Reluctance determinants of dermatologists about tattooing in patients with psoriasis. An international study

Background: Tattoos are an increasingly common phenomenon, with a prevalence of around 10–30 % of the population in Western countries. The “Tatou” project assessed the risks of tattooing for patients with psoriasis. The first part revealed strong opposition to tattoos in these patients on the part of dermatologists, despite fewer than a quarter of them having any personal experience of complications. The second part showed a very low rate (6.6 %) of local complications on tattoos in these patients as well as absence of severe complications. These observations led us to assess the reasons for reluctance about tattoos in the 468 dermatologists involved in the first part of the “Tatou” project. Patients and methods: We conducted a cross-sectional international study in France, Finland and Italy to evaluate the experience and opinions of dermatologists regarding tattoos in psoriasis patients via an anonymous questionnaire. We then examined the stated reasons for opposition to tattoos in order to establish the profiles of “tattoo-sceptical” dermatologists with regard to 4 different situations: active psoriasis, quiescent psoriasis, treatment with topical steroids and biotherapies. Results: The opinion of dermatologists regarding tattoos was generally unfavourable (3.5 ± 2.8/10), in particular, via multivariate analysis, among older dermatologists (P = 0.01), dermatologists in private practice (P = 0.04), and non-tattooed dermatologists (P < 0.0001). In multivariate analysis, the main parameter affecting the position of practitioner with regard to tattoos was their personal opinion of tattoos (P < 0.0001), regardless of disease activity or type of treatment. Italian, Finnish and female dermatologists exhibited greater reluctance but in a less consistent fashion. Conclusion: This analysis suggests a lack of objectivity among dermatologists opposed to tattoos probably stemming more from a poor opinion of this practice than from any fear of complications in their psoriatic patients

Characteristics of patients with plaque psoriasis who have discordance between Psoriasis Area Severity Index and dermatology life quality index scores

International audienc

Real-World Effectiveness and Safety of Apremilast in Older Patients with Psoriasis

Introduction: Apremilast is a drug recently developed for psoriasis. Few data are available on its use in the elderly. We evaluated the tolerance and effectiveness of apremilast used in daily practice for psoriasis treatment in older patients. Methods: We performed a multicenter, retrospective study involving patients aged ≥ 65 years who had received apremilast as a psoriasis treatment. Demographic data and details regarding psoriasis and adverse events (AEs) were collected from patient medical records. Results: 135 patients were included (mean age: 73.5 years). Treatment was stopped in 74 patients (54.8%) for AEs (n = 43, 56.6%), primary failures (n = 18, 23.4%), and relapses (n = 7, 9.2%). When patients were stratified by age at treatment initiation, the main cause of discontinuation in patients ≥ 75 years was AEs, whereas in patients aged 65–74 years it was primary failures (28.3%). Sixty-one patients reported AEs, mainly digestive (n = 49). Regarding effectiveness, 45.2% of patients reached PGA 0/1 between 3 and 6 months after treatment initiation. One-year apremilast continuation rates were better in the 65–74 and 75–84 years subgroups than in the > 85 years subgroup (p = 0.01). Conclusion: Apremilast seems to be an effective and safe therapeutic option for psoriasis in the elderly. The main AEs reported by patients did not seem to differ from those reported previously in younger populations. However, AEs were more frequent in patients > 75 years old leading to more frequent discontinuation of apremilast compared with younger patients, suggesting a higher level of vigilance is needed in the elderly

Effectiveness and safety of anti-interleukin-17 therapies in elderly patients with psoriasis

Anti-interleukin-17 agents have recently been develo-ped for the treatment of psoriasis. This study evaluated the tolerance and effectiveness of anti-interleukin-17 agents for psoriasis in elderly patients in daily practi-ce. A multicentre, retrospective study was performed, involving psoriatic patients aged ≥65 years who had received an anti-interleukin-17 agent, including se-cukinumab, ixekizumab or brodalumab. A total of 114 patients were included: 72 received secukinumab, 35 ixekizumab, and 7 brodalumab. Treatment was stop-ped in 32 patients (28.9%), because of relapses in 14 patients (41.2%), primary failures in 11 patients (32.4%), or adverse events in 7 patients (20.6%). The 3 most frequently reported adverse events were injec-tion site reactions (n = 4), oral candidiasis (n = 3), and influenza-like illness (n = 3). Regarding effectiveness, 80 patients (70%) reached a Physician Global Assessment score of 0/1, 6 months after treatment initiation. In conclusion, anti-interleukin-17 therapy appears to be an effective and safe therapeutic option for psoriasis treatment in patients aged ≥ 65 years

Biological treatments for paediatric psoriasis (BiPe): A retrospective observational study on biological drug survival in daily practice in childhood psoriasis

International audienc