Palmoplantar Psoriasis Research Articles

Treatment of palmoplantar psoriasis with oral roflumilast: a case series.

Palmoplantar psoriasis (PP) is a special area of psoriasis, which can justify systemic treatment. Roflumilast is a targeted inhibitor of phosphodiesterase (IPDE)-4 that has been recently approved by FDA as a cream for the treatment of plaque psoriasis. Also, oral roflumilast has demonstrated efficacy in the treatment of plaque psoriasis in a small randomized clinical trial and single case reports. To the best of our knowledge, we present the first case series of PP treated with oral roflumilast.

Ayurvedic Management of Palmo-Plantar Psoriasis(~Ek kushta) : A Case Report

Psoriasis is a chronic variant of Psoriasis that characterstically affects the skin of the palms and soles and produces significant functional disability. It features hyperkeratotic, pustular skin lesions. Palmoplantar Pustulosis is a possibly related to dermatosis characterized by small sterile pustules that may be a type of Palmoplantar Psoriasis. As such they are associated with substantial impairment in quality of life. The exact cause of Palmoplantar Psoriasis is unkown. However, it is caused by a combination of genetic and enviornmental factors. In the present case study, female of age 40yrs visit in Ayurveda OPD had complaint of severe itching, redness and pain in skin lesions, transient white, brown, or red macule, localized at bilateral sole region and palm region since 2yrs. She had associated complaint of loss of appetite, headache, dizziness, disturbed sleep and irregular bowel evacuation since 2yrs. She took allopathic treatment but does’nt get any improvement so she decided to switch on Ayurveda management for better cure and preventive care. On the basis of clinical presentation patient was diagnosed with Vicharchika, type of Kushtha Roga so the line of management is based on Kushtha Chikitsa. After 2months of drug intervention Panchtikt Ghrita 10ml, OD in morning, in combination with Mahakalyanak Ghrita in dose of 5ml HS(at bed time) and Cap.Stresscom 2tab at night, patient get significant relief in symptoms ie. dryness and peeling of skin, pain and bleeding with severe itching. Size of lesions is reduced. This is effective in reducing the progression of disease and improve quality of life of patient.

Long-term drug survival of risankizumab in psoriasis: insights from a real-life multicenter study on hard-to-treat areas.

Psoriasis, a chronic inflammatory condition, often presents challenges in treatment, particularly in areas such as nails, palms/soles, scalp/face, and genitalia. Monoclonal antibodies (mAb) like risankizumab targeting interleukin-23 (IL-23) have emerged as promising treatments, yet data on long-term efficacy remain limited. This multicenter retrospective study aimed to evaluate the drug survival at 12 and 36 months of 191 psoriasis patients treated with risankizumab, focusing on critical areas. Patients, previously unresponsive to first-line therapies, were treated according to Italian Guidelines. Survival analysis revealed a 97.6% one-year and 95% three-year drug survival rate. Secondary ineffectiveness was the primary reason for discontinuation, particularly in palmoplantar involvement cases. Factors such as BMI, gender, age, disease duration, baseline severity, and previous biologic exposure did not significantly impact drug survival, except for palmoplantar psoriasis (HR 4.72). Risankizumab demonstrated prolonged response with low treatment switch requirements, especially notable in challenging areas. Understanding such factors can aid in optimizing therapeutic approaches for improved patient care and long-term outcomes in managing psoriasis. Further research is warranted to refine treatment strategies in difficult-to-treat areas.

