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PubMed1975

HL-A antigens in psoriasis with special reference to the clinical type, age of onset, exacerbations after respiratory infections and occurrence of arthritis.

HL-A typing was performed in a series of 125 patients with common psoriasis, 12 patients with flexural psoriasis, 16 patients with erythrodermic psoriasis and 16 patients with generalized pustular psoriasis, and compared with typing in a control population. The HL-A antigens 13 and 17 were significantly increased in patients with common psoriasis and erythrodermic psoriasis. HL-A 17 was also found in two of the 16 patients with generalized pustular psoriasis. Neither HL-A 13 nor 17 was increased in patients with flexural psoriasis. It is suggested that flexular psoriasis might be genetically distinct from common psoriasis. TY was increased in patients with common psoriasis. The increase of HL-A 13, 17 and TY was most marked in patients with onset of psoriasis before the age of 40 years. HL-A 13 was found in 38 per cent of the 40 patients with infection-related exacerbations of psoriasis, but only in 17 per cent (p = 0.012) of the remaining 129 patients. HL-A 27 was found in 58 per cent of the 26 patients with sacro-iliitis and in 27 per cent of the 41 patients with peripheral arthritis without sacro-iliitis, but only in eight per cent of the 102 non-arthritic patients (p less than 0.001) and p less than 0.01, respectively).

Adolescent↗

PubMed1979

Particular clinical features of psoriasis in infants and chidren.

The onset of psoriasis is observed before the age of 10 years in 15% of all patients. The clinical pattern often takes on a peculiar form. Psoriasis guttata--or less frequently nummular psoriasis--is the initial phase during childhood. It is very difficult to establish a diagnosis on the basis of incipient features when childhood psoriasis is located on the head, palms, soles, or on the fingers, toes and nails. Intertriginous or flexural psoriasis, psoriasis spinulosa and oral psoriasis is also described. The onset of napkin psoriasis starts at the age of 3 months. Occasionally, Leiner's disease may develop into a typical, chronic psoriasis. We have concentrated our studies on the less common features of childhood psoriasis: the generalized pustular infantile form, congenital psoriatic erythroderma, acquired psoriatic erythroderma, and infantile arthropathic psoriasis.

Adolescent↗

PubMed1977

HL-A antigens in pustular psoriasis.

HL-A typing was performed on 97 patients with pustular psoriasis. HLA-B27 was found increased for the combined three subgroups: localized psoriasis of palms and soles, acrodermatitis continua and generalized pustular psoriasis, who were associated with a high incidence of arthritis. These subgroups have this in common with Reiter's disease indicating a link between the entities. In persistent palmo-plantar pustulosis an increased incidence of HLA-Bw35 was found. HLA-B13, HLA-B17 and HLA-Bw37 which are found markedly increased in psoriasis vulgaris were in acrodermatitis continua, generalized pustular psoriasis and persistent palmo-plantar pustulosis either absent or not increased as compared with the control population. 7 of 30 patients with localized psoriasis of palms and soles had one of these antigens. Our findings confirm that psoriasis vulgaris and pustular psoriasis as such, seem to be different aetiological entities. Some patients with localized psoriasis of palms and soles may be true psoriatics which besides their psoriasis have a tendency to develop a pustular reaction in their palms and soles similar to persistent palmo-plantar pustulosis.

Arthritis↗

PubMed1976

Improvement of recalcitrant psoriasis vulgaris after tonsillectomy.

To study the effect of tonsillectomy as a possible part of the treatment of infection-released, relapsing and recalcitrant (to topical therapy and courses of penicillin) psoriasis vulgaris in children and adolescents and to test a possible correlation between tonsillitis and exacerbations of psoriasis vulgaris, a retrospective study (charts and questionnaires) of the course of psoriasis after tonsillectomy was undertaken in 74 patients with such psoriasis. Each patient served as his own control. At tonsillectomy the average age of patients and the duration of psoriasis were 14-2 years and 4-5 years, respectively, while the average follow-up period was 4-5 years. The clearing of psoriasis vulgaris was stastically significant, p less than 0-01, as 1/3 of the patients obtained clearing of psoriasis throughout the entire follow-up period, while an additional 1/3 noticed considerable improvement of their psoriasis. After having tried both topical therapy of various sorts and courses of penicillin, tonsillectomy might be taken into consideration in relapsing, recalcitrant psoriasis vulgaris in children and adolescents.

