Background: Psoriasis is a chronic inflammatory skin disorder that often leads to psychological distress. Patients with moderate to severe chronic plaque psoriasis are at risk of anxiety and depression, which can negatively affect their quality of life and treatment outcomes. However, data on psychiatric comorbidities in Pakistani patients are limited. Psoriasis is a chronic inflammatory skin disorder that can cause significant psychological distress. Patients with moderate to severe chronic plaque psoriasis are at increased risk of anxiety and depression, which may negatively affect quality of life and treatment outcomes. Data on psychiatric comorbidities among Pakistani patients are limited, highlighting the need for local research. Objective: To determine the prevalence of anxiety and depression in patients with moderate to severe chronic plaque psoriasis. Material and Methods: This cross-sectional study was conducted In the Dermatology Unit of Khalifa Gul Nawaz Teaching Hospital, Bannu, from March 15, 2024, to September 15, 2024. Total 146 patients aged 15-70 years with a Psoriasis Area and Severity Index (PASI) ≥ 7 were recruited through the consecutive sampling method. Patients who had severe comorbid illnesses or psychiatric disorders besides depression and anxiety were not allowed were excluded from the study. The severity of psoriasis was evaluated clinically, and anxiety and depression were determined using the Hospital Anxiety and Depression Scale (HADS). SPSS v25.0 was used to analyze data. Frequencies and percentages were shown to represent categorical variables whereas means +- SD represented continuous variables. The chi-square tests were used to assess the associations with p ≤ 0.05 as significant. Results:Among 146 patients, 16 (11.0%) had depression and 28 (19.2%) had anxiety. Depression was more common in females (14)(17.1% vs.(2)3.1% in males)p=(0.007), high-income individuals (12)(22.6%),(p=0.003) and illiterate patients (9) (18.8%)(p=0.021). Anxiety was higher in males (26.6%) and most frequent in the middle-income group (35.9%). Age, disease duration, and occupation were not significantly associated p>0.05 with either condition. Conclusion: Anxiety and depression are common in a large percentage of patients with chronic plaque psoriasis. The findings indicate the significance of psychosocial assessment and intervention in the daily dermatological practice.

Background The management of psoriasis presents challenges, prompting many patients to seek alternative treatments. Cannabidiol (CBD) has demonstrated potential antioxidant and anti-inflammatory properties which may offer therapeutic benefits for skin conditions. Objective To evaluate the efficacy and safety of cannabidiol oil compared to placebo in chronic plaque psoriasis patients. Methods The randomized, double-blind, placebo-controlled trial enrolled 28 participants, who were administered either oral CBD oil 60 mg/day or placebo. The primary outcome was the Psoriasis Area and Severity Index (PASI) score. Secondary outcomes encompassed disease severity, quality of life, and sleep parameters. Safety was monitored through adverse events and laboratory assessments. Results The CBD group did not demonstrate a significant improvement in PASI scores. However, there was a notable reduction in itch scores by Week 8, and sleep onset latency decreased by Week 6, although this effect was not sustained. Adverse events were mild to moderate in nature and similar across both groups. Limitations The study duration may not fully capture the long-term effects, and the race and disease severity may limit the generalizability of the findings. A larger sample size is suggested for future studies. Conclusion Cannabidiol oil was well-tolerated; however, it did not result in a significant reduction in psoriasis severity. Temporary improvements in itch relief and sleep onset indicate that further research with higher doses and extended durations is warranted.

