BACKGROUND:Palmoplantar pustulosis (PPP) is a chronic inflammatory skin disease characterized by recurrent pustules on the palms and soles. Current treatments, including topical medications, phototherapy, and systemic therapies, often show limited efficacy. Upadacitinib (UPA), a selective JAK1 inhibitor, has shown potential in treating neutrophilic dermatoses by modulating cytokine activity. OBJECTIVE:To evaluate the efficacy and safety of UPA compared with acitretin (ACI) in the acute phase of PPP through a prospective cohort study. METHODS:This study was conducted at the Shanghai Skin Disease Hospital from August 2024 to January 2025. A total of 79 patients with acute PPP were enrolled and randomly assigned to receive UPA (15 mg daily) or ACI (20 mg daily) for 4 weeks. Efficacy was assessed using pustule counts, Palmoplantar Pustulosis Area and Severity Index (PPPASI), and Dermatology Life Quality Index (DLQI). Safety was evaluated by recording adverse events (AEs). RESULTS:At week 2, the rate of complete pustule clearance was significantly higher in the UPA group (41.9%) than in the ACI group (10.5%, P = 0.003). By week 4, all patients in the UPA group achieved a pustule count < 30, compared with 63.2% in the ACI group. The UPA group also showed greater reductions in PPPASI and higher response rates for PPPASI 50/75/90. Quality of life improvements, as measured by DLQI, were more pronounced in the UPA group. In terms of safety, UPA had a favorable profile with lower overall AE incidence compared with ACI. CONCLUSIONS:UPA demonstrated superior efficacy over ACI in rapidly clearing pustules and improving skin lesions and quality of life in acute PPP episodes. The findings suggest that JAK1 inhibition may be a promising therapeutic approach for PPP, warranting further investigation in larger trials. CLINICAL TRIAL REGISTRATION:[ www.chictr.org.cn ], identifier [ChiCTR2000036186].

A 77-year-old Chinese male with a 10-year history of plaque psoriasis had recurrent episodes of symmetric hypertrophic verrucous plaques in the lower legs. The patient was monitored for the evolution of the disease over two years before he came to our attention. Because the lesions were resistant to topical glucocorticoids and vitamin D3 at another dermatological center, the patient was treated with secukinumab for one year. However, the verrucous lesions further worsened, and the patient visited the outpatient department of our hospital in March 2023. Treatment with guselkumab was started. It immediately attenuated the plaques of the trunk and limbs. Surprisingly, the verrucous plaques of both legs showed complete resolution in 6 months.

This case report describes a woman in her 50s who was initially diagnosed with palmoplantar pustulosis but was subsequently found to have synovitis, acne, pustulosis, hyperstosis, and osteitis syndrome, which was successfully treated with abrocitinib.

BackgroundAcrodermatitis continua of Hallopeau (ACH) is a rare, sterile pustular psoriasis variant refractory to many conventional treatments. The eruption typically occurs after local trauma or infection; other etiologies include neural, inflammatory, and genetic causes. Herein we reported a single case of a 64-year-old patient with ACH that was successfully treated with spesolimab for 19 weeks.Case summaryA 64-year-old Chinese male with no personal or known family history of psoriasis had recurrent episodes of redness, swelling, and pustules in the nail bed on seven fingers with progressive degeneration of the nails. The patient was monitored as to the evolution of the disease over half of a year before he referred his case to our attention. A diagnosis of ACH was made, allowing for the administration of local steroids and oral acitretin. However, after 3 months of acitretin treatment, no improvement was observed. In December 2023, this patient came to our inpatient department; his modified nail psoriasis severity index score was 32. Before starting treatment, a comprehensive set of laboratory and instrumental tests were all found to be negative. Moreover, whole-exome sequencing was performed in our patient, and it revealed no rare coding variant in IL36RN, CARD14, or AP1S3. Therefore, the patient was administrated with a dose of 900 mg spesolimab. After 10 days, the patient showed a significant decrease in discomfort and pain. In order to strengthen the therapeutic effect, he was given the second dose of 900 mg spesolimab after 4 weeks. After 19 weeks of spesolimab treatment, the patient’s nail lesions showed complete resolution, and no adverse effects were reported.ConclusionThe case report suggests that spesolimab may offer significant therapeutic benefits for ACH.

