Fadime Mutlu İçduygu, Isil Deniz Oguz, Egemen Akgun
et al.
Introduction: Psoriasis, a widespread inflammatory cutaneous disease, is driven by an interplay of genetic and environmental risk factors. miR-155 and miR-146a have been implicated in the regulation of inflammatory pathways.
Objectives: In the current study, we examined the association between miR-155 rs767649 and miR-146a rs2910164 variants and the predisposition to psoriasis and psoriatic arthritis.
Methods: A total of 544 individuals, including 284 psoriasis cases (68 with psoriatic arthritis) and 260 controls, were enrolled in the present study. Real-time polymerase chain reaction (qPCR) method was used to detect the genotypes of study groups.
Results: The frequencies of the rs2910164 C allele, CC, and GC genotypes were significantly higher in the patient group (P<0.001), while the frequencies of the rs767649 A allele and AA genotype were higher in the control group (P=0.005 and P=0.002, respectively). No statistically significant difference in genotype or allele frequency was observed between patients with and without psoriatic arthritis (P>0.05). Rs2910164 CC and GC genotypes were found to be associated with a younger age at disease onset (P=0.006), and CC genotype was associated with higher PASI score (P=0.024).
Conclusion: The present data suggest an association between the presence of the miR-155 rs767649 and miR-146a rs2910164 variants and susceptibility to psoriasis in the Turkish population. However, although the number of patients with psoriatic arthritis in our study was relatively small, no association was found between these variants and the development of psoriatic arthritis. Furthermore, the rs2910164 polymorphism was found to be associated with both early-onset disease and PASI score.
Inês Pereira Amaral, Ivânia Soares, Madalena Pupo Correia
et al.
Introduction: Kaposi’s sarcoma (KS) is a rare angioproliferative neoplasm associated with human herpesvirus 8 infection, presenting as four subtypes: classic, endemic, iatrogenic, and epidemic. While well documented globally, comprehensive data on KS in Portugal remain scarce. The aim of this retrospective study was to provide a detailed analysis of KS cases diagnosed at Hospital Santa Maria, in Lisbon, between 2014 and 2023.
Methods: A total of 113 histopathologically confirmed KS cases were included, focusing on demographic, clinical, and histopathological characteristics, as well as treatment strategies and outcomes.
Results: The mean age at diagnosis was 59.4 years, with a male-to-female ratio of 4.4:1. Most patients (50.4%) were of African origin. Epidemic KS (45.1%) was the most prevalent subtype. Lesions mainly affected the lower limbs (47.8%), and disseminated, mucosal, and extracutaneous involvement were more common in HIV-positive patients. Tumor-stage lesions were frequent (59.3%). Single-modality treatment was used in 53.1% of cases, while 40.7% required combined therapies. Relapse rates were highest in endemic (39.1%) and iatrogenic KS (28.6%) subtypes. The disease-specific mortality rate was 8%.
Conclusion: Our findings suggest that KS remains a significant concern, particularly in immunosuppressed patients. Early diagnosis and multidisciplinary management are essential to improve outcomes. However, limitations such as potential biases from its retrospective design and the single-center scope should be considered.
Summary: Cutaneous squamous cell carcinoma (cSCC) develops through a stepwise progression from normal skin (NS) to actinic keratosis (AK) and invasive carcinoma. To delineate the cellular and molecular events underlying this transition, we perform single-cell RNA sequencing on 65,485 cells from NS, AK, and cSCC tissues. The analysis revealed dynamic remodeling of keratinocyte, T cell, and B cell populations during disease progression. A progressively expanding KRT6A+KRT16+ keratinocyte subpopulation (Ker-6) displayed an increasing copy number variation burden and activation of tumor-associated pathways. Ligand-receptor analysis indicated that Ker-6 keratinocytes engage proliferative T cells via the interleukin (IL)-13/IL13RA1/IL4R signaling axis. Functional assays using IL13RA1 and IL4R knockdown confirmed that IL-13 signaling promotes keratinocyte proliferation and migration. These findings define a key immunoregulatory pathway linking epithelial transformation and immune interaction, providing a cellular framework for understanding early cSCC development and identifying potential targets for intervention.