Biologic therapies (BT) have revolutionized psoriasis management, yet secondary treatment failure remains a significant challenge. Narrowband ultraviolet B (NB-UVB) phototherapy is an established treatment with local immunomodulatory effects that may synergize with BT to restore efficacy. Evidence supporting this approach, particularly regarding adalimumab failure, is limited. In this prospective, exploratory cohort study, 11 adults with chronic plaque psoriasis exhibiting secondary loss of response to adalimumab (without anti-adalimumab antibodies) underwent adjunctive NB-UVB phototherapy three times weekly for 25-30 sessions, while continuing adalimumab 40mg biweekly. Disease severity was assessed using the Psoriasis Area and Severity Index (PASI). Clinical response was defined as ≥ 50% PASI reduction from flare or return to baseline PASI. Mean PASI increased from 4.1 ± 0.7 at baseline to 11.8 ± 1.6 at flare. Following NB-UVB, mean PASI decreased to 6.2 ± 3.2 (p = 0.006). Excluding non-responders, PASI was 4.0 ± 0.5, comparable to pre-flare values. Five patients (45,5%) achieved PASI 50, two of whom (18.2%) achieved PASI 75. Responses were sustained for at least 24 months. DLQI improved from 14.7 ± 2.4 at flare to 5.6 ± 6.2 after NB-UVB (p = 0.005), indicating a substantial reduction in disease burden. NB-UVB was well tolerated, with no significant adverse events. Three non-responders switched to ustekinumab. Adjunctive NB-UVB phototherapy restored adalimumab efficacy in a majority of patients experiencing secondary failure, offering a safe, accessible, and cost-conscious strategy. Larger controlled studies are warranted to confirm efficacy, elucidate mechanisms, and define the role of combination therapy in modern psoriasis management.

Sleep disorders in psoriasis and their improvement with treatment have not been evaluated in the Indian subcontinent. The aim of the study was to assess the extent of sleep impairment and the effect of treatment on sleep impairment in patients with psoriasis. This was a prospective, observational study with 59 participants of chronic plaque psoriasis, receiving standard non-biological treatment. Psoriasis Area Severity Index (PASI) score, 5D Itch Score, Pittsburg Sleep Quality Index, and Insomnia Severity Index were calculated at baseline, 4 weeks, and 12 weeks of follow-up. The primary outcomes were changes in sleep quality and insomnia at week 4 and week 12 compared to baseline. Poor sleep quality and clinical insomnia were noted in 6 (10%) and 15 (25.4%) participants, respectively. Sleep quality was associated with body mass index (P = 0.01) and pruritus (P < 0.001), while insomnia showed an association with PASI (P < 0.001). With treatment, poor sleep quality decreased to 5% at week 12 and this decrease was significant between weeks 4 and 12 (P < 0.001). Insomnia decreased to 3.4% at week 12. This improvement was significant between baseline and week 4 (P = 0.01) and between weeks 4 and 12 (P = 0.005). The improvement in sleep quality had a positive correlation with a decrease in pruritus at 4 weeks (P < 0.001) and 12 weeks (P = 0.005). Follow-up of 12 weeks only and missing values are drawbacks. Sleep quality and insomnia improved with standard non-biological treatment and correlated with a reduction in psoriasis-induced pruritus. This finding is important as the treatment of psoriasis in resource-poor and developing countries mainly involves non-biological options.

Background: Psoriasis is increasingly recognized as a systemic inflammatory disorder associated with elevated cardiometabolic risk. This study aimed to assess the prevalence and pattern of metabolic abnormalities in patients with chronic plaque psoriasis and explore their correlation with disease severity. Materials and Methods: A total of 120 adult patients with clinically confirmed psoriasis were evaluated in a tertiary care dermatology clinic. Clinical parameters, PASI scores, anthropometric indices, and biochemical markers including fasting glucose, lipid profile, hs-CRP, serum uric acid, and lipoprotein(a) were recorded. Metabolic syndrome was defined using IDF criteria. Statistical analysis included Pearson correlation and logistic regression. Results: The prevalence of metabolic syndrome was 34.1%. Elevated BMI (71.6%), dyslipidemia (51.6%), and hs-CRP (61.6%) were common. PASI scores showed significant positive correlation with hs-CRP (r = 0.62, p &lt; 0.01). Logistic regression identified BMI (OR 2.14), LDL (OR 1.82), and hs-CRP (OR 2.36) as independent predictors of metabolic syndrome. Conclusion: Psoriasis patients exhibit a high burden of cardiometabolic risk factors, even in the absence of overt cardiovascular disease. Routine screening and integrated management strategies are essential to mitigate long-term systemic complications. Keywords: Psoriasis, Metabolic syndrome, Cardiometabolic risk, hs-CRP, PASI, Dyslipidemia, Obesity.