Adolescent↗

PubMed2025

Identification of mitophagy-related biomarkers with immune cell infiltration in psoriasis.

BACKGROUND: Psoriasis is an inflammatory disorder characterized by scaly erythematous plaques and significant comorbidities. Recent studies have suggested that impaired mitophagy, the cellular mechanism for removing dysfunctional mitochondria, may contribute to the pathogenesis of psoriasis. METHODS: In this study, we analyzed bulk RNA sequencing data from 167 healthy individuals and 177 patients with psoriasis obtained from the Gene Expression Omnibus database (GSE30999 and GSE54456). Mitophagy-related genes were isolated using weighted gene co-expression network analysis. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were performed and protein-protein interaction networks were constructed for the functional enrichment of genes associated with mitophagy. The correlations between genes associated with mitophagy, signaling pathways, and immune cell infiltration were analyzed. The potential diagnostic value of genes associated with mitophagy was evaluated using receiver operating characteristic (ROC) curves, which were validated in imiquimod-induced psoriatic skin lesions in mice. RESULTS: We identified 3,839 differentially expressed genes between healthy individuals and patients with psoriasis, and 23 genes were selected as hub genes showing a high correlation with mitophagy in psoriasis. GO and KEGG analyses revealed that hub and associated genes were significantly correlated with skin functions, such as epidermal development and keratinocyte differentiation. In addition, mitophagy-related genes were negatively associated with pro-inflammatory and pro-proliferation pathways in psoriasis. Among the immune cells, CD4+ T cells were most significantly affected by mitophagy-related genes. ROC analysis demonstrated that mitophagy-related genes, especially ACER1, C1ORF68, CST6, FLG2, GJB3, GJB5, GPRIN2, KRT2, and SPRR4 were potential biomarkers of psoriasis for use in diagnosis or treatment. CONCLUSIONS: Mitophagy-related genes play crucial roles in psoriasis and have potential use as biomarkers, providing insights into disease mechanisms and therapeutic targets. Further research may lead to the development of new strategies for psoriasis management.

Psoriasis↗

PubMed2026

Predictors of Efficacy Maintenance After Vunakizumab Discontinuation in Patients With Moderate-to-Severe Plaque Psoriasis: A Post Hoc Analysis of a Randomized Controlled Trial.

BACKGROUND: Efficacy cannot be maintained in some psoriasis patients after biological discontinuation. This study aimed to explore predictors of efficacy maintenance after vunakizumab discontinuation in patients with moderate-to-severe plaque psoriasis. METHODS: This post hoc analysis used data from a phase III trial (NCT04839016); 291 patients with moderate-to-severe plaque psoriasis who achieved 100% improvement in Psoriasis Area and Severity Index (PASI) score at Week 52 were enrolled. Efficacy maintenance was defined as patients who maintained PASI 90 or PASI 100 after 20 weeks of vunakizumab discontinuation. RESULTS: There were 44.7% and 72.5% of patients with PASI 100 and PASI 90 maintenance, respectively. In the multivariate logistic regression model, body mass index (BMI) (odds ratio [OR] = 0.922, p = 0.024) and treatment interruption (OR = 0.550, p = 0.020) were independently associated with a lower possibility of PASI 100 maintenance; however, the association of family history of psoriasis and the first time of PASI 100 achievement with PASI 100 maintenance did not achieve statistical significance. Duration of psoriasis (OR = 0.972, p = 0.049) and treatment interruption (OR = 0.257, p < 0.001) were independently associated with a lower possibility of PASI 90 maintenance. Two nomograms for predicting PASI 90 and PASI 100 maintenance were constructed based on the multivariate models, which disclosed good calibration performance. CONCLUSIONS: PASI 90 and PASI 100 maintenance rates are 72.5% and 44.7% after 20 weeks of vunakizumab discontinuation in patients with moderate-to-severe plaque psoriasis. BMI, treatment interruption, and duration of psoriasis predict a lower possibility of efficacy maintenance after vunakizumab discontinuation.

Humans↗

PubMed1977

The nature and frequency of the histological changes found in psoriasis vulgaris.