Abstract Background Psoriasis a chronic inflammatory skin disease, poses a substantial economic burden on healthcare systems globally. This study examines psoriasis consultations from the provider’s perspective within a dermatology department, aiming to generate detailed cost data to support value-based care. Specifically, it investigates the drivers of consultation-level cost variability, explores opportunities for efficiency, and also estimates one-year treatment costs to inform the development of bundled payment models. The goal is to highlight the importance of patient cost transparency and improving cost structures in chronic disease settings. Methods Using Time-Driven Activity-Based Costing (TD-ABC), treatment costs associated with nurses, doctors, and total visits for 127 patients with mild and moderate forms of psoriasis were measured. Financial data was collected in collaboration with the hospital’s financial department. During consultations, nurses and physicians recorded time and patient-related information. Additional or missing details were retrieved from patient medical files. Descriptive analyses assessed mean costs and variability by patient and disease characteristics. Independent variables: therapy type, patient status (new vs. returning), comorbidities, and treatment changes, were stratified to compare cost differences across groups. Results Mean consultation costs were €55, with a minimum and maximum of €25 and €110. New patients incurred 40% higher costs than returning ones, mainly due to longer interactions with nurses and physicians. Key cost drivers for a total consultation included patient status, personality traits, nurse experience, and therapy switches. Physician consultations were particularly impacted by treatment changes and patient engagement levels. Annual treatment costs varied substantially by medication type: topical treatments averaged €325 per year, systemic treatments €1,353, and biological therapies €11,920, highlighting the significant impact of medication choice on overall expenses. Conclusions This study highlighted substantial variability in consultation and yearly treatment costs for psoriasis patients. These findings emphasized the critical need for detailed cost data to optimise departmental workflows, support efficient resource allocation, and inform the design of equitable bundled payment models. Improving cost transparency was shown to strengthen clinical and financial decision-making. Future research was recommended to explore the cost implications of comorbidities and to extend benchmarking efforts across dermatology settings to guide system-wide improvements in care delivery and sustainability.
ObjectiveThe objective of this meta-analysis is to assess the all-cause and cause-specific mortality in patients with psoriasis.MethodIn accordance with PRISMA guidelines, a systematic search of PubMed, EMBASE, and the Cochrane Library (from inception to March 2025) was conducted. Eligible studies comprised English-language cohort studies comparing mortality risk (HR/OR/RR) in adults with psoriasis versus healthy/non-psoriasis controls. Two reviewers independently screened studies, extracted data, and assessed study quality using the Newcastle-Ottawa Scale. Hazard ratios (HRs) were synthesized using random-effects models in Stata 14.0. Sensitivity analyses, subgroup analyses, and assessments of publication bias (via funnel plots and Egger’s test) were also performed.ResultA total of 20 studies involving 8825989 participants were included. Psoriasis patients demonstrated significantly increased risks of all-cause mortality [HR=1.19, 95% CI (1.11–1.28), P=0.000], cardiovascular mortality [HR = 1.32, 95% CI (1.11–1.58), P = 0.002], infection-related mortality [HR=1.24, 95% CI (1.13–1.36), P=0.000], and suicide mortality [HR=1.50, 95% CI (1.03–2.19), P=0.034]. The risk of mortality due to neoplasms was marginally elevated but not statistically significant [HR=1.05, 95% CI (0.98–1.12), P=0.151]. No significant associations were found for neurological disease mortality [HR=0.96, 95%CI (0.83–1.11), P=0.976] or accident-related mortality [HR=0.91, 95% CI (0.81–1.02), P=0.629]. Sensitivity analysis supports the findings. Subgroup analyses revealed higher all-cause mortality risks in Europe (HR=1.11) and Asia (HR=1.23), as well as an increased risk with greater disease severity (moderate-to-severe: HR=1.44; severe: HR=1.54). No publication bias was detected.ConclusionPsoriasis is associated with an increased risk of all-cause, cardiovascular, infection-related, and suicide mortality, highlighting the need for enhanced monitoring and targeted interventions to prevent adverse outcomes particularly for individuals with severe psoriasis.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251017192, identifier CRD420251017192.
Nicolas Joly-Tonetti, Raphael Legouffe, Aurore Tomezyk
et al.
