adults from clinical trials has limited our knowledge about their effects in this age group. Background/Objectives: This study aimed to investigate the efficacy and safety of biologic drugs for the treatment of psoriasis in elderly patients. Methods: A single-center-based retrospective cohort study design was used. A total of 149 elderly patients with psoriasis were divided into two groups by age at initiation of biologic treatment: <65 years (adult-start group) and >65 years (elderly-start group). Data on patient characteristics were collected and analyzed, and drug survival was evaluated. Results: Demographics, comorbidities, and treatment turnover were similar in the adult-start and elderly-start groups. Drug survival of adalimumab as first-line treatment, and of guselkumab in any treatment sequence, was significantly better in the elderly-start group (p = 0.029 and p = 0.032, respectively). There was no between-group difference in drug safety, as reflected in hospitalizations for infection or death. Conclusions: Biologic treatments for psoriasis demonstrate both efficacy and safety in elderly patients. Some agents exhibited better drug survival when initiated after age 65 years. Full article

Background: Psoriasis is a chronic inflammatory skin disease frequently associated with systemic comorbidities. Human neutrophil peptides 1–3 (HNP1–3), released by neutrophils, have both antimicrobial and proinflammatory effects and may contribute to the pathogenesis of psoriasis and its related conditions. The aim of this study was to evaluate the serum levels of HNP1–3 in patients with psoriasis compared with healthy controls and to assess their association with selected comorbidities and clinical parameters. Methods: In this cross-sectional study, forty-nine patients with psoriasis and forty-nine matched healthy controls were enrolled. Serum HNP1–3 levels were measured using ELISA. Clinical data, including waist-to-hip ratio (WHR), smoking status, and the presence of comorbidities such as psoriatic arthritis (PsA), cardiovascular disease, and pulmonary or autoimmune disorders, were recorded. Results: The mean HNP1–3 levels were significantly higher in the psoriasis patients than in the controls (3.85 ± 0.76 vs. 2.52 ± 0.84 ng/mL; p < 0.001), especially in patients with concomitant PsA (4.21 ± 0.69 ng/mL). Multivariable regression identified increased WHR (β = 1.77, p < 0.01) and smoking (β = 0.45, p < 0.001) as independent predictors of elevated HNP1–3 levels. Positive correlations were also found between HNP1–3 and ESR (r = 0.505, p = 0.019) and IL-6 (r = 0.561, p = 0.008). Conclusions: The elevated serum HNP1–3 levels identified in psoriasis patients—especially those with PsA, central obesity, and smoking history—suggest their potential utility as biomarkers of systemic inflammation. These findings highlight the systemic nature of psoriasis and warrant further research into the clinical utility of HNP1–3 in disease monitoring and risk stratification. Full article

Background/Objectives: We aimed to evaluate the clinical course, demographic characteristics, and risk factors in Polish patients with geographic tongue (GT). Methods: The analysis was based on medical records of 100 patients with GT referred to the outpatient clinic of Poznań University of Medical Sciences (PUMS) from 2013 to 2023. Data regarding age, gender, medical history, habits, subjective complaints, clinical features, localization, histology, and treatment were considered. Results: Patients with GT constituted 11.3% of 887 individuals admitted to the outpatient clinic in the analyzed period. The female-to-male ratio was 52:48. The average age at diagnosis was 51.6 years. Thirteen patients reported smoking, and 2.0% admitted to consuming alcohol excessively. Subjective complaints were reported by 85.0% of patients and mainly included a burning sensation (57.0%), pain (39.0%), xerostomia (22.0%), bleeding (4.0%), and taste disturbance (3.0%), while 15.0% of GT patients were asymptomatic. Comorbidities were found in 76.0% of subjects with GT, and included cardiovascular disorders (37.0%), gastrointestinal and thyroid gland diseases (24.0% and 18.0%), and type II diabetes (15.0%). Psoriasis was observed in one case only. Conclusions: The frequency of GT in a Polish cohort of patients was high and comparable in both genders. The majority of participants reported subjective complaints, and most of the patients were non-smokers. Comorbidities were found in 76.0% of subjects with GT and mainly included cardiovascular and gastrointestinal diseases. GT was often accompanied by other oral conditions, like candidiasis, recurrent aphthous stomatitis, and lichen planus. GT screening should include cardiovascular and gastrointestinal evaluation. Full article

