IntroductionT cell autoreactivity against the autoantigens LL37 and ADAMTSL5 contributes to inflammation in a subset of psoriatic patients. The immunological mechanisms underlying the treatment response in patients showing autoreactivity remain incompletely understood in clinical settings. This study investigated the impact of tildrakizumab on circulating immune populations and on autoantigen-specific T cell reactivity.MethodsPatients with moderate-to-severe psoriasis were enrolled and treated with tildrakizumab according to clinical practice. T cells autoreactivity to LL37 and ADAMTSL5 was assessed at baseline using a stimulation index (SI>2). Longitudinal changes in circulating T cell subsets were analyzed using multiparametric flow cytometry.ResultsTwenty of 38 psoriatic patients (52.6%) displayed circulating autoreactive T cells (SI>2) to LL37 and/or ADAMTSL5, compared with 5 of 33 healthy donors (15.2%). Baseline frequencies of Ki67+CD4+/CD8+, and IL-17+CD4+/CD8+ T cell populations positively correlated with PASI. Stimulation of PBMCs with LL37 or ADAMTSL5 induced Th17- and Th1-related cytokines, but not Th2-related cytokines. During treatment, tildrakizumab significantly modulated multiple circulating T cell subsets, including Ki67+CD4+, Ki67+CD8+, Ki67+Th17, Th17, and Ki67+Tregs, and markedly reduced autoreactivity to both autoantigens. Notably, clinical improvement strongly correlated with reductions in Ki67+CD4+ and Ki67+CD8+ T cell frequencies. LL37-reactive patients exhibited a poorer clinical response at weeks 40 and 52.ConclusionsIn autoreactive patients, tildrakizumab effectively modulated circulating T cell proliferation and reduced autoantigen-specific responses over time. LL37-reactive patients showed distinct long-term responses, suggesting that autoantigen-reactive subjects may represent a more treatment-challenging subgroup within the psoriatic population.

Chronic plaque psoriasis significantly impairs physical, psychological, and social well-being. Patient-reported outcome measures (PROMs) are increasingly recognized as essential endpoints. Tildrakizumab, an interleukin (IL)-23p19 inhibitor, has demonstrated high efficacy and safety in clinical trials, but real-world data on its impact on PROMs remain limited. We aimed to evaluate the effect of tildrakizumab on psoriasis severity, symptoms, and health-related quality of life, including sleep disorders, and to assess correlations between severity of the disease (measured using the Psoriasis Area and Severity Index [PASI]) improvement and PROMs in a real-world cohort. Consecutive adults with moderate-to-severe plaque psoriasis initiating tildrakizumab were enrolled and prospectively followed for 52 weeks. Assessments at baseline, week 16, and week 52 included the PASI; Dermatology Life Quality Index (DLQI); Skindex-16; Visual Analog Scale (VAS) for pruritus, scaling, and pain; the Medical Outcomes Study Sleep Scale (MOS-Sleep); and Work Productivity and Activity Impairment (WPAI) questionnaire. Thirty-three patients were enrolled in the study. Tildrakizumab induced rapid skin clearance and symptoms relief, with marked reductions in PASI and most PROMs by week 16. Pain and MOS-Sleep improved significantly only at Week 52. PASI correlated with PROMs at Week 16 (Spearman correlation), especially DLQI (r = 0.69, p < 0.001) and pruritus (r = 0.70, p < 0.001). At Week 52, correlations weakened for most PROMs, except Skindex-16 (r = 0.62, p < 0.01), pruritus (r = 0.54, p = 0.02), and scaling (r = 0.55, p = 0.02). Repeated-measures correlation analysis demonstrated significant within-subject associations between PASI improvement and most patient-reported outcomes (DLQI, scaling, pain, pruritus, and Skindex-16), while no significant associations were observed for WPAI and MOS-Sleep. Tildrakizumab improves both objective disease severity and quality of life at week 16. PASI strongly correlates with PROM improvements early in treatment, but correlations diminish over time, suggesting possible adaptation once skin clearance is sustained. PROMs should be integrated into long-term management to capture patient-centered benefits beyond skin clearance.