Abstract Introduction Onychomycosis is a fungal infection of the nails that can be challenging to treat. Here, matrix-assisted laser desorption ionization–Fourier transform ion cyclotron resonance (MALDI-FTICR) imaging was applied to the quantitative analysis of the penetration profile of the antifungal compound, amorolfine, in human mycotic toenails. The amorolfine profile was compared with those of three other antifungals, ciclopirox, naftifine, and tioconazole. Methods Antifungal compounds (amorolfine 5% lacquer, ciclopirox 8% lacquer, naftifine 1% solution, and tioconazole 28% solution) were applied to mycotic nails (n = 42). Nail sections were prepared, and MALDI-FTICR analysis was performed on the sections at a spatial resolution of 70 μm to compare the distribution profiles. Based on the minimum inhibitory concentrations of the four test compounds needed to kill 90% (MIC90) of the fungal organism, Trichophyton rubrum, the fold differences between the MIC90 and the antifungal concentrations in the nails (termed the multiplicity of the MIC90) were calculated for each. Results The penetration profiles indicated higher concentrations of amorolfine and ciclopirox in the deeper layers of the nails 3 h after treatment, compared with naftifine and tioconazole. The mean concentrations across the entire nail sections at 3 h were significantly different among the four antifungals: amorolfine, 2.46 mM; ciclopirox, 0.95 mM; naftifine, 0.63 mM; and tioconazole, 1.36 mM (p = 0.016; n = 8 per compound). The median multiplicity of the MIC90 at 3 h was 191-fold for amorolfine, tenfold for ciclopirox, 52-fold for naftifine, and 208-fold for tioconazole. Conclusion In this study, MALDI-FTICR was successfully applied to the quantitative analysis of antifungal distribution in human mycotic nails. The findings suggest that amorolfine penetrates deeper layers of the nail and accumulates at concentrations far exceeding the MIC needed to exert antimycotic activity.
Introduction: Skin lesions are a common extraintestinal manifestation associated with inflammatory bowel disease (IBD), although they may also appear as a complication of IBD treatment. Prompt referral to the dermatologist can be very helpful in practice. Teledermatology complements the traditional in-person health care modality, improving access to dermatological care. Objective: To evaluate the impact of a store-and-forward teledermatology electronic consultation (e-consult) program on the care of IBD patients. Methods: A retrospective study assessing the outcomes of our teledermatology program over its first 2 years of implementation. Results: A total of 39 consultations involving 33 patients (69.2% women, mean age 39.6 years [12–63]) were conducted. The mean number of teleconsultations was 2.8 per month in the initial implementation stage: 33 consultations were carried out in patients with Crohn's disease and 6 in ulcerative colitis. Only 18% of the patients had an active flare-up. The most frequent reason for the e-consult was paradoxical psoriasiform lesions (n = 13, 33.3%), commonly related with anti-tumor necrosis factor agents (70% of the patients) and hidradenitis suppurativa (n = 4, 10.3%). Resolution was achieved in 87% of patients, with a mean waiting time of 4.7 days (0–14). Almost all patients (97%) were satisfied with our program, and considered the referral through the program to be appropriate (92%). Best valued features were the reduced waiting time and the coordinated approach between the two departments involved. Conclusions: Dermatology e-consult is an efficient and useful means of optimizing IBD patient care.
Computer applications to medicine. Medical informatics
Dorsaf Elinkichari, Faten Rabhi, Kahena Jaber
et al.
Introduction: Palmoplantar psoriasis is a rare variant of psoriasis. Its impact on quality of life have been poorly investigated.
Objectives: Our aim was to investigate the prevalence of localized palmoplantar psoriasis (PPP), to assess its severity using the modified-Palmoplantar Pustular Psoriasis Area and Severity Index (m-PPPASI), and to evaluate the correlation with the Dermatology Life Quality Index (DLQI).
Methods: We conducted a descriptive study with prospective data-collection from January to June 2021. We enrolled 223 patients with psoriasis. We excluded patients without palmar/plantar involvement, and those with a body surface area (BSA) greater than or equal to 10%.