In routine clinical settings, identifying the factors that influence the persistence of biologic therapies is crucial for tailoring psoriasis management to individual patient profiles. This study aimed to evaluate the real-world drug survival of tildrakizumab in patients diagnosed with plaque psoriasis at the Dermatology Department of HUCA and to explore the clinical predictors of treatment discontinuation. We conducted a retrospective, hospital-based analysis involving 100 patients treated with tildrakizumab (Ilumetri^®) between 1 January 2021 and 30 April 2024. Kaplan–Meier estimates were used to construct survival curves, and multivariate analyses were performed using Cox proportional hazards regression models. Both crude and adjusted hazard ratios (HRs) were calculated to assess potential differences across patient subgroups. The multivariate analysis identified statistically significant associations between reduced drug survival and the presence of psoriatic arthritis (p = 0.02), previous biologic exposure (p = 0.02), and arterial hypertension (p = 0.012). Other comorbidities did not demonstrate significant effects. The most common reasons for treatment discontinuation were primary inefficacy and suboptimal response in patients with arthritis. Overall, tildrakizumab demonstrated robust survival outcomes in this patient population, though diminished persistence was observed in those with prior biologic use, comorbid arthritis, and hypertension. Full article

Background/Objectives: Psoriasis is a chronic inflammatory skin disease increasingly linked to psychiatric and behavioral comorbidities, including depression, anxiety, and substance use disorders. Shared inflammatory pathways, including elevated IL-6, TNF-α, and IL-17, may link psoriasis with psychiatric disorders such as depression and anxiety. The bidirectional interaction between systemic inflammation and mental health may exacerbate the disease burden and affect treatment outcomes. The objective of this study was to determine the prevalence of psychiatric and behavioral comorbidities in patients with psoriasis and to explore potential demographic and clinical correlations. Assessing these correlations contributes to a better understanding of the mental health status of psoriasis patients, potentially influencing both therapeutic efficacy and quality of life. Methods: We conducted a cross-sectional observational study on 316 patients with clinically and histopathologically confirmed psoriasis, evaluated between January 2021 and March 2025 at the Clinical Railway Hospital in Iași, Romania. Psychiatric and behavioral comorbidities were assessed through clinical interviews, medical record reviews, and standardized tools including AUDIT-C, Fagerström Test for Nicotine Dependence, and the Binge Eating Scale. Psoriasis severity was evaluated using the Psoriasis Area and Severity Index (PASI). Results: Of 316 participants, 88 (27.8%) had psychiatric/behavioral comorbidities. The most frequent conditions were tobacco use disorder (11.1% overall; 39.8% among comorbid patients), alcohol use disorder (9.2%; 32.9%), binge eating (7.9%; 28.4%), anxiety (6.3%; 22.7%), and depression (4.1%; 14.8%). Additional diagnoses included personality disorders, dementia, PTSD, and sleep disorders. Conclusions: Psychiatric and behavioral comorbidities, particularly substance use disorders, are relatively common in patients with psoriasis. These findings support the need for regular mental health screening and integrated care approaches in psoriasis management. Full article

Background: The sales of ultra-processed food (UPF) are rapidly increasing worldwide, and there have been reports linking UPF consumption to several chronic diseases. However, there is limited prospective evidence exploring the impact of UPF on inflammatory skin diseases. Objectives: This study investigates the association between UPF intake and the incidence of psoriasis using data from the UK Biobank. Methods: UPFs were assessed based on the NOVA classification in this large prospective study. Cox proportional hazards regression was employed to estimate the association between UPF intake and the incident risk of psoriasis. Inflammation score (INFLA-score) and body mass index (BMI) were chosen as mediators to examine the mediation effect. Substitution analysis was performed to estimate the psoriasis risk when replacing the absolute amount of UPF with an equivalent weight of unprocessed or minimally processed food. Results: This study enrolled 121,019 participants aged 40–69 years from the UK Biobank. Over a 12-year (median) follow-up period, 1043 participants developed psoriasis. In the fully adjusted model, hazard ratios (95% confidence interval) for psoriasis across increasing quartiles of UPF consumption were 1.00 (reference), 1.07 (0.89, 1.28), 1.19 (1.00, 1.42), and 1.23 (1.03, 1.47), respectively (p for trend = 0.016). Factors such as age, sex, BMI, smoking status, drinking status, physical activity level, and Townsend Deprivation Index (TDI) did not significantly modify this association (p interaction > 0.05). The INFLA-score and BMI explained 6.5% (p = 0.012) and 30.5% (p < 0.001) of the association between UPF consumption and psoriasis risk, respectively. Replacing 20% of UPF weight in total diet with an equivalent proportion of unprocessed or minimally processed foods was associated with an 18% reduction in psoriasis risk (HR: 0.82; 95% CI: 0.72–0.94; p = 0.004). Conclusions: Our findings indicate that increased UPF consumption is associated with a higher risk of psoriasis. This provides valuable dietary guidance for preventing psoriasis and its related comorbidities. Full article