A total of 272 biopsies (from psoriatic lesions with a diameter of 2-10 cm) were performed on 178 psoriasis patients. Sections from these biopsies were stained with haematoxylin-eosin and by the PAS and trichrome techniques. Each section was investigated for the presence or absence of para- and hyperkeratosis, acanthosis, mitoses, intercellular edema and spongiosis of the epithelial ridges, edema at the top of the connective tissue-papillae, the number of leucocytes penetrating the epidermis at the top of these papillae, classical Munro abscesses, abscesses in the horny layer and Kogoj spongiform pustules, and the results were noted. It was found that the site of the biopsy in the psoriasis lesion, the location of the psoriasis lesion from which material for biopsy was taken and the moment of time during the course of the disease at which the biopsy was performed, had no influence on the histological signs observed in a given patient. In other words, the histological picture of psoriasis plaques from 2-10 cm found in a given patient exhibits a high degree of constancy. Some evidence was found indicating that signs of latent psoriasis may probably be present in the healthy skin of a psoriasis patient. It is generally assumed that the epidermis above the connective tissue-papillae in cases of psoriasis is thinner than normal. Our investigation showed that the reverse is the case: the thickness of the epidermis in the psoriasis efflorescences is significantly greater than in healthy skin nearby in the same patient.

Humans↗

PubMed1975

HL-A antigens in patients with persistent palmoplantar pustulosis and pustular psoriasis.

HL-A typing was performed in a series of 22 patients with persistent palmoplantar pustulosis, 14 patients with palmoplantar pustulosis and psoriasis, 15 patients with generalized pustular psoriasis and 45 patients with uncomplicated psoriasis. None of the patients with persistent palmoplantar pustulosis alone had relatives with psoriasis, which was a common finding in the other groups. The HL-A antigens 13 and 17 were markedly increased in the group of uncomplicated psoriasis. In the group of patients with persistent palmoplantar pustulosis alone neither of these antigens was increased, as compared with a control population. Four patients with persistent palmoplantar pustulosis and psoriasis had HL-A 17 or 13 and two patients with generalized pustular psoriasis had HL-A 17. In the latter group HL-A 27 occurred in eight cases and correlated with the presence of sacro-iliitis. It was concluded that persistent palmoplantar pustulosis is an entity genetically distinct from psoriasis even if psoriatic patients might have an increased tendency to develop this type of pustular reaction.

Dermatitis↗

PubMed2026

Causal relationships between psoriasis and coronary artery disease: A two-sample Mendelian randomization study.

Previous studies have revealed a potential association between psoriasis and coronary artery disease (CAD). However, the causal relationship between the 2 remains unclear. This study aims to assess the causal link between psoriasis and CAD, which encompasses coronary heart disease, myocardial infarction, and angina pectoris. After obtaining genome-wide association studies data on psoriasis and CAD, we selected appropriate single nucleotide polymorphisms for Mendelian randomization (MR) analysis. The inverse-variance weighted method was used as the main analytical method. The inverse-variance weighted method indicated that psoriasis was associated with a higher risk of CAD (odds ratio = 11.538, 95% confidence interval = 4.498-29.595, P < .001), and coronary heart disease (odds ratio = 1.080, 95% confidence interval = 1.031-1.132, P = .001). Reverse MR analyses did not show causal effects of CAD on psoriasis. This study shows a significant causal association between psoriasis and incidence of CAD. However, there is no reverse causal association between CAD and psoriasis.

Psoriasis↗

PubMed2026

The effects of tildrakizumab in the epigenetic aging deviation of psoriasis: A 52-week open-label study.

BACKGROUND: While biologic therapies targeting interleukin-23 control cutaneous inflammation in psoriasis, their impact on epigenetic aging has not been previously demonstrated. OBJECTIVES: To evaluate the effects of tildrakizumab treatment in the epigenetic aging deviation of moderate-to severe psoriasis. METHODS: In an open-label 52-week clinical trial, 20 adults with psoriasis were treated with tildrakizumab-asmn 100 mg injections until week 28. Ten age-matched controls without psoriasis were enrolled. Genome-wide DNA methylation was profiled in peripheral blood leukocyte DNA (MethylationEPICv2.0, Illumina) to calculate epigenetic aging clocks predictive of all-cause-mortality, phenotypic age, chronological age, pace of aging, and telomere length. Epigenetic age deviation was calculated as the residuals against chronological age. RESULTS: Psoriasis patients had increased epigenetic age deviation in clocks predictive of mortality: PCGrimAge (P = .008), cytosine-phosphate-guanine (CpG) PTPCGrimAge3 (P = .019), CpGPTGrimAge3 (P = .019), GrimAge2 (P = .049). PCGrimAge was reversed by 0.3 years (week 28, P = .005) and 0.5 years (week 52, P = .04) after the use of tildrakizumab-asmn. The pace of aging was increased in psoriasis patients: DunedinPACE (P = .049). LIMITATIONS: Pilot study (small sample size). CONCLUSIONS: Psoriasis patients presented accelerated epigenetic aging in mortality-predictive clocks. Treatment with tildrakizumab-asmn (interleukin-23 inhibition) showed partial reversal of those clocks in 28 weeks. (Funded by Sun Pharmaceutical Industries, Inc; ClinicalTrials.gov number, NCT05110313).