JAAD Game Changers: Palmoplantar psoriasis is associated with greater impairment of health-related quality of life compared with moderate to severe plaque psoriasis

JAAD Game Changers: Palmoplantar psoriasis is associated with greater impairment of health-related quality of life compared with moderate to severe plaque psoriasis

Efficacy and safety of various drug combinations in treating plaque Psoriasis: A meta-analysis

Background Psoriasis, a chronic inflammatory disease affecting the skin, joints, and nails (2-3% worldwide), significantly affects quality of life. Genetic and environmental factors also play key roles. Topical corticosteroids, calcineurin inhibitors, and oral corticosteroids help to manage plaque psoriasis symptoms, but combination therapies might offer greater effectiveness and improved safety profiles. These combinations could potentially reduce medication dosages and side effects in patients. Objective To assess the efficacy and safety of various drug combinations over conventional monotherapies in the treatment of moderate to severe plaque psoriasis, which incorporates palmoplantar psoriasis and psoriasis vulgaris, by discovering and utilizing research articles comprising the same or similar variables as PASI 75 and evaluating the information using RevMan v5.4.1. Method We reviewed the efficacy and safety of combination therapy vs. monotherapy/placebo for moderate-to-severe plaque psoriasis (palmoplantar and vulgaris) using PASI 75 via RevMan v5.4.1. Risk of bias assessment and funnel plots were employed to assess the heterogeneity of each paper. Inclusion criteria – Publications < 20yrs, RCTs, plaque/palmoplantar/psoriasis vulgaris; exclusion criteria – Guttate/arthritic psoriasis, pediatric and pregnant individuals, publications > 20 yrs. Results Seventeen studies were analyzed, comprising a total of 2291 patients (n=1147 with combination regimens and n=1144 with control regimen in the analysis). A significant PASI 75- response was observed in the pioglitazone combination subgroup as compared to placebo (OR=4.92,95% CI 2.19-11.05, P = 0.0001); methotrexate combination subgroup as compared to placebo (OR=2.56, 95% CI 1.67-3.94, P< 0.0001) test of subgroup differences showed P= 0.14, I2= 34%. Incidence rate of abnormality in levels of liver enzymes (OR=1.89,9.5% CI 6.69-5.22, P=0.22), nausea (OR=1.28,95% CI 0.77-2.14, P=0.34), headache (OR=1.28,95% CI 0.77-2.14, P=0.58), fatigue (OR=0.89, 95% CI 0.41-1.90, P=0.45).] Conclusion This study showed that combination therapy is very effective for plaque psoriasis, with promising combinations of pioglitazone. While safety seems similar between the groups, larger studies are needed to determine the long-term effects. These findings suggest that personalized treatment plans could improve outcomes; however, confirmation through larger trials is crucial before wider use. This opens doors to research on optimal combinations for individual patients.

A Cross-Sectional Study of Dermoscopy and Clinical and Histopathological Study of Acquired Palmoplantar Keratodermas: A Research Protocol.

Background Acquired palmoplantar keratodermas (PPKs) pose diagnostic and therapeutic challenges due to their varied clinical presentations and overlapping features. This study aims to elucidatediagnostic criteria; assess correlations between clinical, dermoscopic, and histopathological features;and evaluate treatment outcomes for acquired PPKs, particularly palmoplantar psoriasis. Methods A prospective, cross-sectional study will be conducted at the Department of Dermatology, Venereology, and Leprosy, Acharya Vinoba Bhave Rural Hospital (AVBRH), Wardha, Maharashtra. Patients with acquired PPKs will undergo comprehensive clinical, dermoscopic, and histopathological evaluations. Treatment outcomes for palmoplantar psoriasis will be assessed following standard therapy. Statistical analysis will include descriptive statistics, diagnostic accuracy assessments, correlation analyses, and treatment outcome evaluations. Results The study is anticipated to establish reliable diagnostic criteria for acquired PPKs, identify correlations between features, and demonstrate the effectiveness of standard therapies for palmoplantar psoriasis. The findings are expected to inform evidence-based guidelines and protocols for diagnosing and managing acquired PPKs. Conclusion This study aims to advance the understanding and management of acquired PPKs by providing insights into diagnostic accuracy, correlations between features, and treatment outcomes. The study seeks to enhance patient care and outcomes for individuals affected by acquired PPKs by improving diagnostic precision and guiding therapeutic interventions.

Real-Life Effectiveness and Safety of Guselkumab in Patients with Psoriasis Who Have an Inadequate Response to Ustekinumab: A 3-Year Multicenter Study.