Background:Psoriasis is a chronic autoimmune inflammatory skin condition characterized by erythema, papules, and scales. It imposes a heavy psychological and social strain on both patients and their families. Surprisingly, there's limited research delving into the disease burden and coping strategies of spouses contending with psoriasis.Objective:The objective is to explore the disease burden faced and coping strategies utilized by spouses of individuals living with psoriasis. This exploration aims to offer insights crucial for devising mental health support and intervention strategies.Methods:The research methodology employed in this study was phenomenological, a qualitative approach. A total of fifteen spouses of patients with psoriasis were selected using an objective sampling method for in-depth, semi-structured interviews. Thematic analysis was then applied to the recorded interview data to derive meaningful themes.Results:This study has identified and analyzed three core themes concerning the disease burden and coping strategies of spouses of patients with psoriasis: Overwhelming disease burden; Lack of support system; Coping strategies (Problem - centered coping strategies: Proactive acquisition of disease knowledge; Active confrontation of illness - related issues; Behavioral habit alteration; and Emotional - centered coping strategies: Active acceptance and normalization; Passive acceptance and internalized stigma; Avoidance of disease - related problems).Conclusion:This study adds valuable insights into comprehending the disease burden encountered by spouses of patients with psoriasis and sheds light on the coping strategies they employ. Healthcare providers should proactively recognize and address the burden experienced by spouses early on. Establishing a robust support network is crucial, and promoting adaptive coping strategies can significantly aid spouses in effectively navigating and managing the complexities associated with psoriasis.

Background: Psoriatic arthritis (PsA) is an immune-mediated form of chronic inflammatory arthritis associated with psoriasis (PsO). It constitutes a significant comorbidity of PsO and is distinguished by the presence of widespread musculoskeletal inflammation. Objective: The aim of this study is to precisely detect asymptomatic PsA using ultrasound (US) examinations and to distinguish between various stages of PsO. Methods: All patients with moderate-to-severe PsO, who consented to undergo musculoskeletal US examinations during their hospitalization between September 2020 and January 2022, were enrolled in the study. We compared patients ' demographic characteristics, comorbidities, disease duration, relevant laboratory parameters, and musculoskeletal US findings. Results: A total of 547 patients with PsO were included in the study, and 114 of them received a diagnosis of PsA. Furthermore, 16.45 % of patients with moderate to severe PsO displayed subclinical PsA. We observed a significantly higher frequency of abnormal US findings in patients with PsA compared to those without PsA, with a sensitivity of 95.61 % and a specificity of 79.22 %. Additionally, the incidence of enthesitis and synovitis varied significantly between PsA and non-PsA patients, and they were identified as independent variables predicting the presence of PsA. Furthermore, the interphalangeal joint, knee joint, and calcaneal tendon were the most frequently affected areas in PsA, as indicated by the observed US changes. Conclusion: Ultrasound examination proves to be a valuable tool for detecting subclinical PsA, facilitating early screening of the condition. Particular attention should be directed towards changes in the interphalangeal joint, knee joint, and calcaneal tendon when reviewing ultrasound images of asymptomatic patients.