Results: We included 33 patients with PPP. This corresponded to a 14.8% prevalence among all psoriasis phenotypes. The mean age was 45 years. The male to female ratio was 2.3. Pruritus was present in 27 cases. The mean m-PPPASI was 11.77. The mean DLQI was 8.33. A significant correlation was found between DLQI and m-PPPASI: Mean DLQI scores for patients with m-PPPASI less than or equal to 10 and m-PPPASI greater than 10 were 5.6 and 11.3, respectively (p=0.002). Only 11.8% of patients with m-PPPASI less than or equal to 10 had a DLQI greater than 10, whereas 50% of those with m-PPPASI greater than 10 had a DLQI greater than 10 (p=0.026).
Conclusions: Based on the present work, we confirm that, although affecting a reduced BSA, PPP is a severe form of psoriasis. We consider the m-PPPASI to be a reliable tool which can be used to assess the severity of PPP.
Yıldız Hayran, Çiğdem Yücel, Esra Fırat Oğuz
et al.
Introduction: Vitiligo is a chronic skin disorder in which immune dysregulation has been reported as one of the major etiopathological factors. Interleukin-12 (IL-12), IL-23 and IL-27 of IL-12 cytokine family were identified as critical cytokines in the pathogenesis of many autoimmune and inflammatory skin diseases including vitiligo. IL-35 is one of the newest member of IL-12 cytokine family.
Objectives: The purpose of our study was to examine serum IL-35 levels in addition to serum IL-12, IL-23, IL-27 levels in the vitiligo patients and control group, and to investigate the relationship of these cytokines with the characteristics of vitiligo.
Methods:
Serum IL-12, IL-23, IL-27 and IL-35 levels of 78 vitiligo patients and 70 healthy volunteers were analyzed using the enzyme-linked immunosorbent assay (ELISA). We compared the IL-12 cytokine family levels in the patient and control groups, and investigated the relationship of these levels with the characteristics of vitiligo.
Results:Patients had higher levels of IL-12 (31.2 versus 20.1, P < 0.001) and IL-35 (9.6 versus 8.1, P = 0.031). Patient and control groups had similar levels of IL-23 (P = 0.78) but were correlated with the Vitiligo Area Scoring Index (VASI) (P = 0.022, r = 0.35). Patients had lower levels of IL-27 (207.6 versus 258.7, P < 0.001). In addition, the levels of serum IL-27 were correlated negatively with the Vitiligo Disease Activity (VIDA), and positively with disease duration (P = 0.007, r = 0.30).
Conclusions: Differences of serum levels between Vitiligo patients and healthy controls, significant relationships with the characteristics of vitiligo suggest that the IL-12 cytokine family may play a role in the pathogenesis of vitiligo.
Alison V. Sears, Rukshana Ali, Jane O’Connor
et al.
Abstract Children and young people (CYP) with skin and hair conditions are at an increased risk of mental health problems and vice versa. Current child and adolescent mental health services are already stretched and in our experience, this unique combination of symptoms and signs requires a multi‐disciplinary approach. We report our experience of establishing a paediatric psychodermatology clinic where, at each appointment, CYP are seen by a consultant dermatologist and a clinical psychologist initially jointly and then individually to ensure all viewpoints are heard and a collaborative treatment plan can be agreed. The clinic was established one month prior to the national lockdown during the COVID‐19 pandemic and the face‐to‐face model was converted to a virtual format. CYP are now seen either face to face or virtually according to CYP/parent/carer preference and this hybrid model increases accessibility and has reduced DNA rates. Referrals were received from primary, secondary and tertiary care settings. Thirty –six new patients were seen and followed‐up over a 2 year period, age range 3–17 years old. The majority of patients presented with compulsive hair pulling (trichotillomania) and medically unexplained signs (dermatitis artefacta); other problems seen were eczema, skin picking and acne. Half of the patients required additional psychology sessions. Seventy‐six percent of patients have been discharged, almost half back to the care of their general practitioner. We use pre‐ and post‐clinic questionnaires and share these and feedback from CYP/families who have found this clinic model helpful and effective.