Background: Guselkumab is the first approved human IgG1λ monoclonal antibody selectively targeting the p19 subunit of IL23. Its effectiveness and safety were widely reported by clinical trials. However, these results must be confirmed in real life since its safety deals with more complicated subjects with respect to trials. Currently, real-life data on the use of guselkumab following treatment failure with ustekinumab are limited, and existing studies usually show a small cohort and/or a reduced follow-up period. In this context, the aim of our study was to evaluate the use of guselkumab in patients who previously did not respond to ustekinumab after up to 3 years of treatment. Methods: A multicenter retrospective study was performed. The study enrolled patients affected by moderate-to-severe plaque psoriasis undergoing treatment with guselkumab who were attending the Psoriasis Center of nine different centers in the Campania region of Italy. Demographic and clinical features were collected for each patient at baseline. Moreover, data on psoriasis severity and adverse events (AEs) were collected at each follow-up visit (week (W)16-W36-W52-W104-W156). Results: A total of 112 patients (70 male, 62.5%; mean age 54.8 ± 11.7 years old) were enrolled. Of these, 48 (42.9%), 34 (30.4%), and 16 (14.3%) reached 1, 2, and 3 years, respectively, of follow-up under guselkumab. A statistically significant clinical improvement was observed since W16, and sustained effectiveness was reported at each timepoint up to W156. No serious AEs were collected. Moreover, a sub analysis on the body mass index, involvement of difficult-to-treat areas, and presence of psoriatic arthritis (PsA) showed that the presence of PsA or palmoplantar psoriasis was associated with a reduced clinical improvement at W16 and W36, without differences from W52. In contrast, the efficacy of guselkumab does not seem to be affected by the BMI, involvement of fingernails, or location in the genital or scalp area. Conclusions: To sum up, our long-term real-life multicenter retrospective study confirmed the efficacy and safety of guselkumab following ustekinumab discontinuation up to 156 weeks of treatment.

Cryotherapy in chronic plaque psoriasis: an effective therapeutic modality

Background Psoriasis is a common, chronic, inflammatory, and proliferative condition of the skin in which both genetic and environmental factors have a critical role. Various topical and systemic drugs which are given as rotational and sequential therapies are commonly prescribed as treatment. However, these are often not effective in prolonging the remission of chronic plaque psoriasis. Aims and objectives To assess the therapeutic efficacy of cryotherapy in chronic plaque psoriasis. Methodology A prospective study on 50 patients with chronic plaque psoriasis was undertaken. Patients were treated with six consecutive sessions of cryotherapy at weekly intervals and further followed-up for another 6 weeks. Results It was observed that among 128 plaques of psoriasis vulgaris, 63 (49%) plaques showed G5 improvement while 40 (73%) among 55 plaques of palmoplantar psoriasis had G5 improvement. Thus, palmoplantar lesions responded better as compared with cutaneous lesions. Conclusion Cryotherapy using nitrous oxide as cryogen has been proven to be an effective therapeutic modality not only for treatment but also for prolonging the remission in localized plaque psoriasis.

Scoring for palmoplantar psoriasis – need for modification of current methodology

Scoring for palmoplantar psoriasis – need for modification of current methodology

Role of Sheeta Upanaha in the Management of Vipadika – A Case Study

Skin is the mirror which reflects the harmony of Internal functions of body. Psoriasis is a non-infective inflammatory, Proliferative, Chronic skin disease in which there are scaly papules and plaques that can involve any part of body. Palmoplantar psoriasis refers to psoriasis that develops on palms and soles. Vipadika is included in Kshudra kusta having sign and symptoms similar to Palmoplantar psoriasis. In this case study, A 65-year-old male patient a known case of Palmoplantar psoriasis approached with symptoms of Scales and fissures over both palms and soles with Pain, Severe itching and burning sensation for the past 1year. After clinical examination and history of the patient he was advised, Deepana & Pachana, Shamana Snehapana and Seetha Upanaha as module of treatment. Even though treatment principles such as Deepana, Pachana, Shamana Snehapana might have helped in the overall result, but it was Seetha Upanaha Chikitsa observed to be quite significant in this case, as patient started feeling better after starting of Seetha upanaha. After implementation of treatment plan patient has become completely symptom free and there was no recurrence even after six months.