119 Time Course of Efficacy of Ponesimod in Patients with Moderate-to-Severe Chronic Plaque Psoriasis

Psoriasis is a chronic inflammatory skin disease increasingly linked to metabolic syndrome, yet the extent of this association remains unclear. This cross-sectional study examined the relationship between psoriasis severity and metabolic syndrome among 122 adults with chronic plaque psoriasis. Psoriasis Area and Severity Index (PASI) scores were significantly higher in patients with metabolic syndrome, indicating greater disease severity. Central obesity and dyslipidemia were the most prevalent metabolic factors associated with elevated PASI scores. Thus, we show the importance of routine metabolic screening in psoriasis patients to improve disease management and outcomes.

Plaque psoriasis, a chronic inflammatory disease, affects up to 2.1% of the global paediatric population. In a Phase 3 study (NCT02471144), secukinumab treatment for up to 104 weeks demonstrated good tolerability and efficacy in paediatric patients with severe chronic plaque psoriasis. Final long-term safety and efficacy results of secukinumab through 236 weeks of treatment in paediatric patients with severe chronic plaque psoriasis. During the extension period (Weeks 52-236), paediatric patients aged 6 to <18 years with severe chronic plaque psoriasis received either 'Any secukinumab' low dose (LD; patients receiving secukinumab LD up to Week 52; patients on placebo who transitioned to secukinumab LD) or 'Any secukinumab' high dose (HD; patients receiving secukinumab HD up to Week 52 and patients on placebo who transitioned to secukinumab HD). Assessments included Psoriasis Area and Severity Index (PASI) 75/90/100 responses, Investigator's Global Assessment modified 2011 (IGA mod 2011) 0/1 response, relapse, rebound, Children's Dermatology Life Quality Index (CDLQI) score, CDLQI 0/1 response and long-term safety up to Week 236. Secukinumab maintained efficacy through 236 weeks of treatment, with consistent responses observed in most assessments across both dose groups. At Week 236, the responder rate for IGA mod 2011 0/1 was 69.4% ('Any secukinumab' LD) and 79.5% ('Any secukinumab' HD); the PASI 75/90/100 responses were 97.2%/77.8%/50.0% ('Any secukinumab' LD) and 97.4%/84.6%/69.2% ('Any secukinumab' HD). CDLQI 0/1 responses remained consistent in both dose groups and were maintained up to Week 236 ('Any secukinumab' LD: 64.3%; 'Any secukinumab' HD: 67.7%). The most common adverse events were nasopharyngitis (EAIR/100 PYs [95% CI]:13.9 [10.0, 18.7]), headache (5.8 [3.7, 8.8]) and tonsillitis (4.7 [2.8, 7.4]). Candida infections were reported in 3 patients. These findings support the sustained efficacy and favourable safety profile of secukinumab in paediatric patients with severe plaque psoriasis over a 236-week treatment period.