Summary:. Celiac artery (CA) occlusion, or stenosis, is not uncommon, and most cases are asymptomatic. If the CA is occluded, collateral circulation from the superior mesenteric artery (SMA) is maintained through the pancreaticoduodenal arcade. However, the pancreaticoduodenal arcade is removed if pancreaticoduodenectomy (PD) is performed, which results in ischemia of the liver, stomach, and residual pancreas. Thus, these patients require CA revascularization, which can include antegrade endovascular reconstruction and retrograde reconstruction using vascular anastomosis from the SMA system to the CA system. Both methods carry risks of restenosis or anastomotic thrombosis. We report a technique that involves a combination of both revascularization methods in an 89-year-old man who underwent PD for lower bile duct cancer. Preoperative endovascular stent placement in the CA preserved antegrade blood flow to the liver, and intraoperative vascular anastomosis of the jejunal artery and right gastroepiploic artery achieved retrograde blood flow. Although we confirmed both stent and anastomosis patency and blood circulation in our case, obstruction of 1 of these revascularization pathways would not likely lead to ischemia of the liver. Thus, our 2-way revascularization technique for managing celiac artery stenosis during PD may reduce the risk of organ ischemia.
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.
Anna Ryś-Czaporowska, Anna E. Płatek, Mariusz Sikora
et al.
Cardiovascular diseases are the leading cause of hospitalization and mortality across the world. In 2013, the estimated number of deaths from cardiovascular diseases exceeded 17 million, accounting for 31.5% of all deaths globally, i.e. twice the number of all cancer-related deaths The article explores the correlation between selected dermatological diseases and an elevated risk of cardiovascular events. In addition, cutaneous manifestations of cardiovascular diseases which are important in the physician’s practice, and therapeutic dilemmas involved in the coexistence of cardiac and dermatological diseases, are discussed.
Jinmin Lee, Victoria P. Werth, Victoria P. Werth
et al.
The 5th Scientific Conference of the International Pemphigus and Pemphigoid Foundation (IPPF), “Pemphigus and Pemphigoid: A New Era of Clinical and Translational Science” was held in Orlando, Florida, on May 15–16, 2018. Scientific sessions covered recent, ongoing, and future clinical trials in pemphigus and bullous pemphigoid, disease activity and quality of life instruments, and the IPPF Natural History Study. Furthermore, the meeting provided an opportunity to hear firsthand from patients, investigators, and industry about their experience enrolling for clinical trials.
Abstract Background Antimicrobial resistance (AMR) and genetic determinants of resistance of N. gonorrhoeae isolates from Hefei, China, were characterized adding a breadth of information to the molecular epidemiology of gonococcal resistance in China. Methods 126 N. gonorrhoeae isolates from a hospital clinic in Hefei, were collected between January, 2014, and November, 2015. The minimum inhibitory concentration (MIC) of N. gonorrhoeae isolates for seven antimicrobials were determined by the agar dilution method. Isolates were tested for mutations in penA and mtrR genes and 23S rRNA, and also genotyped using N. gonorrhoeae multi-antigen sequence typing (NG-MAST). Results All N. gonorrhoeae isolates were resistant to ciprofloxacin; 81.7% (103/126) to tetracycline and 73.8% (93/126) to penicillin. 39.7% (50/126) of isolates were penicillinase producing N. gonorrhoeae (PPNG), 31.7% (40/126) were tetracycline resistant N. gonorrhoeae (TRNG) and 28.6% (36/126) were resistant to azithromycin. While not fully resistant to extended spectrum cephalosporins (ESCs), a total of 14 isolates (11.1%) displayed decreased susceptibility to ceftriaxone (MIC ≥ 0.125 mg/L, n = 10), cefixime (MIC ≥ 0. 25 mg/L, n = 1) or to both ESCs (n = 3). penA mosaic alleles XXXV were found in all isolates that harbored decreased susceptibility to cefixime, except for one. Four mutations were found in mtrR genes and mutations A2143G and C2599T were identified in 23S rRNA. No isolates were resistant to spectinomycin. Gonococcal isolates were distributed into diverse NG-MAST sequence types (STs); 86 separate STs were identified. Conclusions N. gonorrhoeae isolates from Hefei during 2014–2015, displayed high levels of resistance to antimicrobials that had been recommended previously for treatment of gonorrhea, e.g., penicillin, tetracycline and ciprofloxacin. The prevalence of resistance to azithromycin was also high (28.6%). No isolates were found to be fully resistant to spectinomycin, ceftriaxone or cefixime; however, 11.1% isolates, overall, had decreased susceptibility to ESCs.