AN AYURVEDIC MANAGEMENT OF PALMO-PLANTAR PSORIASIS BY BAKULA PATRA- A CASE STUDY

Background Skin diseases are a group of diseases that a larger population of the world is suffering from. Care for the skin is emphasised, as it is the largest organ of our body. In Ayurveda, all skin diseases are dealt with under Kushta. Vipadika Kusthta is one of the Kshudrakusta, which occurs due to Tridosha Prakopa. This causes Teevra Ve-dana, Pani Pada Sputana. In the modern system of medicine, Vipadika Kusta can be correlated to Palmo-plantar psoriasis. The national prevalence of Palmoplantar psoriasis is estimated to be 0.12%. The symptoms include elevated and thickened skin surface, scaling, itching, burning sensation, cracks and bleeding. Aim- To evaluate Bakula Patra Kashaya's efficacy in managing Palmoplantar psoriasis. Methodology- In the present case, a fe-male patient aged 74 years complained of itching, burning sensation, cracks, and scaling over bilateral soles and palms for three months. It was initially treated with Bakula Patra Kashaya for fifteen days, and Shodhana was given, which included Snehapana with Panchatiktaka Guggulu Grita for three days, Vishramakala where Sar-vanga Abhyanga with Yastimadhu Taila for three days in the absence of Swedana and on 7th day Virechana with 25gm Trivrut Lehya followed by 60ml Draksha Rasa was given. Results—Vipadika Kusta was assessed using subjective and objective criteria based on Lakshanas, and the score was noted before and after the treatment. The symptoms were significantly improved after the consumption of Bakula Patra Kashaya. Conclusion- Mimosops elengi Linn, belonging to the Sapotaceae family, is indicated in Twak Vikaras. The leaves contain active princi-ples like Quercetin, Hentriacontane, and steroidal saponin, which have wound-healing properties and might have helped heal cracks. Quercetin has anti-histaminic activity, which might have reduced itching.

Polymorphisms of PDCD1 and COL9A1 Genes in Plaque, Palmoplantar and Arthropathic Psoriasis in Romanian Patients

In recent years, genetic studies have brought new insights into psoriasis, a chronic inflammatory disease with multiple determining and favoring factors. Recent advances in the technology of genetic analysis have enabled the discovery of many loci with causal or susceptibility roles and the finding of correlations related to different types of treatment responses. In this study, genomic deoxyribonucleic acid (DNA) was extracted from 2 mL peripheral blood for the evaluation of rs10204525 for Programmed Cell Death 1 (PDCD1) gene and rs550675 for Collagen Type IX Alpha 1 Chain (COL9A1) gene in 45 psoriasis patients and 43 healthy subjects without a personal pathological history of dermatological diseases. All patients were diagnosed by clinical and histopathological examination, and the severity of disease and its impact on quality of life were evaluated by Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI) scores. Comparisons were made between controls and patients, but also between different clinical types of psoriasis according to disease severity. The rank of C/T alleles for rs550675 (COL9A1 gene) was higher in the patients versus the control group (p = 0.026), while the G/A alleles for rs10204525 (PDCD1 gene) had no differences between the two groups (p = 0.450). Case and control comparisons also showed statistical significance between homozygous CC/TT genotypes (p = 0.039). After subdividing the three types of psoriasis (plaque psoriasis, arthropathic psoriasis and palmoplantar psoriasis) according to disease severity, there were differences between CC/CT genotype (p = 0.0246) and CC/TT (p = 0.007) genotype in patients with plaque psoriasis in favor of severe disease. At the same time, the GA/GG versus AA pattern was significantly higher in patients with plaque psoriasis.