BackgroundRandomized controlled trials indicated guselkumab, the first anti-interleukin-23 monoclonal antibody, is efficacious in plaque psoriasis. However, guselkumab's performance in real life is scarcely examined, especially in China.ObjectivesThis work aimed to assess the long-term effectiveness of guselkumab in actual clinical practice in China.MethodsA retrospective study was performed for plaque psoriasis cases administered guselkumab in Shanghai Skin Disease Hospital between January 2020 and September 2022.ResultsA total of 37 patients were included (29 men, 78.4%), with a mean follow-up period of 72.3 ± 26.7 weeks (range of 12–108 weeks). At baseline, clinical examination revealed a mean PASI of 12.3 ± 7.1, a mean BSA of 17.1 ± 18.1, and a mean DLQI of 7.7 ± 4.3. Twenty-two (62.9%) and 17 (48.6%) cases achieved PASI 90 and PASI 100 responses at week 28. From weeks 60 to 92, >80% of cases achieved PASI 90 and PASI 100 responses. Regarding safety, no cases of serious AEs were recorded. A total of nine cases (24.3%) had different abnormal results in HBV markers, and two were T-SPOT positive. There was no hepatitis B virus or tuberculosis outbreak in these patients.ConclusionThis real-life study confirmed the long-term efficacy and safety of guselkumab in daily clinical practice.

Ustekinumab is a biological therapy that has been approved for treating moderate-to-severe psoriasis. Although injection site reactions, nasopharyngitis, headaches, and infections are the common adverse events associated with ustekinumab, the development of bullous pemphigoid (BP) is also thought to be related to ustekinumab. Given that psoriasis itself can be complicated by BP, it is worthwhile to investigate the relationship between ustekinumab, psoriasis, and BP. Here we report a case of a male patient who developed BP twice after psoriasis treatment with ustekinumab. The patient's psoriasis and BP were brought under control by discontinuing ustekinumab and administering methotrexate, minocycline, and topical corticosteroids. Because of the increasing use of biologics in patients with psoriasis, BP should be considered a potential adverse event associated with ustekinumab.

2017年,度普利尤单抗(Dupilumab)获批成为一种治疗中重度特应性皮炎(AD)的有效药物,在适应证以外的慢性皮肤病治疗中也显示出了疗效.在病例报告和病例系列中,已报道Dupilumab在治疗慢性瘙痒症、结节性痒疹(PN)、湿疹、荨麻疹、大疱性类天疱疮(BP)方面的有效应用.临床试验正在评估Dupilumab对接触性皮炎(CD)、慢性手部湿疹(CHE)、斑秃(AA)、慢性自发性荨麻疹(CSU)和胆碱能性荨麻疹的疗效.

Little is known about different Ixekizumab (IXE) dosing regimens during routine clinical practice. To evaluate the real-world effectiveness and safety of different IXE dosing regimens in patients with psoriasis. This study retrospectively compared patients who were dosed with IXE every two or four weeks (80 mg/week following a starting dose of 160 mg at Week 0). At Weeks 0, 4, and 12, the Psoriasis Area and Severity Index (PASI) and the Dermatology Life Quality Index (DLQI) were recorded, with adverse events also documented. In total, 66 patients were analysed, of whom 30 (45.5%) and 36 (54.5%) were included in the two-week and four-week IXE dosing groups, respectively. In the overall patient cohort, 86.3%, 60.6%, and 31.8% exhibited PASI 75, PASI, 90, and PASI 100 responses at Week 12, respectively. The mean baseline PASI score was 12.4 ± 7.6 and the mean baseline DLQI score was 11.3 ± 6.9, with these values declining rapidly following IXE administration to 1.6 ± 2.4, and 2.6 ± 4.0 at Week 12, respectively. Response rates were elevated in the two-week group as compared to the four-week group at Weeks 4 and 12 of treatment, but these differences were not significant. Adverse events were reported in 25 patients (37.9%), with injection site reactions being most common, followed by infections. IXE is effective and safe in a real-world setting for the treatment of plaque psoriasis. Moreover, patients can reduce their medical expenses by choosing a four-week dosing regimen while still attaining therapeutic benefits.