To the Editor: Angioimmunoblastic T-cell lymphoma (AITL) is an uncommon peripheral T-cell lymphoma that accounts for 1% to 2% of all forms of non-Hodgkin lymphoma and usually affects middle-aged individuals. 1It primarily appears on the skin and mimics an inflammatory dermatosis, leading to diagnostic and therapeutic delays. 2 No gold-standard treatment has been identified for AITL; the prognosis often remains poor, with a 5-year progressionfree survival rate of approximately 25%. 3 Because of the rarity of AITL and the unmet need of a standard-of-care treatment regimen, relapsing and remitting disease is common and continues to challenge clinicians.Methotrexate (MTX), a dihydrofolate reductase inhibitor used to treat many autoimmune diseases, is prescribed at a higher dosage (>500 mg/m 2 ) to manage cancers, including refractory AITL. 4 In blocking dihydrofolate

Background: Melanoma is currently the most prevalent malignant neoplasm among adults and represents the second most common cancer in both sexes among individuals aged 0 to 39 years. This retrospective multicenter study delves into the distinctive clinical, anamnestic, histopathologic, and prognostic attributes of melanoma in Adolescent and Young Adults (AYA), defined as patients diagnosed at ≤40 years, across four Italian centers. Methods: Through a computer-based review of clinical records from 1 January 2010 to 30 September 2023, AYA melanomas were contrasted with non-AYA melanomas (>40 years) among 1452 patients. Data on demographics, melanoma localization, histological type, Breslow thickness, ulceration, and sentinel lymph node (SLN) biopsy status were meticulously collected and analyzed. Results: Our analysis revealed a female predominance in the AYA group and a male predominance in the non-AYA group, with significant differences in anatomical localization and histological types between the two. AYA melanomas showed nearly equal trunk and limb involvement, contrasting with the trunk predominance in non-AYA melanomas. While Breslow thickness was similar across both groups, the presence of ulceration and total number of nevi showed no significant difference. Survival analysis indicated a marginally higher Disease-Free Survival (DFS) in AYA patients compared to non-AYA patients, without a significant difference in Overall Survival (OS). Conclusions: This study highlights demographic and clinical distinctions between AYA and non-AYA melanoma patients, underscoring the need for tailored follow-up and treatment strategies. Despite these insights, the heterogeneity of melanoma among young adults calls for further research, including genetic analyses, to fully understand this unique melanoma subgroup. Indeed, AYA melanoma patients could represent a different and specific target for both follow-up and treatments.

Background: Psoriasis is a chronic inflammatory skin condition that affects millions of individuals worldwide, impacting their physical and emotional well-being. The management of psoriasis requires effective communication and a strong physician–patient relationship. Objective: We aim to develop a novel algorithm to enhance patient well-being and care in moderate-to-severe psoriasis, considering the time constraints that dermatologists have in public hospitals. Methods: This project employed a multidisciplinary approach, involving collaboration between 14 experienced dermatologists (referred to as Key Opinion Leaders: KOLs) and a psychologist. During three separate meetings (an initial virtual session, a face-to-face meeting, and a final virtual meeting), an algorithm (Embracing Patients’ Well-being in their Journey of Moderate-to-Severe psoriasis: EMPATHY), describing the patient’s reception through the entire first visit and follow-up visits, was developed and refined. Results: The EMPATHY algorithm provides a step-by-step approach from the moment the patient arrives at reception, through the first visit and on to subsequent visits. This algorithm fills a critical gap in the existing guidelines by specifically addressing how to foster empathy during psoriasis patient visits within time-limited consultations. The algorithm outlines patient-centered strategies at each visit. Key aspects include creating a welcoming environment, active listening, respecting privacy, tailoring communication styles, and managing patient expectations. Conclusions: The EMPATHY algorithm represents a novel and promising approach to improving patient care and well-being in moderate-to-severe psoriasis. Developed together by dermatologists and a psychologist, this algorithm offers healthcare providers practical guidance for managing both initial and follow-up patient visits. While further validation is necessary, the potential for adapting the EMPATHY algorithm to diverse healthcare settings and patient populations holds promise for improving patient outcomes across various chronic conditions.