Management of Vaipadika (Palmo Plantar Psoriasis) through Shodhana and Shamana- A Case Study

A localized form of Psoriasis known as Palmo plantar psoriasis is characterized by the development of thick, scaly and hyperkeratotic plaques. Despite the fact that this disease mostly affects the palms and soles, the hardness of the skin makes it difficult to do daily tasks. This condition is related to Vaipadika in Ayurveda. In the framework of Kshudra kusta, Vaipidika is explained. This illness is mostly caused by the Vatakapha dosha, which is identified by Pani pada sphuthana and Teerva vedhana. Here is a case of a 55 years old female with history of dryness ,scaling and cracks over her bilateral palms and soles associated with pain , blackish discoloration and severe itching and burning sensation, associated with bloody discharge since 1 year .Patient was treated with Snehana and Swedana and later Shamana oushadi were given for 7 days along with life style modification. Patient had good relief in symptoms.

Efficacy of anti-interleukin-17A biological agents for palmoplantar psoriasis and palmoplantar pustulosis: A network meta-analysis

BackgroundThe comparative efficacy of anti-IL (interleukin)-17A biological agents in palmoplantar psoriasis (PP) and palmoplantar pustulosis (PPP) are not well established. ObjectiveTo investigate the efficacy of different dosage regimens of anti-IL-17A biological agents compared with placebo in PP and PPP. MethodsA literature search was conducted in PubMed, clinicaltrials.gov, and Embase. Meta-analysis was performed for all outcomes of randomized controlled trials, while network meta-analysis was only performed for the primary outcome. ResultsIn total, 21 articles exploring the efficacy of 5 treatment options were included, 4 cohort studies were also reviewed. Meta-analysis demonstrated a statistically significant difference favoring anti-IL-17A biological agents versus placebo (OR = 6.84, 95 %[CI] [5.34, 8.76]). On-label secukinumab was identified as the most effective treatment option for patients with PP (OR = 33.50, 95 %[CI] [4.37,256.86]). PPP treated with secukinumab 300 mg showed benefit in terms of PPPASI 75 responses over 52 weeks. ConclusionIL-17A biological agents had better PP disease clearance compared with placebo and on-label secukinumab was identified as the most effective treatment option for PP patients. Secukinumab 300 mg showed benefit for PPP patients.

Study on clinical, histopathological and dermoscopic features of palmoplantar pustulosis and palmoplantar psoriasis with pustules

Background: Palmo-plantar pustulosis (PPP) and palmoplantar psoriasis with pustules (PPso)/Palmoplantar pustular psoriasis are entities that present with chronic cyclical eruptions of vesicles and pustules of palms and soles, which were initially considered to be similar but was defined as separate entities by the international psoriasis council in 2007. Individuals with PPP are at increased risk of psoriasis vulgaris, psoriatic arthritis, autoimmune thyroid disease and 90% of pustulosis patients can have psoriasis-like rash at some stage of the disease. Aim was to assess the clinical, histopathological and dermoscopic features of PPP and palmoplantar psoriasis with pustules. Methods: A cross sectional analysis of all patients who presented to us over 1 year with vesicles and/or pustules of hands and/or feet and were diagnosed with PPP and palmoplantar psoriasis with pustules/palmoplantar pustular psoriasis, both clinically and histologically, were done. The severity was analysed using palmoplantar pustulosis area severity index (PPPASI) and the clinical, histological and dermoscopic features were noted. Results: Twenty-four patients were categorized into 2 groups of 12 each, with a male predominance in both the groups. Majority (66.6%) of PPP belonged to the age group of 20-40 years whereas 83% of PPso belonged to >40 years of age. Dermoscopic findings noted in both groups were translucent yellow areas, yellow/red-brown globules, dotted regularly arranged vessels, yellow crust and globules following dermatoglyphics. Conclusions: The study, though with limited sample size, highlights few clinical, histopathological and dermoscopic features which helps in differentiating the two groups.