Little real‐work data regarding the efficacy and safety of dupilumab in the treatment of atopic dermatitis (AD) is available at present. To assess the efficacy and safety of dupilumab at 12 weeks in the treatment of AD in clinical routine clinical practice. A retrospective, single‐centre study of adult patients with moderate to severe AD treated with dupilumab for 12 weeks in China. In total, 60 patients (48 male, 12 female; mean age: 53.2 ± 15.6) were enrolled in this retrospective study. These patients exhibited a mean AD disease course of 10.6 years (6.0), 30% exhibited a family history of allergies, and 31 (51.7%) had one or more allergic comorbidities. Following dupilumab treatment for 12 weeks, 83.3% and 42% of patients had achieved EASI‐50 and EASI‐75, respectively. Overall, adverse events (AEs) were reported by 15% of patients, with the most common being conjunctivitis, injection site reactions, and herpes simplex virus infections. Laboratory testing after 12 weeks revealed pronounced decreases in both circulating eosinophil counts (from 0.6 (0.1–2.8) to 0.3 (0.1–9.7) 109/L) and total IgE concentrations (from 327 (2.46–2500) to 230 (47.6–2200) U/ml) in these patients. These real‐world data reaffirm the safety and efficacy of dupilumab as a treatment for moderate‐to‐severe AD among Chinese patients in clinical practice.

Background: Data pertaining to biologic agents used for treating psoriasis in real-world settings are lacking at present. To compare drug survival at 52 weeks for a range of biologics used to treat psoriasis under real-world conditions. Methods: This was a retrospective, single-center, observational study of a cohort of patients diagnosed with plaque psoriasis treated using ixekizumab, secukinumab, guselkumab, or adalimumab between January 2020 and December 2021. Baseline demographic characteristics, duration of psoriasis, and prior biological treatments for all patients were recorded. Drug survival rates were analyzed in different patient groups using Kaplan-Meier curves and Log rank tests. Results: In total, this study included 386 plaque psoriasis patients, of whom 70, 175, 36, and 105 were, respectively, treated using ixekizumab, secukinumab, guselkumab, and adalimumab. Over a 52-week period, the overall cumulative drug survival rates for ixekizumab, secukinumab, guselkumab, and adalimumab were 67.1%, 63.0%, 72.2%, and 37.1%, respectively. Lack of efficacy was the primary cause of discontinuation for these biologic therapies, followed by economic burden and adverse event incidence. Conclusion: These results suggest that guselkumab exhibited superior drug survival, drug survival outcomes for ixekizumab and secukinumab were comparable, and significantly better than those of adalimumab in China. Preventing a loss of drug efficacy a to survival in

