Psoriasis Research Articles

Identification of neutrophil extracellular traps genes as potential biomarkers in psoriasis based on bioinformatics analysis

The epidermal infiltration of neutrophils is a hallmark of psoriasis (PSO) and its activation leads to the release of neutrophil extracellular traps (NETs). However, the molecular mechanism of NETs-related genes (NETRGs) has not been extensively studied in PSO. To define NETs-related-biomarkers for PSO. The GSE13355 and GSE78097 datasets, and NETRGs gene set were included in this study. The datasets used in this study were all microarray data. The weighted gene co-expression network analysis (WGCNA) and machine learning algorithms were used to mine key genes. Later on, single-gene gene set enrichment analysis (GSEA) and immune infiltration analysis were implemented. Finally, the expression of key genes was verified using quantitative real-time fluorescence PCR (qRT-PCR). A total of 3 key genes (S100A9, CLEC7A, and CXCR4) were derived, and they all had excellent diagnostic performance. The single-gene GSEA enrichment results indicated that the key genes were mainly enriched in the chemokine signaling pathway and humoral immune response in the high-expression group, while focal adhesion was enriched in the low-expression group. The correlation analysis indicated that all key genes were strongly negatively correlated with resting mast cells and TGF-β family member receptor, while they were strongly positively correlated with activated CD4 memory T cells and antigen processing and presentation. Lastly, the experimental results showed that the expression trends of key genes were consistent with public database. In this study, we successfully screened three potential PSO diagnostic genes (S100A9, CLEC7A and CXCR4) that were closely related to NETs, and these findings not only provided new molecular marker candidates for the precise diagnosis of PSO patients, but also revealed possible future therapeutic targets. However, further in-depth research and validation were necessary.

Unraveling Mitochondrial Reactive Oxygen Species Involvement in Psoriasis: The Promise of Antioxidant Therapies.

Psoriasis is a chronic inflammatory skin disorder characterized by immune dysregulation and aberrant keratinocyte proliferation. Despite tremendous advances in understanding its etiology, effective therapies that target its fundamental mechanisms remain necessary. Recent research highlights the role of reactive oxygen species dysregulation and mitochondrial dysfunction in psoriasis pathogenesis. Mitochondrial reactive oxygen species mediate cellular signaling pathways involved in psoriasis, such as proliferation, apoptosis, and inflammation, leading to oxidative stress, exacerbating inflammation and tissue damage if dysregulated. This review explores oxidative stress biomarkers and parameters in psoriasis, including myeloperoxidase, paraoxonase, sirtuins, superoxide dismutase, catalase, malondialdehyde, oxidative stress index, total oxidant status, and total antioxidant status. These markers provide insights into disease mechanisms and potential diagnostic and therapeutic targets. Modulating mitochondrial reactive oxygen species levels and enhancing antioxidant defenses can alleviate inflammation and oxidative damage, improving patient outcomes. Natural antioxidants like quercetin, curcumin, gingerol, resveratrol, and other antioxidants show promise as complementary treatments targeting oxidative stress and mitochondrial dysfunction. This review aims to guide the development of personalized therapeutic methods and diagnostic techniques, emphasizing the importance of comprehensive clinical studies to validate the efficacy and safety of these interventions, paving the way for more effective and holistic psoriasis care.

Asia-Pacific consensus recommendations on the management of generalized pustular psoriasis.

Generalized pustular psoriasis (GPP) is a rare, chronic, heterogeneous, and potentially life-threatening disease characterized by primary, sterile, and macroscopically visible pustules with or without systemic symptoms. There are ethnic differences in the genetic mutations associated with GPP that might affect the clinical manifestations and treatment responses. Currently, there is limited evidence from the patient population in the Asia-Pacific (APAC) region, resulting in a general paucity of information on the effective management of patients with GPP in this region. This modified Delphi panel study aimed to identify current evidence and gain advanced insights to facilitate the development of a regionally tailored APAC consensus on the management of GPP. A systematic literature review (SLR) was conducted to identify published literature and develop consensus statements on (i) definition and clinical course, (ii) diagnosis of GPP, (iii) treatment outcomes, goals, and monitoring measures, and (iv) optimal management strategies and clinical practices. Statements were rated by a panel of dermatologists in two rounds, with the threshold for consensus at ≥80% agreement. Twenty experts from the APAC region reached consensus on 106 statements that were developed based on the SLR and experts' collective expertise. The experts agreed that GPP is a rare, severe, and potentially life-threatening condition that is distinct from plaque psoriasis. This consensus emphasized the importance of a tailored treatment strategy taking into account the GPP flare severity and each patient's unique clinical circumstances. The experts reached consensus on the severity classification of GPP flares and recommended first-line and maintenance treatment options for adult GPP, childhood GPP, and GPP in pregnancy. These consensus outcomes have been synthesized into treatment algorithms to guide dermatologists in the APAC region in their clinical decision-making processes.