Introduction: About one in four people show an immunological reaction to an infection with Mycobacterium tuberculosis, which can remain latent or lead to active forms of the disease. Psoriasis is a chronic, immune-mediated skin disease that can be associated with numerous comorbidities. Biologic therapies have revolutionized psoriasis treatment but carry the risk of reactivating latent tuberculosis infection. However, the link between tuberculosis as a triggering factor for the onset of psoriasis remains unknown. Clinical Case: We present the case of a patient initially diagnosed with secondary pulmonary tuberculosis, who, two months after the diagnosis, showed a remarkable clinical evolution by developing lesions consistent with vulgar psoriasis, necessitating a multidisciplinary treatment approach. Discussions: This unique case highlights the shared immune mechanism of these diseases, particularly involving TNF-α, IL-17, and CD4+ T cells. Conclusions: The coexistence of these conditions raises critical questions about the interplay between infectious and autoimmune diseases and the impact of genetic susceptibility. Full article

Psoriasis is a systemic disease affecting 2–3% of the general population. Tryptophan (TRP) is an amino acid metabolized in the kynurenine pathway (KP). The aim of this study was to assess the kynurenine pathway’s metabolites in serum and urine of psoriatic patients and explore the possible interplay with the disease’s pathogenesis and its comorbidities. The study involved 60 patients with plaque psoriasis and 30 healthy volunteers matched for gender, age, and BMI. Serum and urine samples were taken from the participants and tested for TRP, indoleamine 2,3-dioxygenase (IDO), 2,3-tryptophan dioxygenase (TDO), kynurenine (KYN), kynurenic acid (KYNA), quinolinic acid (QUIN), and numerous laboratory parameters. Correlations between the metabolites’ levels and clinical, laboratory parameters and depression occurrence were statistically evaluated. Concentrations of tryptophan, kynurenic acid, and quinolinic acid in serum and urine were significantly higher among patients with psoriasis (p < 0.05 and p < 0.001, p < 0.05 and p < 0.05 and p < 0.001 and p < 0.001, respectively). A significant stimulation of the kynurenine pathway in serum and urine of patients with psoriasis suggests its role in its pathogenesis and interplay between chronic inflammation or comorbidities. Further research is needed to discover whether the increase in KP metabolites is an indicator of inflammation or a compensatory mechanism in psoriasis. Full article

Psoriasis is an immune-related disorder that is marked by abnormal thickening of the skin, the rapid multiplication of keratinocytes, and complex interactions between immune cells and the affected areas. Although psoriasis cannot currently be cured, drugs can alleviate symptoms by regulating immune homeostasis and preventing comorbidities. There are many types of drugs to treat psoriasis: small-molecule drugs, including corticosteroids; retinoids; vitamin D analogs; and immunosuppressants, such as glucocorticoid ointment, tretinoin cream, methotrexate tablets, etc. Macromolecular biological drugs, such as Certolizumab, Secukinumab, Guselkumab, etc., include monoclonal antibodies that target various inflammatory signaling pathways. Compared with traditional small-molecule drugs, biological therapies offer better targeting and lower systemic side effects, but their high costs and invasive administration modes constrict their widespread use. Spesolimab is the latest biological agent used to target the interleukin-36 receptor (IL-36R) to be approved for market use, which significantly reduces the risk of general pustular psoriasis (GPP) flare by 84%. Additionally, there are several biological agents used to target the interleukin-23/T helper 17 cell pathway that have already entered Phase II and III clinical trials. At present, the first-line therapeutic strategy for mild psoriasis is topical administration. Systemic therapy and phototherapy are preferred for treating moderate to severe types. However, the current therapeutic drugs for psoriasis cannot completely meet the clinical needs. More advanced drug delivery systems with optimized target effects and better bioavailability are required. Nanocarriers are emerging for the delivery of proteins, nucleic acids, and cell-based therapies. In this review, we analyze the current status of psoriasis therapeutics and discuss novel delivery systems for diverse psoriasis drugs, as well as emerging cell-based therapies. We also summarize the therapeutic effectiveness of different delivery strategies. Full article

