Background:Psoriasis is widely recognized as a systemic inflammatory condition associated with numerous comorbidities. Among these, eating disorders (ED) and ED-related behavior, defined as restrictive or dysfunctional attitudes toward food, have been increasingly reported in patients with psoriasis. Aim of our study was to evaluate the prevalence of ED-related symptoms in psoriasis patients with excess body weight and to explore their association with body mass index (BMI) across the overweight and obese ranges. Methods:A multicenter, cross-sectional study was conducted on adult patients with psoriasis and BMI ≥25 kg/m2. ED-related symptoms were assessed using the Binge Eating Scale (BES ≥17) and Eating Attitudes Test-26 (EAT-26). Screening positivity required a positive result in at least one questionnaire. Patients were stratified into four BMI categories. Variables were compared using standard non-parametric tests, and logistic regression assessed predictors of screening positivity. Results:A total of 104 patients were included. Overall, 13 patients (12.5%) tested positive in at least one questionnaire. No statistically significant differences in the proportion of screening-positive patients were observed across the BMI categories or between the overweight and obese groups. Similarly, the mean BES and EAT-26 scores did not differ significantly between groups. Logistic regression analysis confirmed that BMI was not a significant predictor of ED-related screening positivity (OR = 0.942, 95% CI: 0.813-1.091). Spearman's analysis showed no significant correlation between BMI and BES scores (ρ = 0.031, p = 0.753) but a weak negative correlation between BMI and EAT-26 scores (ρ = -0.211, p = 0.032). Conclusion:Approximately one in eight psoriasis patients with excess body weight screened positive for ED-related symptoms. BMI category was not a predictor of ED-screening positivity. The weak negative correlation between BMI and restrictive eating attitudes indicates that dysfunctional eating behaviors may be more pronounced in patients with milder excess weight.
Background:Psoriasis is associated with increased epicardial adipose tissue (EAT), a metabolically active fat depot in direct contact with the myocardium, and a mediator of coronary artery disease and atrial fibrillation. The effects of psoriasis treatments on EAT are largely unknown. We conducted a post hoc analysis of the Vascular Inflammation in Psoriasis (VIP) trial (NCT01553058, NCT01866592). Methods:VIP compared, in a 1:1:1 randomized manner, placebo (n=27), adalimumab (n=31), and phototherapy (n=28) from baseline to week 12, with all subjects then receiving adalimumab for 52 weeks. EAT volume was quantified from CT imaging at baseline, week 12, and week 52, with concurrent assessment of clinical variables and metabolic and inflammatory biomarkers. Results:At baseline (N=86), EAT volume was positively correlated with age (r = 0.51, p= 2.44 × 10-), body mass index (r = 0.48, p= 2.01×10-6), and weight (r = 0.52, p= 3.17 × 10-), and with inflammatory biomarkers GlycA (r = 0.27, p= 9.48×10-3), C-reactive protein (r = 0.25, p= 9.94×10-3), and IL-6 (r = 0.23, p= 0.02). Over 12 weeks, adalimumab treatment reduced EAT volume (mean change -11.9 cm3, p=0.04; baseline mean EAT 183.1 cm3), with no improvement observed in the placebo or phototherapy groups. When compared with the placebo and phototherapy arms combined, adalimumab was associated with a greater reduction in EAT at week 12 (between-group difference -13.9 cm3, p=0.03). The reduction in EAT was not significantly associated with changes in weight or PASI. No additional reduction in EAT was observed after 52 weeks of adalimumab treatment. Conclusion:Adalimumab was associated with an early reduction in EAT that was not significantly correlated with changes in weight or psoriasis activity. These findings indicate treatment-specific effects on a high-risk cardiac fat depot and suggest that TNF inhibition may influence cardiac adiposity relevant to cardiovascular disease.