The Journal of DermatologyEarly View LETTER TO THE EDITOR Secukinumab treatment for a psoriasis patient co-infected with HIV and latent tuberculosis: A case report Hui Qin, Hui Qin orcid.org/0000-0002-2316-8127 Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China Institute of Psoriasis, Tongji University School of Medicine, Shanghai, ChinaSearch for more papers by this authorJiajing Lu, Jiajing Lu orcid.org/0000-0002-0827-0596 Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China Institute of Psoriasis, Tongji University School of Medicine, Shanghai, ChinaSearch for more papers by this authorXuemei Yi, Xuemei Yi Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China Institute of Psoriasis, Tongji University School of Medicine, Shanghai, ChinaSearch for more papers by this authorYangfeng Ding, Corresponding Author Yangfeng Ding dingyangfeng@hotmail.com Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China Correspondence Yuling Shi and Yangfeng Ding, Department of Dermatology, Shanghai Skin Disease Hospital, Institute of Psoriasis, Tongji University School of Medicine, 1278 Baode Road, Jingan District, Shanghai 200443, China. Email: shiyuling1973@tongji.edu.cn; dingyangfeng@hotmail.comSearch for more papers by this authorYuling Shi, Corresponding Author Yuling Shi shiyuling1973@tongji.edu.cn orcid.org/0000-0002-1273-7881 Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China Correspondence Yuling Shi and Yangfeng Ding, Department of Dermatology, Shanghai Skin Disease Hospital, Institute of Psoriasis, Tongji University School of Medicine, 1278 Baode Road, Jingan District, Shanghai 200443, China. Email: shiyuling1973@tongji.edu.cn; dingyangfeng@hotmail.comSearch for more papers by this author Hui Qin, Hui Qin orcid.org/0000-0002-2316-8127 Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China Institute of Psoriasis, Tongji University School of Medicine, Shanghai, ChinaSearch for more papers by this authorJiajing Lu, Jiajing Lu orcid.org/0000-0002-0827-0596 Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China Institute of Psoriasis, Tongji University School of Medicine, Shanghai, ChinaSearch for more papers by this authorXuemei Yi, Xuemei Yi Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China Institute of Psoriasis, Tongji University School of Medicine, Shanghai, ChinaSearch for more papers by this authorYangfeng Ding, Corresponding Author Yangfeng Ding dingyangfeng@hotmail.com Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China Correspondence Yuling Shi and Yangfeng Ding, Department of Dermatology, Shanghai Skin Disease Hospital, Institute of Psoriasis, Tongji University School of Medicine, 1278 Baode Road, Jingan District, Shanghai 200443, China. Email: shiyuling1973@tongji.edu.cn; dingyangfeng@hotmail.comSearch for more papers by this authorYuling Shi, Corresponding Author Yuling Shi shiyuling1973@tongji.edu.cn orcid.org/0000-0002-1273-7881 Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China Correspondence Yuling Shi and Yangfeng Ding, Department of Dermatology, Shanghai Skin Disease Hospital, Institute of Psoriasis, Tongji University School of Medicine, 1278 Baode Road, Jingan District, Shanghai 200443, China. Email: shiyuling1973@tongji.edu.cn; dingyangfeng@hotmail.comSearch for more papers by this author First published: 21 June 2022 https://doi.org/10.1111/1346-8138.16494 Hui Qin and Jiajing Lu contributed equally to this work. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Early ViewOnline Version of Record before inclusion in an issue RelatedInformation

The burden of hepatitis B virus (HBV) infection in China is high. The safety and efficacy of secukinumab in psoriasis patients with HBV infection have not been fully elucidated.To investigate the safety and efficacy of secukinumab in psoriasis patients with HBV infection in China.In this retrospective study, 20 psoriasis patients with HBV infection were identified, all of whom had been treated with secukinumab for ≥24 weeksFour patients had chronic inactive HBV infection, two patients had occult HBV infection, and the other 14 patients had resolved HBV infection. The HBV-DNA load and HBV markers measured at baseline and Week 24 showed no viral reactivation. Nineteen patients showed normal levels of liver enzymes after 24 weeks of therapy. However, one patient with resolved HBV infection and fatty liver with elevated baseline liver enzymes experienced hepatitis, with negative HBV load at baseline and Week 24. All patients showed a significant improvement in the Psoriasis Area and Severity Index (−13.35 ± 7.41: p < 0.0001), per cent of body surface area (−17.11 ± 17: p = 0.0002), Investigator Global Assessment (−2.55 ± 0.94: p < 0.0001), and Dermatology Life Quality Index (−12.3 ± 7.39; p < 0.0001)Secukinumab showed good efficacy in psoriasis patients with HBV infection. Chronic, inactive, occult and resolved HBV infection may not increase the risk of hepatitis during secukinumab treatment. Patients with poor baseline liver function, without any intervention during secukinumab treatment, may experience hepatitis. Periodic monitoring with HBV markers, HBV-DNA load, and serological liver function tests is necessary during secukinumab treatment.