Development and evaluation of an online training tool to aid in the diagnosis of chronic plaque psoriasis

AbstractBackgroundChronic plaque psoriasis (CPP) is underdiagnosed, undertreated and mistaken for other skin conditions such as eczema, tinea corporis and pityriasis rosea.ObjectivesTo develop and evaluate an online training tool to improve the diagnostic skills of nondermatologists for CPP.MethodsThe study involved: (i) developing an online training tool to improve CPP diagnosis by nondermatologists; and (ii) evaluating the performance of the newly developed training tool by conducting a before‐and‐after exploratory investigation. Participants included three groups of primary care health professionals: general practitioners (GPs); nurses; and pharmacists. The tool contained written recommendations for the diagnosis of CPP in different skin colours and a medical artist's illustrations of psoriasis to overcome the lack of representative images of the disease in skin of colour and to illustrate the salient features more clearly than clinical photographs.ResultsIn total, 60 participants completed the study (20 per participant group). The training tool improved participants' diagnostic skills for CPP. The diagnostic ability of GPs was, on average, higher than nurses and pharmacists before and after training. Participants found the training valuable and relevant to CPP diagnosis in primary care settings.ConclusionsOur findings show that a training tool, using medical illustrations, for nondermatologists can be beneficial in terms of recognition of CPP. This may lead to more timely diagnosis and treatment of psoriasis and support relevant and faster referral to specialist dermatology clinics.

The Risk of Candidiasis During Treatment with Bimekizumab for the Management of Plaque Psoriasis: A 16-Week Multicenter Real-World Experience - IL PSO (Italian Landscape Psoriasis).

Anti-interleukin (IL)17 use has been associated with a higher risk of candidiasis, as this cytokine is involved in maintaining mucosal barriers and orchestrating immune responses to fungal pathogens. We performed a real-life retrospective multicenter study aiming of assessing the risk of candidiasis in patients undergoing treatment with bimekizumab at labelled dosage for psoriasis, for at least 16 weeks.

Not just another psoriasis.

We present a memorable case of severe verrucous psoriasis in an immunocompetent 36-year-old Caucasian lady with a background history of limited plaque psoriasis.

Secondary Preventive Management of Kitibha Kushta (Plaque Psoriasis) - A case study

Levels of prevention has been a wide idea concept which includes all the aspects related to health and disease like preventive, curative, promotive and rehabilitative measures. Applicability of this concept in Ayurveda has elaborative understanding in a more simplified manner. Despite leading to both physical and psychological issues, the importance given to skin diseases is always the least. Changing food habits and lifestyle is being the major reason in the current era for increased prevalence of skin diseases especially in young adults. In a way to cope up with fast living culture, people are compromising with their health and well being which needs immediate attention and action. Early diagnosis and complete treatment is the basis of Kushta Chikitsa (treatment of skin diseases) and the same has been highlighted as a secondary preventive measure. One such case is being discussed here which is diagnosed initially and treated as per Ayurveda chikitasa siddhtanta (Ayurvedic treatment principle), considering Dosha (bio-forces of body), Agni(metabolism), Bala (Strength), Ritu (season) etc giving complete relief and self confidence of the patient. This not only prevents the further occurrence of complications due to chronicity but also brings back the faith in Ayurveda treatment modalities. It is high time to make the young minds realize the importance of healthy living, which otherwise can impair the health status of the nation, dragging back its growth and development.

The Contribution of the Skin Microbiome to Psoriasis Pathogenesis and Its Implications for Therapeutic Strategies.

Psoriasis is a common chronic inflammatory skin disease, associated with significant morbidity and a considerable negative impact on the patients' quality of life. The complex pathogenesis of psoriasis is still incompletely understood. Genetic predisposition, environmental factors like smoking, alcohol consumption, psychological stress, consumption of certain drugs, and mechanical trauma, as well as specific immune dysfunctions, contribute to the onset of the disease. Mounting evidence indicate that skin dysbiosis plays a significant role in the development and exacerbation of psoriasis through loss of immune tolerance to commensal skin flora, an altered balance between Tregs and effector cells, and an excessive Th1 and Th17 polarization. While the implications of skin dysbiosis in psoriasis pathogenesis are only starting to be revealed, the progress in the characterization of the skin microbiome changes in psoriasis patients has opened a whole new avenue of research focusing on the modulation of the skin microbiome as an adjuvant treatment for psoriasis and as part of a long-term plan to prevent disease flares. The skin microbiome may also represent a valuable predictive marker of treatment response and may aid in the selection of the optimal personalized treatment. We present the current knowledge on the skin microbiome changes in psoriasis and the results of the studies that investigated the efficacy of the different skin microbiome modulation strategies in the management of psoriasis, and discuss the complex interaction between the host and skin commensal flora.

