Li Zhang,1,2,* Jingwen Wu,1,* Jie Zheng,1,2 Lihong Chen,1 Youcong Wang,1 Xia Li11Department of Dermatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 2Ruijin-Yatsen Joint Laboratory, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xia Li, Department of Dermatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin Er Road, Shanghai, 200025, People’s Republic of China, Email drlixia@126.comBackground: Eczematous eruption (EE) is a paradoxical adverse event during interleukin-17A (IL-17A) inhibitor therapy for psoriasis and may require modification or discontinuation of biologic therapy. However, evidence guiding its management remains limited.Methods: We retrospectively reviewed 13 patients with psoriasis who developed EE during IL-17A inhibitor therapy and subsequently received selective Janus kinase 1 inhibitors (JAK1i; upadacitinib, n=11; abrocitinib, n=2).Results: JAK1i treatment resulted in rapid clinical improvement, with mean Eczema Area and Severity Index (EASI) scores decreasing from 14.7 to 3.0 and pruritus visual analogue scale scores from 9.1 to 2.2 after 4 weeks; all patients showed marked clinical improvement by week 8. During a median follow-up of 68 weeks from JAK1i initiation, subsequent psoriasis treatment was individualized according to disease course, with heterogeneous subsequent treatment strategies across patients.Conclusion: These findings support the potential use of selective JAK1 inhibitors for rapidly controlling IL-17A inhibitor-associated EE, with subsequent psoriasis management individualized according to the clinical course.Keywords: psoriasis, eczematous eruptions, janus kinase inhibitors, IL-17 inhibitor
Marielle Nyheim-Tømmerås,1 Bjørn Kromann,1 Line Bruun Pilgaard Møller,1 Ann Mari Rosager,2,3 Michael Bzorek,4 Jens Ole Eriksen,5 Marianne Bengtson Løvendorf,1,6 Beatrice Dyring-Andersen1,6,71Department of Dermatology, Zealand University Hospital, Roskilde, Denmark; 2Department of Pathology, Hospital of Southern Jutland, Aabenraa, Denmark; 3Department of Regional Health Research, University of Southern Denmark, Odense, Denmark; 4Department of Pathology, Zealand University Hospital, Køge, Denmark; 5Department of Pathology, Zealand University Hospital, Roskilde, Denmark; 6The Leo Foundation Skin Immunology Research Center, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; 7Department of Clinical Medicine, University of Copenhagen, Copenhagen, DenmarkCorrespondence: Beatrice Dyring-Andersen, Email beatriceda@sund.ku.dk
Priyanka Pagh, Sandra Hertz, Kasper F HjulerDepartment of Dermatology and Venerology, Aalborg University Hospital, Aalborg, DenmarkCorrespondence: Priyanka Pagh, Department of Dermatology and Venerology, Aalborg University Hospital, Moelleparkvej 4, Aalborg, 9000, Denmark, Email Priyanka_pagh@hotmail.comAbstract: Psoriasis vulgaris is a common dermatological condition that significantly impacts patients’ quality of life and is associated with various comorbidities, such as psoriatic arthritis and cardiometabolic disease. Although several therapeutic modalities are currently available, patients continue to seek alternative treatments such as dietary supplements to alleviate their symptoms. This review examines the existing literature on a range of oral dietary supplements, including: coenzyme Q10, selenium, carotene, vitamin A, probiotics, vitamin B, vitamin C, vitamin D, vitamin E, phospholipids, fish oil/omega-3 fatty acids, curcumin, zinc, resveratrol, prebiotics, keratins, flavonoids, bakuchiol, cobber, phosphorus, arginine, magnesium, lecithin, luteolin, calcium, collagen, hyaluronic acid and quercetin. Across all studies, the supplements investigated are characterized by considerable heterogeneity, small sample sizes, and divergent methodologies and dosages. Consequently, current evidence is insufficient to recommend any dietary supplement routinely for psoriasis treatment. However, some supplements, particularly probiotics, omega-3 fatty acids, and curcumin, show promising trends that warrant further investigation. Clinicians should therefore discuss supplements on an individual basis, considering potential benefits, risks, and the limited evidence regarding their efficacy and safety.Keywords: psoriasis vulgaris, dietary supplements, vitamins