AYURVEDIC MANAGEMENT OF VAIPADIKA – A CASE STUDY

In the realm of Ayurveda, various dermatological conditions are encompassed under the broad term "Kushta." One specific subtype is Vaipadika Kushta, categorised as a form of Kshudra Kushta, distinguished by the fissuring of both palms (Pani) and soles (Pada), accompanied by intense pain (Teevra Vedana). This manifestation bears a resemblance to palmoplantar psoriasis in conventional medical terms. In a particular case, a patient had been grappling with the distressing symptoms of dryness and cracking on both feet for two years. These symptoms were further compounded by slight bleeding and intense itching. The therapeutic approach involved a combination of Raktamokshana (bloodletting), Aragwadha Takradhara (medicated buttermilk pouring), and Shamanoushadha (palliative medication). Remarkably, within a span of three months, this integrated treatment regimen yielded significant and positive results for the patient.

Comparison of the clinical efficacy of topical tretinoin 0.05% cream and tacrolimus 0.1% ointment plus iontophoresis in the management of palmoplantar psoriasis.

Palmoplantar psoriasis (PPP) is a localized variant of psoriasis that may be resistant to topical therapy, owing to the poor penetrability of topical agents at this anatomical site. Modalities that enhance localized cutaneous delivery of drugs could help to solve this problem. Iontophoresis is one such procedure that augments transdermal drug delivery, thus enabling better and expeditious therapeutic outcomes. To compare the therapeutic efficacy and safety of iontophoresis with tretinoin 0.05% cream and tacrolimus 0.1% ointment in treating patients with PPP. Sixty patients with PPP (28 males and 32 females, age range 8-76 years) were enrolled and randomly assigned to one of two groups comprising 30 patients each. One group (12 males and 18 females) received iontophoresis with tretinoin 0.05% cream; the other (16males and 14 females) received iontophoresis treatment with tacrolimus 0.1% ointment. Both groups received treatment weekly from baseline until 4 weeks and then fortnightly at weeks 6 and 8. Clinical images were taken at each visit and improvement of psoriasis was evaluated using the erythema, scaling, induration and fissuring (ESIF) score. The percentage reduction in ESIF score was also assessed on completion of treatment and the grade of improvement noted for each patient. Twenty-seven patients in the iontophoresis with tretinoin 0.05% cream group and 29 in the iontophoresis treatment with tacrolimus 0.1% ointment group completed the study. The mean (SD) ESIF score in the former decreased significantly from 8.7 (2) at baseline to 3.2 (1.7) at the study endpoint (P < 0.001). Similarly, in the latter group, there was a substantial reduction in mean (SD) ESIF score from 8.2 (1.9) at baseline to 3.3 (1.1) at the study end (P < 0.001). No significant adverse effects were encountered in either treatment arm. Iontophoresis using tretinoin and tacrolimus was found to be effective and safe for the treatment of PPP. Although iontophoresis with tretinoin showed slightly better results than with tacrolimus, these were not statistically significant.

Effectiveness of ixekizumab for the treatment of moderate-to-severe plaque psoriasis with involvement of difficult-to-treat areas: A 52-week multicenter retrospective study.

Biological drugs have dramatically changed the approach to treating moderate-to-severe plaque psoriasis, achieving excellent skin clearance and safety outcomes. However, the management of difficult-to-treat areas (e.g., scalp, palms/soles, nails, and genitalia) still represents a challenge in psoriasis treatment. Data in the literature on difficult-to-treat sites are limited and, frequently, no specific analysis is performed during clinical trials. We conducted a 52-week, retrospective study to evaluate the effectiveness of ixekizumab in 120 patients with moderate-to-severe plaque psoriasis of at least one difficult-to-treat area (scalp, palmoplantar surfaces, nails, and genitalia). Ninety-nine patients had scalp psoriasis, 35 had involvement of the palms or soles, 27 were affected by genital psoriasis, and 22 patients reported involvement of the nails. After 1 year of treatment, 96% of patients with scalp involvement, 95.6% of patients with palmoplantar psoriasis, 95.2% of patients with genital psoriasis, and 85% of patients with nail involvement achieved a site-specific Physician's Global Assessment of 0 or 1 (clear or almost clear). No serious adverse events were observed during the study. Our study supports the effectiveness of ixekizumab in plaque psoriasis involving difficult-to-treat sites.

