Potential serum biomarkers of treatment response to ustekinumab in patients with psoriasis: a pilot study

Currently available biologics for psoriasis target the function of TNF-α, IL-17A or IL-12/23 and include etanercept (anti-TNF receptor fusion protein), adalimumab and infliximab (anti-TNFα antibodies), anti-IL-17(receptor) molecules and ustekinumab. Ustekinumab is a fully human immunoglobulin monoclonal antibody targeting the p40 subunit shared by IL-12 and IL-23. This prevents binding to the IL-12Rβ1 receptor unit on immune cells and subsequent signaling. The Psoriasis Area and Severity Index (PASI) is used for evaluation of the efficacy of therapies in psoriasis. This article is protected by copyright. All rights reserve

Depression in patients with hidradenitis suppurativa

Background Hidradenitis suppurativa (HS) is a chronic recurrent inflammatory skin disease with abscess formation and scarring predominantly in the inverse areas. The disease is often difficult to treat and patients experience a decreased quality of life (QoL). It is hypothesized that depression is more common in HS patients than among other dermatological patients. Objectives To evaluate the prevalence of depression in patients with HS. Methods In total 211 HS patients were included in the study and 233 were dermatological control patients. Their QoL and depression scores were assessed using the Dermatology Life Quality Index (DLQI) and the Major Depression Inventory (MDI) questionnaires. HS severity was recorded with a questionnaire and Hurley stages were extracted from the case records. Results The DLQI was significantly higher for HS patients than for the control patients, 8.4 +/- 7.5 vs. 4.3 +/- 5.6 (

Regulated genes in psoriatic skin during treatment with fumaric acid esters

BackgroundFumaric acid esters (FAEs) are widely used in Europe for the treatment of psoriasis because of their clinical efficacy and favourable safety profile. However, the mechanisms of action by which FAEs improve psoriasis remain largely unknown. ObjectivesTo identify pathways and mechanisms affected by FAE treatment and to compare these with pathways affected by treatment with the antitumour necrosis factor (anti-TNF)- biologic etanercept. MethodsIn a prospective cohort study, 50 patients with plaque psoriasis were treated with FAEs for 20weeks. Nine patients were randomly selected for gene expression profiling of plaque biopsies from week 0 and week 12. The groups consisted of FAE responders [>Psoriasis Area and Severity Index (PASI)-75 improvement] and nonresponders ( ResultsResponse to FAE treatment was associated with a2-fold change (P ConclusionsFAE treatment induces glutathione and Nrf2 pathway genes in lesional skin of patients with psoriasis. In responders, FAEs specifically regulate the transcription factors PTTG1, NR3C1, GATA3 and NFBIZ, which are important in normal cutaneous development, and the T-helper (Th)2 and Th17 pathways, respectively. What's already known about this topic? Fumaric acid esters (FAEs) are used in the treatment of psoriasis, but the mechanisms of action are poorly known.In vitro actions of FAEs include inhibition of keratinocyte proliferation and inhibition of dendritic cell maturation. What does this study add? FAE treatment of patients with psoriasis specifically induces activation of the Nrf2 and glutathione pathways in psoriatic skin. GATA3 and NFBIZ are FAE-specific molecules related to treatment response and these transcription factors are important in the T-helper (Th)2 and Th17 pathways, respectively

Hidradenitis suppurativa: an update on connecting the tracts

Hidradenitis suppurativa (HS) is a devastating disease involving abscesses, sinus tracts, and inflammation classically affecting the axilla, groin, and/or anogenital region. Although the disease pathogenesis is not fully understood, recent advances suggest that HS pathology runs much deeper than the cutaneous manifestations. It is now believed that HS is a systemic inflammatory disease that gives rise to the characteristic cutaneous manifestations. This disease is problematic for both patients and physicians to manage because of a variety of diagnostic and management difficulties. This article seeks to provide updates on the current understanding of HS to increase awareness and improve management