BACKGROUND:Ribociclib is approved for hormone receptor positive (HR+), human epidermal growth factor receptor 2 negative (HER2-) advanced breast cancer (ABC) treatment, in combination with endocrine therapy. Hematological, hepatic, and cardiac adverse events (AEs) emerged from pivotal trials, but little is known about cutaneous adverse events (CAEs). PATIENTS AND METHODS:We report data from a retrospective cohort study of all patients with HR+/HER2- ABC treated with ribociclib at Humanitas Cancer Center between June 2017 and December 2022. We recorded clinical-pathological data, the incidence, and treatment of ribociclib-related CAEs. These were evaluated according to the NCI-CTCAE v5.0 classification. Progression-free survival (PFS) was estimated by Kaplan-Meier method and the log-rank test was used to analyze differences between groups. RESULTS:Thirteen of 91 patients (14.3%) experienced treatment-related CAEs (mean time to the occurrence: 3.9 months). The most frequent CAEs were eczematous dermatitis (53.8%) and maculo-papular reaction (15.4%). Itch was reported by all 13 patients. The grade was G3 in 8 cases, G2 in 4, and G1 in 1. An integrated approach based on ribociclib dose modulation and dermatological interventions (oral antihistamine, moisturized cream, topical, and/or systemic steroids) could prevent ribociclib discontinuation in most patients. At a median follow-up of 20 months, the median PFS was 13 months (range, 1-66) with a better PFS curves for patients experiencing CAEs (P = .04). CONCLUSION:We mapped frequency and types of ribociclib-induced CAEs. An interdisciplinary management of CAEs incorporated into routine care may reduce the rate of drug discontinuation thus potentially contributing to better long-term outcomes.

The assessment of quality of life (QoL) in patients with psoriasis plays a crucial role in understanding the impact of the disease and evaluating treatment outcomes. We provide an overview of the key measures used to assess QoL in psoriasis patients, including both generic and psoriasis-specific instruments. The limitations and strengths of instruments such as the Dermatology Life Quality Index (DLQI), Skindex, and Psoriasis Disability Index (PDI) are discussed, highlighting their psychometric properties and areas for improvement. Furthermore, this review examines the potential of disease-specific QoL measures in providing greater sensitivity to disease-related burden and change compared to generic instruments. However, most of the available psoriasis-specific patient-reported outcome measures need further validation. We aim to provide valuable insights into the importance of using validated QoL measures in clinical practice and research, ultimately contributing to a more comprehensive assessment of the impact of psoriasis on patients’ lives and enhancing the evaluation of treatment interventions.

Dermatology Unit, Humanitas Research Hospital, IRCCS, Rozzano, Milan, Italy Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy U.O. Laboratorio Analisi, Humanitas Research Hospital—IRCCS, Rozzano, Milan, Italy Skin Pathology Lab, Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy Pediatrics Unit, Mariani Foundation Center for Fragile Child ASST-Lariana, Sant'Anna Hospital, San Fermo della Battaglia, Como, Italy Pathology, Humanitas Research Hospital—IRCCS, Rozzano, Milan, Italy Plastic and Reconstructive Surgery Unit, Humanitas Research Hospital—IRCCS, Rozzano, Milan, Italy Endocrinology, Humanitas Research Hospital—IRCCS, Rozzano, Milan, Italy

A nationwide cross-sectional online survey was administered to dermatologists managing patients with moderate-to-severe plaque psoriasis across Italy to obtain real-world dermatologists’ perspectives on the impact of psoriasis and its treatment on patients’ daily lives and quality of life (QoL). A total of 91 dermatologists (aged 39.1 ± 11.2 years) completed a 31-question survey and workshop sessions were undertaken in order to identify the best management approach to achieve patient wellbeing. Social (4.2 ± 0.1), physical (4.26 ± 0.2) and mental components (4.1 ± 0.3) were rated by dermatologists as contributing to patient wellbeing to similar extents. While a high proportion (85.4%; rating of 4.3 out of 5) of dermatologists felt that they considered the QoL of patients, a lower proportion (69.6%; rating of 3.7 out of 5) felt that patients were satisfied in this regard. The psoriasis area and severity index and body surface area were the instruments most frequently used to assess the physical domain, while interviews/questions and the dermatology life quality index were used to assess social and mental domains, with only 60% of dermatologists following up on these aspects. The importance of investigating the presence of comorbidities was recognized but not always carried out by many dermatologists, (>70%), particularly for obesity and anxiety/depression. This survey identified key components contributing to barriers impacting on the QoL of patients with moderate-to-severe psoriasis from the perspective of the dermatologist.

Accepted: July 27, 2023; Published: April 2023 Copyright: ©2023 Toso et al. This is an open-access article distributed under the terms of the Creative Commons AttributionNonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited.