目的 评估窄谱中波紫外线(NB-UVB)联合祛银方治疗头皮银屑病有效性和安全性.方法 将90例头皮银屑病患者随机分为治疗组和对照组,每组45例.治疗组给予NB-UVB照射联合祛银方外洗治疗,对照组给予NB-UVB照射治疗.治疗8周,观察2组患者治疗前后头皮严重指数(PSSI)评分、头皮指数(Scalpdex)和不良事件发生率(AE)评分变化情况,并评价2组的临床疗效和安全性.结果 2组治疗期结束时,治疗前后PSSI和Scalpdex评分差异均有统计学意义(P＜0.05).在本研究中,与NB-UVB组相比,NB-UVB联合祛银方组在第4周有明显的改善,此后差异有所下降.2组治疗均耐受性良好,不良事件发生率低.结论 NB-UVB联合祛银方治疗头皮银屑病有良好的疗效和安全性.

目的:探讨凉血潜阳方随症加减治疗寻常型银屑病血热证的临床疗效.方法:117例寻常型银屑病血热证患者被随机分成两组,固定方组58例,采用凉血潜阳方联合卡泊三醇软膏治疗;加减组59例,采用凉血潜阳方随症加减联合卡泊三醇软膏治疗.以银屑病面积和严重程度指数(PASI)、瘙痒视觉模拟评分(VAS),皮肤病生活质量指数(DLQI),汉密尔顿抑郁量表(HAMD)、临床疗效、安全性等为观察指标.结果:加减组总有效率(83.05％,49/59)和愈显率(27.12％,16/59)均优于固定方组总有效率(67.24％,39/58)和愈显率(10.34％,6/58)(P＜0.05).两组治疗后PASI、VAS、DLQI及HAMD评分均较治疗前降低(P＜0.05),加减组在改善PASI、DLQI及HAMD评分上优于固定方组(P＜0.05).所有患者治疗前后肝肾功能、血常规检查均未见异常.结论:凉血潜阳方随症加减联合卡泊三醇软膏可显著改善寻常型银屑病血热证患者的临床症状,提高生活质量,安全性高.

目的 评价刺络拔罐治疗斑块型银屑病血瘀证的临床疗效及安全性.方法 73例斑块型银屑病血瘀证患者,随机分入刺络拔罐组(37例)和卡泊三醇软膏组(36例).观察2组患者治疗前后的临床疗效,以及银屑病皮损红斑、浸润、脱屑的症状评分,并分析不良反应.结果 2组患者治疗前后银屑病皮损面积及严重程度指数(PASI)评分的差异均有统计学意义(P<0.05).治疗第4周治疗组患者的PASI评分低于对照组,差异有统计学意义(P<0.05).2组患者红斑和脱屑评分在治疗前后比较差异有统计学意义(P<0.05),治疗第4周治疗组对红斑评分的改善较对照组更为明显,而对照组对脱屑评分的改善较治疗组更为显著.治疗第4周,治疗组有效率为94.59％,对照组有效率为77.78％,差异有统计学意义(χ2=4.365,P<0.05).结论 刺络拔罐治疗斑块型银屑病血瘀证的疗效好,安全性高.

Background: Although there have been many epidemiological studies, research focusing on psoriasis' health burden on a global scale is still lacking. Trends and variations in the global health burden of psoriasis are evaluated by time, age, gender, geographical location, and socioeconomic status, using disability-adjusted life years (DALYs) from the Global Burden of Disease Study. Methods: The health burden of psoriasis was evaluated by DALYs, which combined years lost to disability (a morbidity component) with years of life lost (a mortality component). The global and national DALYs number, crude DALYs rate, and age-standardized DALYs rate were obtained from the GBD 2017 study database. The corresponding human development index (HDI) was collected from the United Nations Development Programme. Results: From 1990 to 2017, the DALYs number and crude DALYs rate due to psoriasis increased by 73 and 22%, respectively. In comparison, the age-standardized DALYs rate showed a slight increase. Patients in the age range of 65–69 years bear a more significant psoriasis burden. Both males and females showed an increasing trend in burden caused by psoriasis over the past 27 years, with females bearing a more significant psoriasis burden than males. The health burden of psoriasis was substantially unequal in geography with a Gini coefficient of 0.27. The concentration indexes indicated a socioeconomic associated inequality in psoriasis burden with values of 0.22, accounting for 48.64% variance across countries (R2 = 0.4864, p < 0.001). Between-nation inequality in the distribution of psoriasis burden continued to decline throughout the past 27 years. Gini coefficients of psoriasis burden decreased from 0.280 in 1990 to 0.265 in 2017. The concentration indexes indicated the same trend with 0.236 in the 1990s and 0.223 in 2017. Conclusions: Global health progress in psoriasis together with inequality in the past few decades. Although the inequality of psoriasis burden has shown some improvement during the past 27 years, disparities still exist in age, gender, geographical location, as well as socioeconomic status. The findings of this study highlight the global importance of psoriasis and is important in policy planning for psoriasis services on a global scale.