Introduction: Psoriasis is a chronic inflammatory immunemediated skin disease associated with systemic manifestations that affects about 0.5% - 2.5% of the population, which varies according to regions. It is a conglomeration of multiple variants that have distinct morphological features. A histopathological study provides the diagnosis of psoriasis in classic form and its variants. Aim: The present study aimed to analyse the incidence of age, sex, disease duration, and distribution of various psoriasis variants while underscoring the clinical significance of histopathological assessment of epidermal and dermal features. Materials and Methods: The present cross-sectional study was conducted at Baroda Medical College, Vadodara, Gujarat, India, from January 2024 to December 2024. Hundred newly diagnosed patients of different variants of psoriasis visiting the Dermatology Outpatient Department (OPD) were included in the study, and a detailed clinical history with special reference to gender, duration, site of onset, seasonal exacerbation or remission, triggering factors, past treatment, family history and other systemic disease was taken. Complete head-to-toe cutaneous examination and systemic examination were carried out, and findings were noted. Biopsied specimens were processed in the histopathology section and stained with Hematoxylin and Eosin (H&amp;E) stain, and 10 parameters like parakeratosis, elongated rete ridges, Munro’s microabscess, acanthosis, suprapapillary thinning, hypogranulosis, Kogoj abscess, capillary dilatation, dermal infiltrate, and spongiosis were used to assess and classify various types of psoriasis. Collected data were statistically analysed by the Chi-square test and a p-value of &lt;0.05 was considered significant. Results: Total 100 patients were included among which male preponderance with 60 (60%) cases noted, with the maximum cases in the 31-40 year age group. The predominant histological type was Chronic Plaque Psoriasis (CPP) in 44 (44%) cases, followed by Palmoplantar Psoriasis (PPP) in 32 (32%). Amongst various cutaneous features of psoriasis, erythema was present in 79 (79%) followed by plaques 54 (54%). Auspitz sign and Woronoff ring were noted in 40 (40%) and 20 (20%) cases, respectively. Amongst the epidermal histopathological features of psoriasis, parakeratosis was found in 93 (93%) followed by hyperkeratosis 84 (84%). The dermal feature showed dermal infiltrate in 95 (95%) cases. These findings were statistically significant (p-value &lt;0.0001). Conclusion: Present study emphasises the role of histopathological study in various clinical variants of psoriasis to see the two aspects simultaneously for effective diagnosis and treatment. The current study concluded that even though most changes occur in the epidermis, there are a few dermal changes which can help in arriving at a diagnosis.

IntroductionRoflumilast cream 0.3% contains a selective, highly potent phosphodiesterase 4 inhibitor approved to treat plaque psoriasis. The Psoriasis Area and Severity Index (PASI)-High Discrimination (PASI-HD) is more precise than PASI when psoriasis involves < 10% of the area of an anatomic region. Clinical trials of roflumilast utilized PASI and its modified version, PASI-HD, to assess disease improvement. The objective of this analysis was to demonstrate the effect of topical roflumilast in patients with psoriasis and to compare PASI-HD with PASI.MethodsDERMIS-1 and DERMIS-2 were phase III, 8-week, randomized, vehicle-controlled trials of once-daily roflumilast cream 0.3% in patients aged ≥ 2 years with psoriasis involving 2–20% body surface area. PASI and PASI-HD were clinical endpoint measures.ResultsAt week 8, statistically significantly more roflumilast- than vehicle-treated patients achieved ≥ 75% reduction in PASI (40.3% vs 6.5%; P < 0.0001) and PASI-HD (59.9% vs 17.9%; P < 0.0001). Evaluations using PASI-HD resulted in larger effect sizes compared with PASI at higher levels of response.ConclusionsRoflumilast-treated patients experienced greater improvements in disease severity than vehicle-treated patients. The PASI-HD can more accurately assess disease changes compared with PASI.Trial RegistrationClinicalTrials.gov Identifiers: DERMIS-1, NCT04211363; DERMIS-2, NCT04211389.Supplementary InformationThe online version contains supplementary material available at 10.1007/s13555-025-01562-4.

We report the first documented case of concurrent remission of chronic plaque psoriasis and pouchitis with tildrakizumab therapy. A 66-year-old male achieved sustained psoriasis clearance and pouchitis improvement following IL-23p19 inhibition, after inadequate response to UV therapy, cyclosporine and adalimumab. This case highlights the potential role of selective IL-23 blockade in managing coexisting immune-mediated inflammatory conditions.