DNA methylation clocks↗

PubMed1976

Cytokinetics and chemotherapy of psoriasis.

The successful treatment of psoriasis with folic acid antagonists during the past 25 years has led to extensive research in the areas of cytokinetics and chemotherapy. In this paper we shall review selected aspects of these topics relevant to the treatment of psoriasis. The effectiveness of methotrexate treatment of psoriasis can be related to both the hyperproliferative cytokinetics of psoriasis and an increased biochemical sensitivity of psoriatic epidermal cells to this drug. Future research goals in chemotherapy of psoriasis include (a) optimizing drug schedules for available drugs; (b) identifying other susceptible biochemical points of selective drug attack; (c) identifying secondary advantages in order to facilitate selective drug action in psoriasis, such as ultraviolet light therapy in combination with a systemic drug; and (d) developing topically effective chemotherapeutic agents. Approaches to research on topical therapy are reviewed with specific reference to animal testing models for psoriasis and percutaneous penetration of topically applied agents.

Administration, Topical↗

PubMed1975

Improvement of refractory psoriasis vulgaris after tonsillectomy.

In order to ascertain what effect tonsillectomy may have in the treatment of children and adolescents with recurring psoriasis vulgaris, refractory to topical therapy and courses of penicillin, and triggered by infection, and also to test a possible correlation between tonsillitis and exacerbations of psoriasis, a retrospective study of the course of psoriasis after tonsillectomy, using charts and questionnaires, was undertaken in 74 psoriatic patients. Each patient served as his won control. The average age of the patients at tonsillectomy and the duration of psoriasis were 14.2 years and 4.5 years, respectively, while the average follow-up period was 4.5 years. The clearing of the psoriasis was statistically significant (p less than 0.01) as it occurred throughout the entire follow-up period in one-third of the patients, while an additional third noticed considerable improvement of their psoriasis. After trying tropical therapies of various sorts as well as courses of penicillin, tonsillectomy might be considered for recurring, refractory psoriasis vulgaris in children and adolescents.

Adolescent↗

PubMed1975

Psoriasis: a review. Part I.

The recent literature relating to pathogenesis, clinical features and management of psoriasis has been reviewed. The features of the accelerated epidermopoiesis are described and its relationship to a possible primary fault in keratinisation or dermal influences discussed. The present position on the genetics and epidemiology of psoriasis is summarised. Recent observations on the relationship of histocompatibility system antigens to ordinary and pustular psoriasis could lead to important advances. Clinical discussion is confined to psoriasis in childhood, the hair, nails and mucosal psoriasis; pustular psoriasis and psoriasis arthropathica.

Age Factors↗

PubMed1979

Psoriasis: odd varieties in the adult.

Occasionally we observe particular varieties of psoriasis and in rare cases transitional features with other diseases, which pose problems concerning the differential diagnosis and the nosological classification. This communication deals with the following clinical and histological aspects of psoriasis: 1) Sebopsoriasis. Relationship of psoriasis to pityriasis rubra pilaris. 2) Erythema annulare centrifugum type of psoriasis. 3) Is subcorneal pustular dermatosis an expression of pustular psoriasis? 4) Salient histopathological criteria for the diagnosis of the different atypical forms of psoriasis. 5) Presentation of an unusal case with striated and retiform verrucous psoriasis-like eruptions, which show a relationship to parakeratosis variegata.

Adult↗

PubMed1979

[Histological differential diagnosis of psoriasis vulgaris and seborrheic eczema of the scalp].