Background:Psoriasis is a chronic disease with a multidimensional impact that extends beyond skin symptoms, affecting physical, emotional, social well-being and satisfaction with care. This study aims to explore the perceived self-reported impact of psoriasis on patients' well-being across different life stages and to identify risk and protective factors associated with well-being over time. Methods:A cross-sectional observational study was conducted using an electronic questionnaire administered to adult patients with psoriasis and healthcare professionals involved in psoriasis management. Patients retrospectively self-reported the perceived impact of psoriasis on overall well-being and its physical, emotional, social, and treatment-related domains across consecutive 10-year life stages. Both patients and healthcare professionals evaluated perceived risk and protective factors for well-being. Results:A total of 53 patients and 54 healthcare professionals completed the questionnaire. Most patients (90.6%) reported psoriasis had negatively affected their general well-being at some point during the disease course, with the physical (90.6%) and emotional (88.7%) domains being the most impacted. The highest perceived burden was reported between 31 and 40 years of age. Better reported symptom control was associated with lower perceived impairment in well-being. Key risk factors included affected body areas (95.3%), comorbidities (93.5%), and disease severity (89.7%), whereas appropriate treatment (96.3%), adequate medical care (93.5%), and a positive physician-patient relationship (89.7%) were identified as protective factors. Conclusion:These exploratory findings suggest that the self-reported perceived impact of psoriasis on well-being varies across life stages and is strongly influenced by symptom control and holistic disease management. These findings support a longitudinal, patient-centered approach to optimize long-term well-being.
Purpose:While dietary factors are known to be associated with the development and progression of psoriasis, their effect on treatment efficacy remains unclear. Therefore, this study aimed to elucidate the influence of tea consumption, sugar drinks, and high-fat foods on the treatment response in psoriasis. Patients and methods:We undertook a prospective cohort study comprising 559 patients with psoriasis from Shanghai Skin Disease Hospital between 2022 and 2024. Data on demographics, lifestyle (including tea, sugary drinks, and high-fat food consumption), and disease severity (PASI, BSA, PGA) were collected via structured questionnaires at baseline, week 4, and week 8. The primary endpoints were the proportions of patients achieving PASI 50 responses at week 8. Multivariable logistic regression was used to estimate odds ratios with 95% confidence intervals, adjusting for age, sex, BMI, smoking, alcohol, and treatment regimen. Data were analyzed using SAS 9.4 software. Results:In the psoriasis cohort (mean age 48.5 years; 73.2% male), 37.1% and 68.7% of patients consumed sugar drinks and high-fat foods ≥2 times/week, respectively. Frequent sugar drinks consumption (≥4 times/week) was independently associated with significantly reduced odds of achieving PASI 50 (adjusted OR=0.24, 95% CI: 0.08-0.75) and PASI 75 (adjusted OR=0.27, 95% CI: 0.07-1.00) at week 8. Moderate intake of high-fat foods (2-3 times/week) showed an inverse, borderline significant association with PASI 50 at week 4 (adjusted OR=0.68, 95% CI: 0.45-1.00). Tea consumption showed a non-significant association with treatment response (e.g, week 8 PASI 50 adjusted OR=1.44, 95% CI: 0.88-2.35), warranting further investigation in larger cohorts. Conclusion:This study demonstrates that high consumption of sugar drinks and high-fat foods is associated with suboptimal treatment response in psoriasis. Tea consumption was not significantly associated with treatment outcomes, although further investigation with larger cohorts may be warranted. These findings highlight the importance of integrating dietary assessment and counseling into comprehensive psoriasis management.
Purpose:To explore genotype-phenotype associations of IL36RN variants and clinical outcomes of spesolimab treatment in acrodermatitis continua of Hallopeau (ACH). Patients and methods:This multicenter retrospective study included 14 ACH patients with IL36RN genotyping from 2019 to 2025. Clinical features were compared across all genotypes. Medical records of individuals who received spesolimab were reviewed to describe treatment responses, with a follow-up observation period up to 56 weeks. Results:Compared with monoallelic or wild-type genotypes, biallelic IL36RN variants were associated with earlier disease onset age (23 vs 48 and 47 years, P <0.05) and higher baseline disease severity (median GPPGA score, 4 vs 3 and 2, P <0.001). Among 6 patients with biallelic, refractory ACH who received spesolimab, including 3 isolated cases that were administered at a 450-mg dose, overall percentage improvement across disease activity and patient-reported measures occurred rapidly, reaching 54% at week 1 and 74% at week 4. Relapse occurred in 4 patients between weeks 31 and 44, with disease activity remaining lower than baseline and improvement observed after re-treatment. Conclusion:Spesolimab was associated with clinical improvement in refractory ACH with biallelic IL36RN mutations, including isolated ACH treated with a 450-mg dose, supporting further evaluation of dose individualization below the approved 900-mg regimen for GPP flares.