Sequential digital dermoscopy (SDD) enables the diagnosis of a subgroup of slow-growing melanomas that lack suspicious features at baseline examination but exhibit detectable change on follow-up. The combined use of total-body photography and SDD is recommended in high-risk subjects by current guidelines. To establish the usefulness of SDD for low-risk individuals, we conducted a retrospective study using electronic medical records of low-risk patients with a histopathological diagnosis of cutaneous melanoma between 1 January 2016 and 31 December 2019, who had been referred and monitored for long-term follow-up of clinically suspicious melanocytic nevi. We sought to compare the distribution of "early" cutaneous melanoma, defined as melanoma in situ and pT1a melanoma, between SDD and periodical handheld dermoscopy in low-risk patients. A total of 621 melanomas were diagnosed in a four-year timespan; 471 melanomas were diagnosed by handheld dermoscopy and 150 by digital dermoscopy. Breslow tumor thickness was significantly higher for melanomas diagnosed by handheld compared to digital dermoscopy (0.56 ± 1.53 vs. 0.26 ± 0.84, p = 0.030, with a significantly different distribution of pT stages between the two dermoscopic techniques. However, no significant difference was found with respect to the distribution of pT stages, mean Breslow tumor thickness, ulceration, and prevalence of associated melanocytic nevus in tumors diagnosed on periodical handheld dermoscopy compared to SDD. Our results confirm that periodical dermoscopic examination enables the diagnosis of cutaneous melanoma at an earlier stage compared to first-time examination as this was associated in our patients with better prognostic features. However, in our long-term monitoring of low-risk subjects, Breslow tumor thickness and pT stage distribution did not differ between handheld periodical dermoscopy and SDD.

Citation: Cortese A, Pancetti S, Pressiani T, et al. Sorafenib-Induced Acute Generalized Exanthematous Pustulosis. Dermatol Pract Concept. 2023;13(2):e2023130. DOI: https://doi.org/10.5826/dpc.1302a130

Atopic dermatitis (AD), also referred to eczema, is a common inflammatory skin disease that usually presents during infancy or childhood but affects patients of all ages. It is a pruritic, chronic/relapsing condition that may significantly impact the patients’ quality of life and can be associated with other atopic comorbidities including asthma and rhinoconjunctivitis. Inflammation in AD is mostly sustained by type 2 inflammation. Most patients are satisfactorily managed with a combination of emollients, avoidance of triggering factors, topical glucocorticoids, and/or topical calcineurin inhibitors. However, a proportion of patients with moderate or severe AD might require phototherapy or systemic immunosuppressants, which are limited in time due to possible safety concerns and progressive efficacy loss. In recent years, the availability of T helper 2 (Th2)-blocking agents dupilumab and tralokinumab has revolutionized the long-term treatment of moderate-to-severe AD. Here are discussed recent advances in the clinical development of biologic treatments for AD. The clinical implementation of these novel drugs has the potential not only to greatly improve the quality of life of patients with this chronic and disabling condition but also to clarify the biological processes underlying AD, in turn enabling further development of more effective, safer treatments. This research paper aims to provide an overview of biological therapies currently in use and under investigation in the setting of AD.

This record contains raw data related to article “Anti-IL17 and anti-IL23 biologic drugs for scalp psoriasis: A single-center retrospective comparative study" Abstract Scalp is a frequent localization of psoriasis that has a massive impact on patient's quality of life. Managing this psoriasis' manifestation is often challenging, thus biologic drugs are widely used as a treatment option in refractory scalp psoriasis. The aim of our study is to retrospectively compare the efficacy of anti-interleukin (IL) 23 drugs (guselkumab, tildrakizumab, risankizumab) and anti-IL17 or anti-IL17RA biologics (secukinumab, ixekizumab, and brodalumab) in real-life patients affected by scalp psoriasis. One hundred twenty-seven patients with a clinical diagnosis of scalp psoriasis and a baseline scalp Physician Global Assessment ≥3 were enrolled; 65 patients were treated with anti-IL23 and anti-IL62 with anti-IL17 or anti-IL17RA. Statistical analysis trough χ2 test was performed in order to evaluate the percentage of response among the two groups of patients. Responders' percentage of patients under anti-IL23 was 41.5%, 75.4%, 88.1%, 87.5%, 93.7%, and 100% at Week 4, 16, 48, 96, and 144, respectively. In the group on anti-IL17 was 62.9%, 90.3%, 91.2%, 97.3%, 96.9%, and 95.2% at Week 4, 16, 48, 96, and 144, respectively. Both anti-IL17 and anti-IL23 appeared to be effective on scalp psoriasis; in particular patients treated with anti-IL17 drugs reached a faster significant reduction of the lesions; on the other hand, anti-IL23 monoclonal antibodies were slightly superior in maintaining the clinical improvement through the follow-up.