The clinical differential diagnosis between seborrheic dermatitis and psoriasis vulgaris of the scalp can be difficult. We, therefore, tried to elaborate histopathological criteria for a differentiation of the two dermatoses. Forty excisional biopsies were analysed without knowing the clinical diagnosis. The histopathological substrate within the epidermis is characterized in psoriasis by dermatitis-like and in seborrheic dermatitis by psoriasis-like alterations. Therefore, in some cases a definite histopathological diagnosis could not be made. Strong criteria favouring psoriasis are: moderate condensed hyperkeratosis with alternating parakeratosis, PAS-reactive serum inclusions and Munro abscesses within the horny layer, spongiform pustles and neutrophilic leukocytes within the epidermis. Strong criteria for seborrheic dermatitis are: irregular acanthosis with relatively thin condensed orthoor parakeratotic horny layer, spongiosis and spongiotic vesicles, exocytosis of lymphocytes and the lack of any hard criterias for psoriasis. The results may suggest that seborrheic dermatitis of the scalp may transform into psoriasis in patients with a genetical disposition ("psoriatic diathesis", "latent psoriasis") via a Köbner reaction. The existence of the seborrheic dermatitis (Morbus Unna) is not doubted by these investigations.

Biopsy↗

PubMed1979

[Features of the course of psoriasis in patients with organic diseases of the nervous system].

Of 190 patients suffering from psoriasis in 65 (34.2%) hypothalamic syndrome, sequelae of neuroinfections and craniocerebral injuries, acute and chronic insufficiency of cerebral circulation were noted. These diseases preceded the development of psoriasis in 22.6% of the patients, the fact, that gives one grounds to regard them with a greater probability as a pathogenetic factor of psoriasis. In the patients suffering from psoriasis and the above diseases of the nervous system an inclinication to exudative and pustulous manifestations, arthropathy, and erythroderma, as well as frequent resistance to the therapy and torpid course of the disease were observed. An exacerbation of psoriasis aggravated some neurological disorders, and a deterioration of the neurological state coincided in time in some patients with exacerbation of psoriasis. The interaction between the dermal and the neurological disturbances appeared to be a reason for supplementing the complex of measures for psoriasis treatment with means improving the metabolic processes in the brain, psychotropic and vasocative drugs, and diadynamic currents that produce normalizing effects on the vegetative functions and cerebral hemodynamics.

Adolescent↗

PubMed1975

[The geographic distribution of psoriasis].

On the basis of data published in the literature the geographical distribution of psoriasis vulgaris is described. One of the most interesting results is the increase of the psoriasis frequency in countries such as Japan, Korea, Kazachstan and East Africa. This could be due to the fact, that altered life conditions in connection with an increasing industrialization favour the manifestation of psoriasis genes. How far population differences of the psoriasis frequencies are to be seen exclusively as genetical ones, is hitherto unclear, but rather unlikely. No relations between psoriasis and climatec factors could be seen. Associations between psoriasis and several antigens (HL-A 13 and W 17) of the HL-A-systems seem to be present. These associations could be of considerable importance for the interpretation of the geographical distribution pattern of psoriasis. Further studies in psoriatic families are required, which describe the distribution of the HL-A specifities in the possibly potential psoriatic members of the families, who carry the respective genes.

Africa↗

PubMed1978

[The skin trichophytin reactivity in psoriasis vulgaris. A contribution to the pathogenesis and clinical aspects of psoriatric skin changes].

On the basis of the resultats of four years lasting studies on 330 patients with psoriasis the allergic mechanism of the dermatosis is discussed. In 65 cases it was able to make a clinical diagnosis of the primary psoriasis focus (PPH) and to cultivate from it in 12 cases trichophyton fungi. The possibility to show the relevant mycotic antigen from the PPH is demonstrated, the development of the disease from the initial focus is described by analogy to the clinical development and a difference is made between the acute--subacute psoriasis and the chronic psoriasis with regard to the responsiveness of the competent immunological system. With 330 patients intracutan-tests have been made with trichophytin, and at the same time control tests with tuberculin, toxoplasmin and candida alb. for a period of 12 months up to 24 months. The relative and even absolute blocking of the trichophyton immunological system (TAS) and which is in correlation to the pushes and remittences of the disease constitutes the impressing resultat of the tests. With regard to the working mechanism the opinion is held that the immunological complex which is existant in the psoriatic epidermis participates to a great extent in the release of the epidermopoesis which is typical for the psoriasis. The classification into the stade of PS I (early psoriasis), PS II and PS III (late psoriasis) makes the differentiation of the process possible.

Antibody Formation↗