Stay up-to-date on new clinical findings on Psoriasis. View the latest articles, case reports, supplements, CME activities, Podcast episodes and more!
Psoriasis is a chronic, inflammatory, remitting/relapsing autoimmune condition involving a dysregulated inflammatory response of the interleukin (IL) 23/T-helper (Th)-17 pathway. Greater understanding of the immune-mediated pathology of the disease has led to the development of numerous biological therapies and biosimilars that target the various inflammatory pathways.
There is limited data supporting the combination of biological agents in the management of psoriasis and psoriatic arthritis. This is the first case report of plaque psoriasis with arthritis, successfully treated with guselkumab and adalimumab combination therapy, without concurrent use of other systemic agents during the treatment. However, further studies need to be carried out to evaluate the efficacy and safety of this biologic combination therapy.
Psoriasis is a common dermatologic condition with a variety of morphologic presentations. These variations include the less common hyperkeratotic form, psoriasis ostracea, defined as having pronounced adherent scales resembling an oyster shell. Of the ostraceous cases that have been reported in the literature, many occur as generalized outbreaks in patients with long-standing history of psoriasis. Rarely does this remarkable variant occur as a direct flare from a cutaneous insult. In these situations, when a pre-existing dermatosis appears in response to a traumatic insult to skin, the process is referred to as the Koebner phenomenon.
A 50-year-old African-American woman presented to the dermatology clinic with a pruritic eruption of 3 years’ duration. On clinical examination, the patient had well-demarcated, pink, atrophic plaques and superficial erosions over the inframammary folds and mid-chest. She also had well-demarcated, hyperpigmented, hyperkeratotic scaly plaques over the abdomen, suprapubic region, elbows, knees, and back with sporadic small superficial blisters.
What questions should you be asking? What matters most when discussing therapeutic options? What is the best way to partner to ensure a long term relationship? If we could read minds this podcast would not be necessary but alas, it sorely is. Check it out!
We (and our patients) are fortunate to live during a time when we have many safe and effective options to treat a chronic inflammatory skin disease such as Psoriasis. We are reminded of this, nay inundated, with warm and fuzzy headlines in the lay dermatology press that humblebrag said efficacy. However, how does this translate to the real world, when the perfect, neat lines of clinical trials are blurred by practical issues such as access, patient and practitioner perception, and long term use and efficacy? In a JDD Podcast first, we had not one but two investigators share their work and first steps to evaluate just that.
I’m a biologic girl in a biologic world…or so I think myself and never say out loud when reviewing therapeutic options for moderate to severe psoriasis. We are so fortunate to have so many wonderful options, however certain clinical scenarios may limit our ability to capitalize on said armament mostly due to limited experience and data. Enter previous malignancy – in most phase 3 studies these patients are weeded out or the history of malignancy must be at least 5 years prior to entry. So what to do? Our colleagues at Tufts Medical Center asked this very question. Tune in to hear what Dr. David Rosmarin, Assistant Professor of Dermatology and Residency Program Director learned from performing a retrospective chart review and how his work and his experience guides his clinical decision making when managing psoriasis. Don’t flake (or is it scale?)….check it out.
In this edition of the JDD Podcast, Dr. Adam Friedman reviews phototherapy protocols and pearls with psoriasis expert Dr. Jashin Wu, Director of Research at Kaiser Permanente based on his study published in the August 2016 Journal of Drugs in Dermatology titled “Comparison of Phototherapy Guidelines for Psoriasis: A Critical Appraisal and Comprehensive Review.” Also tune in to hear how Dr. Wu counsels his psoriasis patients on psoriasis comorbidities and initiates, and manages them with phototherapy, topicals, and systemic immunosuppressants.
Dr. Jon Zippin, Assistant Attending Dermatologist and Assistant Professor of Dermatology at Weill Medical College of Cornell, elucidates the complexity of cAMP biology and the translational impact of PDE4 inhibition as it relates to chronic inflammatory skin diseases. Tune in to learn why targeting this pathway is clinically meaningful but also where more work is needed to improve outcomes.
Dr. Abrar Qureshi, Professor and Chair of Department of Dermatology at The Warren Alpert Medical School of Brown University, reviews his research to uncover the biological basis for many of the co-morbidities associated with, and risk factors for, psoriasis. Through this clear and clinically oriented presentation, the common pathophysiological threads are elucidated with a focus on identifying preventive strategies and therapeutic targets for current and future treatments.
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