Chronic plaque psoriasis (CPS) and lichen planus (LP) are two chronic, immune-mediated inflammatory skin conditions that often spontaneously heal, even if recurrence is common. In both diseases, the immune system mistakenly targets skin cells, leading to inflammation and visible cutaneous lesions. Although the pathogenesis of LP is not fully understood, it is thought to involve an alteration of epidermal self-antigens, which activates T cells lymphocytes causing a persistent chronic inflammation at the dermal-epidermal junction. In psoriasis (PSO), an involvement of not properly considered immune cells, such as dendritic cells, monocytes, macrophages, neutrophils, keratinocytes and natural killer (NK) cells is present. Trophoblast surface antigen 2 (Trop2) is a type I transmembrane glycoprotein belonging to the epithelial cell adhesion molecule (EpCAM) family involved in cell adhesion. We conducted a retrospective study on 30 patients with the following diagnoses: 10 cases of Lichen planus (LP), 10 cases of chronic plaque psoriasis (CPS) and 10 healthy skin samples (HS). In all these samples, we performed an immunohistochemical analysis of Trop2 expression. LP and CPS samples showed a significant decrease in Trop2 expression compared to HS. Contrarily to LP, basal and supra-basal layers of CPS samples were completely negative, while the medium layers were highly positive for Trop2. The sub-corneal layers were negative for Trop2 in both LP and CPS. Our findings suggest that Trop2 may play a protective or regulatory role in maintaining skin homeostasis, particularly in the setting of immune-mediated inflammation.

Abstract Background: Psoriasis is a multifactorial immune-mediated inflammatory disorder in which the involvement of the skin is merely the tip of the iceberg. It poses a significant global problem affecting both children and adults, with childhood onset occurring in almost one-third of the cases. Early diagnosis of pediatric psoriasis is crucial to address, identify, and manage the growing list of established extracutaneous manifestations and comorbidities. Aims and Objectives: To study the clinico-epidemiological profile of pediatric psoriasis and determine the prevalence of various comorbidities associated with it. Materials and Methods: This was a cross sectional observational study conducted at the Department of Dermatology of a tertiary care hospital of North India over a period of 36 months and included all patients aged 9 months to 18 years with a clinical diagnosis of psoriasis. A predesigned structured proforma was used to collect the required information from the study subjects. Results: Eighty-six patients were recruited in this study, of which 47 (54.65%) were males and 39 (45.34%) were females. The most common type of psoriasis seen in this study was chronic plaque psoriasis (63%). Eight (9.30%) patients had evidence of psoriatic arthritis at presentation. Abnormal waist circumference was observed in 26 (30.23%) of the 86 patients recruited in the study. Abnormal BMI was recorded in 49 (56.97%) patients, of which 27 (31.39%) were overweight and 22 (25.58%) were obese. Ten (11.62%) patients had evidence of impaired fasting glucose, while 1 (1.16%) patient had type 2 diabetes mellitus. Increased levels of total cholesterol were observed in 13 (15.11%) patients involved in the study. Fifty-nine (68.60%) patients had at least 1 lipid profile abnormality. Eight (9.30%) participants fulfilled the criteria for metabolic syndrome. Concomitant autoimmune diseases were seen in 42 (48.83%) patients, of which hypothyroidism was the most common, followed by vitiligo, alopecia areata, type 1 diabetes mellitus, systemic lupus erythematosus, and juvenile rheumatoid arthritis. Conclusion: Although the association between psoriasis and various comorbidities is well documented in adults, studies demonstrating the same relationship in children are still lacking. However, psoriasis begins in childhood or adolescence in approximately 40% of patients, suggesting that the risk of comorbidities may also begin early in life. This presents an opportunity for prevention, early detection, and intervention for children who may suffer from or be at a risk of comorbidities, especially metabolic ones.