Canbin Dong, Yilun Wang, Jiazheng Sun, Jui-Ming Lin, Xiaonian Lu, Junhao Zhu, Lanmei Lin, Xinyi Zhu, Huiyu Huang, Jinhua Xu, Wenyu Wu, Juan DuDepartment of Dermatology, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Wenyu Wu; Juan Du, Email wenyu_wu@fudan.edu.cn; dujuan@huashan.org.cnBackground: Psoriasis is a prevalent immune-mediated inflammatory skin disease. Deucravacitinib, an oral selective allosteric tyrosine kinase 2 (TYK2) inhibitor, provides a novel therapeutic option, but real-world data on its short-term efficacy, safety, and predictors of response among Chinese patients remain limited.Objective: To evaluate the 12-week efficacy, safety, and predictors of response to deucravacitinib in Chinese patients with moderate-to-severe plaque psoriasis in a real-world setting.Methods: This prospective, single-center cohort study enrolled 120 adult patients with moderate-to-severe plaque psoriasis (Psoriasis Area and Severity Index ≥ 10, body surface area ≥ 10%, or Dermatology Life Quality Index ≥ 10) at a tertiary hospital in Shanghai, China. All patients received oral deucravacitinib 6 mg once daily for 12 weeks.Results: Among the 120 patients (mean age, 37.2 years; 58.3% male), the week 12 PASI 75, PASI 90, and PASI 100 response rates were 59.6%, 24.0%, and 4.8%, respectively. Regional PASI 75 response rates were highest for the head and neck (79%), followed by the trunk (76%), lower limbs (74%), and upper limbs (72%). Baseline body mass index < 24 kg/m2 independently predicted higher PASI 90 achievement (odds ratio, 5.34; 95% CI, 1.28– 22.21), but was not associated with PASI 75. Exploratory comparisons showed that PASI 75 non-responders had higher baseline levels of TNF-α, IL-1β, IL-23p19, IFN-γ, and G-CSF in exploratory comparisons, with no differences in other Th1, Th2, Th17, or regulatory T-cell cytokines. Adverse events occurred in 41 of 120 patients (34.2%); the most common events were acne (24/120, 20.0%), folliculitis (13/120, 10.8%), and upper respiratory tract infection (7/120, 5.8%), and most were mild to moderate.Conclusion: In this real-world study, deucravacitinib was associated with significant clinical improvement over 12 weeks and had a favorable safety profile in Chinese patients with moderate-to-severe psoriasis, including improvement in difficult-to-treat anatomical regions. Baseline body mass index < 24 kg/m2 and lower pretreatment levels of proinflammatory cytokines were associated with better treatment responses.Keywords: deucravacitinib, psoriasis, TYK2 inhibitor, real-world, predictive factors, biomarkers
Hamed Mamizadeh,1,2 Hamideh Herizchi Ghadim,1,2 Sajjad Pourasghary31Department of Dermatology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran; 2Department of Dermatology, Sina Medical Research and Training Hospital, Tabriz University of Medical Sciences, Tabriz, Iran; 3Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, IranCorrespondence: Sajjad Pourasghary, Drug Applied Research Center, Tabriz University of Medical Sciences, Medical Research and Development Complex Daneshgah St. P.O. BOX: 51656-65811, Tabriz, Iran, Tel +989375996070, Email pourasgary@yahoo.com; pourasghary.s@tbzmed.ac.irPurpose: To evaluate whether adding topical 5% caffeine to fluocinolone acetonide 0.025% cream (FAC) improves short-term clinical outcomes compared with FAC alone in patients with chronic plaque psoriasis.Patients and Methods: This randomized, parallel-group, masked, active-controlled clinical trial included 40 patients with chronic plaque psoriasis treated at the dermatology outpatient clinic of Sina Hospital, Tabriz, Iran. Participants were randomly allocated in a 1:1 ratio to receive either topical 5% caffeine plus fluocinolone acetonide 0.025% (intervention group, n=20) or topical fluocinolone acetonide 0.025% alone (control group, n=20). Psoriasis severity was assessed using the Psoriasis Area and Severity Index (PASI) at baseline and weekly for four weeks. Treatment response and adverse events were also recorded.Results: Baseline PASI scores were comparable between the intervention and control groups (3.41 ± 1.86 vs 3.79 ± 1.51, respectively; P=0.484). PASI scores were significantly lower in the intervention group at each post-treatment assessment. At week 4, mean PASI was 0.39 ± 0.17 in the intervention group and 2.29 ± 1.31 in the control group (P=0.001). The mean reduction from baseline to week 4 was 3.01 ± 1.48 with 5% caffeine plus FAC and 1.49 ± 1.01 with FAC alone (P< 0.001). Complete clearance, defined as PASI=0, occurred in 14 of 20 patients (70%) in the intervention group compared with 1 of 20 (5%) in the control group (P=0.001). No adverse events were reported during the study.Conclusion: Adding topical 5% caffeine to FAC produced a greater short-term reduction in psoriasis severity than FAC alone. No adverse events were reported during the 4-week treatment period. Larger randomized trials with longer follow-up are warranted to confirm efficacy and characterize longer-term tolerability.Trial Registration: Iranian Registry of Clinical Trials (IRCT), IRCT20091012002581N10, registered on October 28, 2023; https://irct.ir/trial/73367.Keywords: psoriasis, caffeine, fluocinolone acetonide, topical therapy, psoriasis area and severity index, randomized controlled trial