Successful treatment of acrodermatitis continua of Hallopeau coexisting with flexural psoriasis with Upadacitinib: a case report.

Successful treatment of acrodermatitis continua of Hallopeau coexisting with flexural psoriasis with Upadacitinib: a case report.

The effectiveness of Psoriaten products in treatment of patients with chronic plaque psoriasis

Objective — to determine the efficacy and tolerability of Psoriaten ointment and Psoriaten dermatocosmetic products in patients with chronic plaque psoriasis. Materials and methods. The study included 67 patients with chronic plaque psoriasis and 32 healthy individuals of a similar age (control group). All patients were examined according to existing standards. The severity of psoriasis was assessed by PASI and BSA indices. The level of anxiety was determined according to the Spielberger scale, the level of neuroticism — according to the L.I. Wasserman scale, the level of depression — according to the Beck scale, the quality of life — according to the Dermatological Life Quality Index (DLQI) and the CQLS integrative index. After the previous standard therapy, patients with chronic plaque psoriasis were divided into two groups. The experimental group included 32 patients who received topical Psoriaten ointment for therapeutic purposes and Psoriaten delicate cleansing gel as a dermatocosmetic skin care product. In case of psoriasis localisation on the scalp, they were additionally prescribed Psoriaten shampoo for 3 months. The control group included 35 patients with psoriasis who did not receive Psoriaten ointment or dermatocosmetic products of the Psoriaten line. Results and discussion. The use of Psoriaten ointment, Psoriaten delicate cleansing gel and Psoriaten shampoo for 3 months ensured a significant decrease in both — BSA index and PASI index in patients with psoriasis, normalization of skin microbiocenosis disorders. Statistically significantly lower situational anxiety, neuroticism and depression and higher life quality were noted in the experimental group, in comparison with the data obtained at enrollment in the study. The obtained data indicate the high effectiveness of combined use of Psoriaten ointment, Psoriaten delicate cleansing gel and Psoriaten shampoo in patients with chronic plaque psoriasis. Conclusions. Psoriasis is accompanied by cutaneous microbiocenosis changes, high personal and situational anxiety, increased neuroticism, tendency to depression and decreased life quality. The use of Psoriaten ointment and products of the Psoriaten dermatocosmetic line in patients with chronic plaque psoriasis is reasonable and appropriate, as it promotes the regression of psoriatic rashes and improves skin microbiocenosis. The results obtained give grounds to recommend the widespread use of Psoriaten ointment and dermatocosmetic products of the Psoriaten line for the treatment of patients with chronic plaque psoriasis, regardless of the standard therapy performed earlier.

Metabolic Syndrome in Psoriasis and Psoriatic Arthritis in a Mixed Race Population: Comparison of Their Prevalences.

There is a growing body of evidence suggesting the association between psoriasis (PsO) and psoriatic arthritis (PsA) separately with metabolic syndrome (MS) in different populations. The literature is relatively scarce in terms of comparing the prevalence of MS in PsO and PsA with controls without systemic inflammatory diseases. We aimed to assess the prevalence of MS among patients with PsO, PsA, and a control group without systemic inflammatory disease, in addition to investigating the risks of MS occurrence and its different components in each group. This is a cross-sectional case-control study with three groups of patients: PsO, PsA, and control. The diagnosis of MS was defined according to the modified 2009 NCTEP ATP III criteria. Patients underwent thorough physical examination and fasting blood samples. A total of 195 patients were included in this analysis (PsO = 50; PsA = 64, and controls = 81). The prevalence of MS in the control, PsO, and PsA groups was 37%, 56%, and 57.8%, respectively (p < 0.001). Waist circumference (p = 0.013) and arterial hypertension (p < 0.001) were the most significant components of MS in patients with PsO and PsA. Multivariate analysis confirmed an independent risk of MS in women, elderly patients, obese patients, patients with hyperglycemia, and patients with psoriasis, especially PsA (OR = 6.2 [CI 95% 2.4-16.2], p < 0.001). MS is more prevalent in patients with PsA, which can be determined by the increase in inflammatory pathways.