With the widespread use of COVID-19 vaccines, several cutaneous adverse reactions are emerging, including flares of pre-existing dermatoses1, 2: we describe the case of a 47-year-old female patient, affected by plaque psoriasis since 2001, who presented to our Emergency Department with an exacerbation of psoriasis after the second dose of BNT162b2 COVID-19 vaccine. The patient referred the rapid worsening of her psoriasis, starting from 10 days after the vaccination (Second dose inoculated on 23 May 2021). She was on treatment with ustekinumab 90 mg since 2016, and she skipped the scheduled administration in May 2021. She was also affected by obesity and psoriatic arthritis; she was previously treated with infliximab, discontinued for intolerance. On physical examination, we observed wide erythematous plaques confluent to both the trunk and the four limbs, covered by large scales. The PASI was 29.8 and the involved body surface was more than the 30% of the total area. She had fever (38.2 °C) and arthralgias; blood examinations showed 11 000/mm3 white cells, C-reactive protein 14.56 mg/dL. After the hospitalization, blood cultures at the febrile peak returned negative; and 2 days later, we observed numerous small pustules surrounding the erythematous scaling plaques, although the pustular eruption was particularly intense on the cutaneous folds. The clinical appearance was suggestive for a flare of generalized pustular psoriasis (GPP) superimposed on a plaque psoriasis, and we supposed the relationship with the second shot of BNT162b2 COVID-19 vaccine. During the hospitalization, the pustules became larger, coalescent and thicker, involving also patient’s palms and soles; few patches began to ulcerate and the scaly plaques involved also the face and the scalp (Figs. 1 and 2a,b). Tumour markers for malignancy were negative. Having considered the risk of a superimposed infection, the comorbidities and the severity of the psoriasis, we therefore decided to start therapy with risankizumab 75 mg/fl with two subcutaneous injections, while an oral therapy with daptomycin 850 mg/day was prescribed. One week after the first dose of risankizumab, the pustular eruption disappeared and after 2 weeks of hospitalization the plaques improved, with only slight erythema. She received the second dose of risankizumab and to date she is still on therapy, having achieved the complete disease control (PASI 0) at Week 16 (Fig. 2c). Flare-up of plaque psoriasis in the setting of SARS-CoV2 infection3 and after COVID-19 vaccines is widely described in literature, usually resolving after few weeks but, sometimes, needing rescue therapies.4-6 D. Pesqué et al. suggested a relevant role of COVID-19 vaccines in the re-activation of inflammatory pathways underlying a pre-existing plaque psoriasis.7 B. Awada et al. hypothesized that COVID-19 vaccination (or infection) may lead to an IFN-I-mediated immune response by stimulating the plasmacitoid dendritic cells. It has also been suggested the role of Sars-CoV-2 infection as a trigger to an IFN-driven inflammatory disorder such as GPP in genetically susceptible individuals.8 D. Perna et al. also reported a GPP flare in a patient affected by plaque psoriasis who received the first dose of BNT162b2 vaccine, treated with acitretin.9 Regarding the therapy, we prescribed risankizumab, a IL-23 inhibitor, since our patient was intolerant to infliximab, previously on optimal therapy with ustekinumab, affected by severe obesity and at risk of superimposed infections. In conclusion, we described GPP flare and exacerbation of psoriasis in a patient who previously received BNT162b2 vaccine: this could probably be a rare adverse reaction related to COVID-19 vaccine, in a patient who interrupted the biological therapy. Since the high rate of comorbidities in psoriatic patients, the vaccination should be strongly recommended in this population. On the other hand, dermatologists should keep in mind the possibility of rare flare-up of pre-existing dermatoses or the onset of new cutaneous manifestations in genetically predisposed patients. No guidelines are currently available concerning the management of a GPP flare after COVID-19 vaccine, and further cases should be collected to deepen our knowledge. The patient in this manuscript gave written informed consent to publication of her case details. A. Narcisi has served on advisory boards, received honoraria for lectures and research grants from Almirall, Abbvie, Leo Pharma, Celgene, Eli Lilly, Janssen, Novartis, Sanofi-Genzyme, Amgen and Boehringer Ingelheim. A. Costanzo has been consultant and/or speaker for AbbVie, Almirall, Amgen, Janssen, Leo Pharma, Eli Lilly, Galderma, Boehringer, Novartis, Pfizer, Sandoz and UCB; R.G. Borroni has been consultant for Almirall and speaker for Abbvie. None. Additional data are available on request to the corresponding author.