ABSTRACT Background The STELLAR-2 study compared the efficacy, safety, immunogenicity, and pharmacokinetics of Bmab 1200 with reference ustekinumab through Week 52 in patients with moderate-to-severe chronic plaque psoriasis. Research design and methods In this double-blind, Phase 3 study, patients were randomized 1:1 to receive Bmab 1200 or reference ustekinumab (45 mg or 90 mg). At Week 16, patients responding to ustekinumab (improvement in Psoriasis Area and Severity Index [PASI] score ≥50%) were re-randomized to continue with reference ustekinumab or switch to Bmab 1200 and followed through Week 52. Results Overall, 324 patients completed the study. At Week 52, the mean (SD) percentage reduction in PASI scores from baseline was −95.5% (7.51) for Bmab 1200, −96.6% (5.67) for continued-reference ustekinumab, and −94.7% (7.95) for switched-to-Bmab 1200 groups. Efficacy and safety outcomes were comparable across groups. From 28 to 52 weeks, 37.8% of patients had at least one treatment-emergent adverse event. The incidence of post-switch antidrug antibodies was also comparable (Bmab 1200: 63.7%; continued-reference ustekinumab: 80.2%; switched-to-Bmab 1200: 72.6%). Conclusions Bmab 1200 demonstrated clinical biosimilarity to reference ustekinumab through Week 52 even after switching. Long-term comparable efficacy and safety were also maintained. Trial registration www.clinicaltrials.gov identifier is NCT05335356 and www.clinicaltrialsregister.eu identifier is 2021-006668-25.

A randomized, double-blind, phase 3 study to compare efficacy, safety, and immunogenicity between DMB-3115 and reference product ustekinumab in patients with moderate-to-severe chronic plaque psoriasis

Psoriasis remains an incurable and recurrent condition despite modern treatment. Traditional Unani Medicine recommends numerous formulations for psoriasis, but with little supporting scientific evidence. The study aimed to evaluate the efficacy and safety of Majoon Mundi and Roghan Gul compared to apremilast and coconut oil in managing chronic plaque psoriasis (CPP). The study was a randomized, open-label, standard-controlled clinical trial, with 33 participants. 20 patients completed the 6-week treatment course in the test group, while 10 patients completed the 6-week treatment course in the control group. The study was conducted at the National Institute of Unani Medicine (NIUM), Bangalore, India, from June 2021 to December 2021. Participants aged 18-60 years, of either gender, diagnosed with CPP, and based on psoriasis area and severity index (PASI) score. The participants in the test group received 10 g of Majoon Mundi orally twice daily after meals and Roghan Gul for topical use twice daily, while the participants in the active control group received apremilast orally in a titrated dose and coconut oil as a topical application twice daily. The primary outcome of the study was a reduction in PASI score, and the secondary outcome was a reduction in dermatology life quality index (DLQI) score. Photographic assessments were conducted at the 14th, 28th, and 42nd day of the follow-up period. Intragroup analyses revealed that the test and control groups experienced a statistically significant reduction in PASI and DLQI scores (P < .001). Intergroup analysis showed no statistically significant difference in the reduction of PASI and DLQI scores between groups (P = .772 and .775, respectively). This study found that together, Majoon Mundi and Roghan Gul are as effective as apremilast and coconut oil in decreasing PASI and DLQI scores for managing CPP. apremilast, comparative study, herbal medicine, psoriasis, unani medicine.