Efficacy of long-term risankizumab treatment for moderate-to-severe plaque psoriasis: Subgroup analyses by baseline characteristics and psoriatic disease manifestations through 256 weeks (LIMMitless trial).

Psoriasis is an inflammatory skin disease that impacts a heterogeneous group of patients and can have multiple clinical manifestations. Risankizumab is approved for the treatment of moderate-to-severe plaque psoriasis. To evaluate the long-term efficacy of risankizumab according to baseline patient characteristics, and for the treatment of high-impact disease manifestations (nail, scalp and palmoplantar psoriasis), through 256 weeks of continuous treatment in the phase 3 LIMMitless study. This subgroup analysis evaluated pooled data from patients with moderate-to-severe plaque psoriasis who were randomized to risankizumab 150 mg during two double-blind, phase 3, 52-week base studies (UltIMMa-1/2; NCT02684370/NCT02684357) and were enrolled in the phase 3 LIMMitless open-label extension study (NCT03047395). Subgroup assessments included the proportion of patients who achieved ≥90%/100% improvement in Psoriasis Area and Severity Index (PASI 90/100). Among patients with nail, scalp and/or palmoplantar psoriasis in addition to skin psoriasis, assessments included changes from baseline in and resolution of these three psoriatic manifestations. Overall, a numerically similar proportion of patients (N = 525) achieved PASI 90/100 through Week 256, regardless of their baseline age, sex, body mass index, weight, PASI or psoriatic arthritis status. Patients with nail, scalp and/or palmoplantar psoriasis experienced substantial improvements in manifestation-specific indices (mean improvement from baseline to Week 256 of >81%, >94% and >97%, respectively); in patients with all three manifestations (N = 121), 44.6% achieved complete clearance of these manifestations at Week 256. Risankizumab demonstrated generally consistent efficacy through 256 weeks across patient subgroups and showed durable long-term efficacy for psoriatic disease manifestations.

Patient Perspectives of the Impact of Psoriatic Disease on Quality-of-Life in India: Sub-analysis from the Global Psoriasis and Beyond Survey.

Psoriatic disease (PsD), including plaque psoriasis (PsO) and psoriatic arthritis (PsA), comprises a wide spectrum of manifestations and significantly impacts quality-of-life (QoL). Here, we assessed patients' understanding of PsO and PsA as a systemic disease, its impact on their physical and emotional well-being, and patients' experiences with healthcare professionals for shared treatment decision-making. The Global Psoriatic Disease and Beyond Survey was a cross-sectional, qualitative, online survey conducted on patients with moderate-to-severe PsO with/without concomitant PsA. This analysis reports findings from Indian patients. Of the 261 surveyed patients, 27% with PsO reported concomitant PsA, of whom 89% reported PsA severity as moderately or highly active. Overall, 92% had heard the term "PsD," and 90% knew their condition was a systemic disease. Few were aware of PsD manifestations (palmoplantar psoriasis, 49%; nail psoriasis, 43%; axial symptoms, 40%; PsA, 34%) and comorbidities (cardiovascular disease, 33%; obesity, 30%; diabetes, 28%). Eighty-nine percent of patients indicated their skin problems had a "very-large" to "extreme-large" impact on QoL. Ninety-seven percent of patients experienced discrimination and stigmatization from others. Eighty-one percent of patients were not involved in deciding treatment goals. Few (PsO, 6%; PsA, 9%) patients were dissatisfied with current treatment; ≥50% patients reported incomplete relief of skin symptoms (PsO) and joint symptoms (PsA) as the reason for dissatisfaction. Lack of awareness of the manifestations and comorbidities associated with PsD and poor QoL highlights the need for patient education, shared treatment decision-making, and a multidimensional approach to PsD management in India.