目的 探讨吡格列酮对人永生化角质形成(HaCaT)细胞胰岛素抵抗的影响.方法 培养HaCaT细胞,使用10-4 mol/L、10-5 mol/L、10-6 mol/L、10-7 mol/L、10-8 mol/L 5个浓度刺激HaCaT细胞,探索最佳的胰岛素浓度和作用时间;用吡格列酮(10、20、40、80、160μmol/L)处理细胞,用细胞计数方法 (CCK-8)检测HaCaT细胞活性;实验分为正常组、模型组、实验组(吡格列酮组),正常组不做处理,模型组用10-6 mol/L胰岛素干预36 h,实验组胰岛素干预后给予吡格列酮处理,用葡萄糖测定试剂盒检测各组细胞的耗糖量.结果 胰岛素10-6 mol/L干预36 h可建立胰岛素抵抗模型;给药36 h,当吡格列酮的浓度为40μmol/L时,细胞存活率为92.06％;不同浓度的吡格列酮均可促进胰岛素抵抗细胞的葡萄糖消耗.结论 吡格列酮可以增加胰岛素抵抗HaCaT细胞的葡萄糖消耗,减轻胰岛素抵抗,改善角质形成细胞稳态,为其治疗银屑病提供部分理论依据.

Abnormal lipid metabolism is regarded as a crucial cause of psoriasis. The specific mechanism of how phospholipase PLA2G4B mediates local immune dysfunction and skin lesions remains unclear. The aim of this study was to explore the mechanisms of anti-psoriasis and immune suppression effect by inhibiting PLA2G4B in psoriasis progression. We successfully transfected si-PLA2G4B in a murine keratinocyte cell-line PAM212 to verify the effect of progression by PLA2G4B. The Imiquimod psoriasis mouse model was then successfully constructed, followed by emulsion wrapped PLA2G4B-siRNA applied to the skin lesions. The phenotype, pathology, immunofluorescence staining of PLA2G4B, IL17, CD3, and CD1b, and bulk transcriptome analysis were performed to decipher the effect and mechanism of si-PLA2G4B. Interfering with PLA2G4B significantly inhibited the proliferation and migration of PAM212. The interference of PLA2G4B in vivo showed a therapeutic effect on psoriasis, comparable to that of betamethasone. The phenotype and pathology revealed reduced keratinocytes in the si-PLA2G4B group compared to the model mice. Immunofluorescence showed that CD1b, CD3+ T cells, and IL17 were suppressed in the skin lesions. RNA-seq and deconvolution revealed that immune cells such as myeloid dendritic cell and T cell CD8+ naive were inactivated. Th17 reduce the release of inflammatory factors such as IL17 and IL36. Pathway analysis revealed the potential therapeutic mechanism involved in the inhibition of sphingolipid or ceramide secretion. This study verified the anti-psoriatic effect of using si-PLA2G4B. The immune response was alleviated after administration. This phospholipase inhibition-based therapy sheds light on the pharmaceutical potential against psoriasis.