Purpose:To study the characteristics of ophthalmic comorbidities in patients with chronic plaque psoriasis.Methods:We assessed the clinical and epidemiological attributes and characteristics of ophthalmic comorbidities of patients who had chronic plaque psoriasis for 15–25 years (mean ± standard deviation [SD], 3.9 ± 4.8 years). Out of 100 patients, 57 were males and 43 were females. In this cohort, the age range was from 19 to 77 years (mean ± SD, 41.8 ± 13.9 years). The severity of psoriasis was defined by the psoriasis area severity index (PASI) score as mild (PASI ≤6), moderate (PASI >6–12), or severe (PASI >12).Results:Psoriasis was mild in 77, moderate in 13, and severe in 10 patients, respectively. Three patients had asymmetric oligoarthritis. In a cohort of 100 patients, there were 23 patients with moderate-to-severe psoriasis and 77 patients with mild psoriasis. In the moderate-to-severe psoriasis group, 18 out of the 23 patients also had ophthalmic abnormalities. In the mild psoriasis group, 53 of 77 patients also had ophthalmic abnormalities. Itching (n = 12; psoriasis was mild in 7, moderate-to-severe in 5 patients), decreased vision (n = 12; psoriasis was mild in 10, moderate-to-severe in 2 patients), redness (n = 9; psoriasis was mild in 5, moderate-to-severe in 5 patients;), watering/discharge (n = 8; psoriasis was mild in 6, moderate-to-severe in 2 patients), and pain or burning (n = 6; psoriasis was mild in 4, moderate-to-severe in 2 patients) were commonly complained by 31 patients. The major ophthalmic comorbidities in order of frequency observed were keratoconjunctivitis sicca/dry eye (n = 41), blepharitis (n = 29), meibomian gland dysfunction (MGD) (n = 18), conjunctivitis (n = 10), corneal abnormalities (n = 13), cataract (n = 14), retention cyst (n = 2), and anterior uveitis in 2 patients (without psoriatic arthritis). Common corneal abnormalities were punctuate keratitis (n = 7), corneal opacities (n = 4), band-shaped keratopathy (n = 1), and superficial vascularization (n = 1). Posterior segment manifestations of arteriosclerotic changes (n = 4), media haze (n = 2), and macular degeneration (n = 1) were likely to be age-related.Conclusions:The ophthalmic comorbidities, such as blepharitis, MGD, conjunctivitis, keratoconjunctivitis sicca, corneal abnormalities, and presenile cataract, can occur in patients with psoriasis. These are largely asymptomatic and subtle findings that are often missed. They require an early consult to ophthalmology for appropriate management. The major limitations in this study are that it is a single-center, cross-sectional study design that has a low number of patients, lacks a healthy patient control group, and there is a lack of long-term follow-up.

ABSTRACTBackgroundNarrowband‐ultraviolet B (NB‐UVB) phototherapy is an effective treatment for psoriasis in patients who have failed topical regimens or those who desire to avoid systemic treatment. Despite its regular use in non‐white individuals, NB‐UVB treatment response for psoriasis in skin of color (SOC) has not been systematically reviewed.MethodsWe conducted a systematic review on the basis of the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) on all available studies to date assessing NB‐UVB for psoriasis treatment in skin of color (SOC) (up to 15 November 2024). The primary outcome was qualitative data on clinical outcomes of UVB (PASI 75). Random‐effects meta‐analysis was performed to assess treatment responses. Secondary outcomes of biochemical and immunologic mechanisms of NB‐UVB, NB‐UVB in combination with other treatments, and NB‐UVB compared to other forms of phototherapy were assessed.ResultsOf 1283 articles initially identified, 54 were ultimately included for formal review. We identified 43 articles assessing clinical outcomes of NB‐UVB phototherapy in patients with Fitzpatrick skin type III–IV for a total of 1322 patients with chronic plaque psoriasis and 12 patients with palmoplantar psoriasis. Nine studies were included for meta‐analysis of PASI75 response; 70.5% of patients achieved PASI75, and all studies demonstrated statistically significant PASI improvement after treatment. NB‐UVB demonstrated a higher rate of complete clearance when compared to BB‐UVB but did not result in a statistically significant difference in the proportion of the patient population achieving PASI75 when compared to PUVA.ConclusionsPhototherapy is effective for the treatment of psoriasis in SOC patients and remains a valuable treatment option despite the advent of various topical, systemic, and biologic treatments for psoriasis.