Vaccinations may induce cutaneous adverse events, due to nonspecific inflammation or immuno-mediated reactions. Several types of vasculitis have been observed. We report on a 71-year-old woman who developed cutaneous small-vessel vasculitis after the second dose of Vaxzevria COVID-19 vaccination, showing leukocytoclastic vasculitis on histopathological examination of a skin biopsy. Cutaneous small-vessel vasculitis is a rare condition which can be idiopathic or secondary to underlying infections, connective tissue disorders, malignancy, and medications. The pathogenesis involves immune complex deposition in small blood vessels, leading to activation of the complement system and recruitment of leukocytes. Exacerbation of small-vessel vasculitis has been reported following the administration of various vaccines, particularly influenza vaccine. It is expected that SARS-CoV-2 vaccine results in the activation of B- and T-cells and antibody formation. We hypothesize that leukocytoclastic vasculitis caused by immune complex deposition within cutaneous small vessels could be a rare side effect of Vaxzevria COVID-19 vaccination.

A nationwide survey was conducted in adult patients with psoriasis (PsO) across Italy to obtain their real-world perspective of the impact of PsO on their wellbeing. Patients completed a 26-question survey (based on the patient benefit index; PBI, The Dermatology Life Quality Index; DLQI and the World Health Organization-five; WHO-5 wellbeing index) and workshop discussion sessions were undertaken by dermatologists to interpret results from the survey. 392 patients with PsO completed the survey. Analysis of results was restricted to patients who had moderate-to-severe plaque psoriasis (assessed by patients; n = 252; 64.3%). Dermatologists (n = 32) completed one question from the survey related to wellbeing and rated social, physical and mental domains as contributing to a similar extent, with comparable scores also observed by patients. For treatment, biologics yielded higher scores on average, whereas little difference was observed between topical and conventional systemic treatments. Only 23.8% of patients felt that their dermatologist was taking into consideration their wellbeing and 32.6% of the patients considered their therapy as inadequate in improving signs and symptoms of the disease. This survey identified key factors contributing to barriers impacting on patient wellbeing. Simple, but comprehensive questionnaires can provide important insight to patients' needs that may significantly increase clinician awareness during visits leading to tailored treatment.

Dear Editor, An 80-year-old man with a history of fibromyalgia, arthralgias, and arterial hypertension presented for the recurrence of a skin lesion on the right infraorbital region. Three years earlier, an incisional biopsy reported actinic keratosis and the lesion was treated with cryotherapy and topical diclofenac 3% gel, with only partial improvement. On physical examination, an erythematous, scaly, welldemarcated plaque of 5.5 cm in diameter was present on the lower eyelid, extending to the medial canthus of the right eye. Ectropion was also evident (Figure 1A). Histological examination of a new incisional biopsy revealed the presence of cutaneous squamous cell carcinoma in situ with a focal invasion of the dermis (Figure 1B).

Ulcerative colitis (UC) is a chronic relapsing disorder of the colonic tract, characterized by a dysregulated innate and adaptive immune response to gut microbiota that contributes to the perpetuation of intestinal inflammatory processes. The Interleukin (IL) 23/IL17 axis has been reported to play a key role in UC pathogenesis promoting Th17 cells and cytokines-related immune response. Recently, the blockade of IL23/IL17 pathways has been raised enormous interest in the treatment o several chronic inflammatory disorders. In this review, we summarize the emerging results from clinical trials that evoked both promise and discouragement in IL23/IL17 axis in the treatment of UC. Targeting IL23 p40 through Ustekinumab results safe and effective to induce and maintain clinical remission, low inflammatory indexes, mucosal healing, and a better quality of life. Studies targeting IL23 p19 through Mirikizumab, Risankizumab, Brazikumab and Guselkumab are still ongoing. To date, no clinical studies targeting IL17 pathway are ongoing in UC. IL-17 targeting is thought to have a context-dependent biological effect, based on whether cytokine is selectively targeted or if its function is dampened by the upstream block of IL23.