Psoriasis is a chronic immune-mediated skin disease characterized by cytokine dysregulation. Pro-inflammatory mediators, including tumor necrosis factor-alpha (TNF-α), interleukin (IL)-17, and IL-23, play pivotal roles in the pathogenesis of psoriasis. Emerging evidence suggests that dietary interventions can modulate cytokine activity, providing a complementary approach to standard therapies. This narrative review examines the impact of various dietary strategies, including a Mediterranean diet, ketogenic diet, gluten-free diet, and fasting-mimicking diet, on cytokine profiles and clinical outcomes in psoriasis. Research insights reveal that dietary components such as omega-3 fatty acids, polyphenols, and short-chain fatty acids influence immune signaling pathways. These pathways include nuclear factor-kappa B (NF-κB) and Signal Transducer and Activator of Transcription 3 (STAT3). Additionally, these dietary components promote anti-inflammatory effects mediated by gut microbiota. Clinical studies demonstrate significant reductions in psoriasis severity, improved quality of life, and modulation of key cytokines associated with disease activity. Despite these advancements, significant challenges persist in effectively integrating these findings into clinical practice. These challenges include variability in patient responses, adherence issues, and the need for robust biomarkers to monitor efficacy. Future directions emphasize the potential of personalized nutrition and precision medicine approaches to optimize dietary interventions tailored to individual cytokine profiles and genetic predispositions. Integrating these strategies into psoriasis care could transform treatment paradigms by simultaneously addressing both systemic inflammation and comorbid conditions. Full article

Psoriasis disease is a chronic, systemic condition. Various epidemiological studies have indicated a connection between psoriasis and psychiatric diseases. It is obvious that easily visible psoriatic skin lesions cause stigmatization of patients and impact noticeably their life quality, increasing the risk of anxiety and depressive disorders. More and more attention is recently being paid to the common pathogenesis of psoriasis and depression. The underlying cause of psoriasis is chronic inflammation, and depression is also increasingly recognized as a result of neuroinflammation. Therefore, the complexity of the processes underlying both disease entities implies the need to observe psoriatic patients in terms of possible comorbidities, such as mental disorders, regardless of the severity of skin lesions and social stigmatization. This study aims to present an update on the common pathophysiology of both diseases. Full article

Background/Objectives: Several gene targets were identified for psoriasis. Some are currently being explored as potential therapeutic targets, including CCL11. Our task was to prove a possible association of single-nucleotide polymorphisms +67 G/A and -426 T/C in the eotaxin gene (CCL11, 17q 21.3) with the development and clinical aspects of psoriasis as an immune-based dermatological disease and evaluate its relationship to potential comorbidities. Material and Methods: In total, 460 patients with psoriasis were included in the case–control and genotype–phenotype study together with 167 control persons of similar age and sex distributions without a personal and/or family history of chronic disease of the skin. Two eotaxin gene polymorphisms were detected from isolated DNA via standard PCR, restriction analysis methods, and horizontal electrophoresis. Results: No significant case–control differences in the frequency of the CCL11 genotype in both polymorphisms were observed. In polymorphism +67 G/A, a significant increase in the AA genotype in patients with psoriasis guttata compared to plaque psoriasis was found (p = 0.006). A significant association of the A allele in psoriatic patients with a personal history of allergy was found (p = 0.02). The A alle was also significantly associated with a family history of psoriasis (p = 0.00008). In men, a higher risk of a delayed start of psoriasis (later than 40 years) associated with the T allele of -426 T/C polymorphism (p = 0.0007) was found. When double genotypes of both polymorphisms were evaluated, we observed significant differences in double genotype distribution between men with and without a family history of allergy (Pdg = 0.0005) and between those with and without affected siblings (Pdg = 0.03). In women with psoriasis, a higher risk of the TT genotype of -426 T/C polymorphism in patients with a personal history of diabetes (p = 0.001) as well as in patients with both a personal history of cardiovascular disease and diabetes (p = 0.00005) was proved. When double genotypes of both polymorphisms were evaluated, the significance of double genotype difference between those with and without personal history of diabetes was very high (Pdg = 0.0002). Similarly, the significance of the double genotype difference between those with and without personal history of cardiovascular diseases and diabetes was very high (Pdg = 0.000001). Conclusions: CCL11 is considered one of the basic chemokines responsible for the origin and development of immune-based reactions. Based on our results, we suggest that the +67 G/A CCL11 polymorphism should be considered as a gene modulator of psoriasis in specific subgroups of patients. Full article