&lt;p&gt;乾癬是慢性發炎的皮膚疾病，生物製劑為近代廣泛使用的治療。Ixekizumab為一種單株抗體，是針對與乾癬致病機轉的IL-17開發的藥物，已經核准並且用於臨床。在2024年一篇長期安全性報告中，有提及此藥物可能會誘發發炎性腸道疾病，雖然發生率極低，潰瘍性結腸炎為千分之三，克隆氏症為千分之二，但是依然值得注意。發炎性腸道疾病在亞洲族群發生率是低於歐美族群，並且此藥物在臨床實驗時，納入的亞洲族群日本人並無任何人罹病。但是我們以Ixekizumab治療一名28歲無任何過去病史及家族史的乾癬病人後，卻產生克隆氏症，其發生速度快，依仿單使用在第二劑施打完二天，就發生血便腹痛症狀，經大腸鏡檢查並切片證實，病人也在馬上停藥治療後，一周後緩解，七個月皆無復發，此一罕見使用Ixekizumab後快速發生克隆氏症病例報告，顯示臨床醫師早期發現，早期治療期，可獲得良好預後。&lt;/p&gt;&lt;p&gt;Psoriasis is a chronic inflammatory dermatosis. Ixekizumab is a monoclonal antibody that targets interleukin 17A (IL-17A) and indicated for plaque psoriasis. In 2024, a study analyzed the long-term safety of ixekizumab in patients with psoria-sis(6892 cases) and identified 31 cases of inflammatory bowel disease (IBD; 0.5%, incidence rate 0.2 per 100 PY), of which 18 were cases of ulcerative colitis (0.3%, incidence rate 0.1 per 100 PY) and 13 of Crohn’s disease (CD; 0.2%, incidence rate 0.7 per 100 PY). However, subgroup analysis of Japanese patients in a phase III study on ixekizumab uncovered no cases of IBD. The literature suggest that CD fol-lowing ixekizumab therapy is uncommon, especially in Asian patients. Herein, we report the case of a Taiwanese patient who developed rapid-onset de novo CD fol-lowing ixekizumab therapy for chronic plaque psoriasis. Ixekizumab therapy was administered as per the instruction sheet, and his symptoms appeared 2 days follow-ing the 2nd dose of ixekizumab. Due to the rarity, we report this case to highlight the importance of adverse event. Early detection and diagnosis result in a good outcome. Physicians should be alert to its possibility. Careful history taking of gastrointestinal symptoms is recommended before and after anti-IL-17 therapy.&lt;/p&gt;

Background In psoriasis patients treated with biologics, some achieve an ideal response to biologics and remain clear of lesions for several months, even years (super-responders-SRs), whereas others repeatedly fail to respond (super-non-responders-SNRs) to the biologic. Objective To investigate the clinical characteristics of SRs and SNRs in psoriasis patients treated with biologic interleukin-17 inhibitors. Methods Chronic plaque psoriasis or psoriasis vulgaris patients who received IL-17i treatment for more than 6 months were included. Results In total, 664 patients were included, with 120 (18.63%) categorised as SRs and 82 (12.73%) as SNRs. Compared to SNRs, SRs were mostly female, had lower body weight and BMI, and were less likely to have received previous systemic treatment. Lower weight and BMI and the absence of previous treatment may serve as predictors of SRs. Compared to controls, the SNRs had higher body weight and BMI, longer disease duration, were more likely to have received previous systemic treatment, and had a greater number of comorbidities. Higher BMI, longer disease duration, the presence of previous treatment, and abnormal C-reactive protein (CRP) value serve as predictors of SNRs. Limitations Single-centre study has a relatively small size. Conclusion Lower BMI and the absence of previous treatment may serve as predictors of SRs. In contrast, higher BMI, longer disease duration, the presence of previous treatment, and abnormal CRP value may serve as predictors of SNRs.