Comparative Analysis of the Cutaneous Microbiome in Psoriasis Patients and Healthy Individuals—Insights into Microbial Dysbiosis: Final Results

Psoriasis is one of the most frequent chronic inflammatory skin diseases and exerts a significant psychological impact, causing stigmatization, low self-esteem and depression. The pathogenesis of psoriasis is remarkably complex, involving genetic, immune and environmental factors, some of which are still incompletely explored. The cutaneous microbiome has become more and more important in the pathogenesis of inflammatory skin diseases such as acne, rosacea, atopic dermatitis and psoriasis. Dysbiosis of the skin microbiome could be linked to acute flare ups in psoriatic disease, as recent studies suggest. Given this hypothesis, we conducted a study in which we evaluated the cutaneous microbiome of psoriasis patients and healthy individuals. In our study, we collected multiple samples using swab sampling, adhesive tape and punch biopsies. Our results are similar to other studies in which the qualitative and quantitative changes found in the cutaneous microbiome of psoriasis patients are different than healthy individuals. Larger, standardized studies are needed in order to elucidate the microbiome changes in psoriasis patients, clarify their role in the pathogenesis of psoriasis, decipher the interactions between the commensal microorganisms of the same and different niches and between microbiomes and the host and identify new therapeutic strategies.

Arterial function is preserved in successfully treated patients with psoriasis vulgaris.

Endothelial dysfunction is an early precursor of atherosclerosis and is common in patients with psoriasis, presumably primarily due to psoriasis-related inflammation. We investigated endothelial function, arterial stiffness, and circulating markers of endothelial activation in young patients with psoriasis vulgaris of varying severity, all of whom were effectively treated achieving PASI 90. We conducted a cross-sectional study of 80 patients (54 men/26 women, 30-45 years) who were effectively treated with topical therapy, methotrexate, adalimumab, secukinumab or guselkumab, and 20 healthy controls. Endothelial dysfunction was measured by flow-mediated dilation and arterial stiffness was measured by pulse wave velocity and common carotid artery stiffness. The following circulating biomarkers of endothelial activation were measured: ICAM-1, VCAM-1, E- and P-selectin, GDF-15, and TRAIL. Endothelial function and arterial stiffness parameters did not differ between patients with effectively treated psoriasis and the control group. Circulating endothelial activation biomarkers did not show relevant differences between the groups of effectively treated patients or controls. Although cardiovascular disease is the leading cause of morbidity and mortality in patients with psoriasis, effective antipsoriatic treatment appears to slow the progression of atherosclerosis, even when there are cardiovascular risk factors, such as smoking or obesity. This may suggest that antipsoriatic treatment exerts a cardioprotective effect. Our results suggest that early and effective treatment of varying-severity psoriasis vulgaris in young patients appears to prevent arterial dysfunction related to psoriasis and consequent cardiovascular risk.The study is registered at http://clinicaltrials.gov (identifier: NCT05957120).

A Descriptive, PostHoc Analysis of Efficacy and Safety of Risankizumab in Diverse Racial and Ethnic Patient Populations With Moderate-to-Severe Psoriasis.

Historically, patients with skin of color are underdiagnosed with psoriasis and underrepresented in clinical trials. In this study, we assess the efficacy and safety of risankizumab in patients with moderate-to-severe plaque psoriasis by race and ethnicity in the open label extension LIMMitless (NCT03047395). Patients received continuous treatment with 150mg risankizumab through their initial trial and the open label extension. Patients self-identified their race and ethnicity. Efficacy was assessed using Psoriasis Area Severity Index (PASI) and Dermatology Life Quality Index (DLQI). Safety is reported by events/100 patient-years. A total of 897 patients (race: 662 White, 196 Asian, 25 Black or African American, 14 Other; ethnicity: 98 Hispanic or Latino, 799 non-Hispanic or Latino) were included in this analysis. Compared to baseline, patients had a mean percent reduction in PASI between 94.6% (Asian) and 99.3% (Black or African American) and reported mean percent improvements in DLQI ranging from 87.1% (Asian and Black or African American) to 93.7% (Hispanic or Latino) at week 100. While the data presented here comprise a small retrospective descriptive analysis and cannot detect statistical differences, efficacy of risankizumab for the treatment of moderate-to-severe plaque psoriasis appears similar across the racial and ethnic groups studied and no new safety signals were detected.

Real-World Data on Brodalumab Treatment in Patients with Moderate-to-Severe Plaque Psoriasis: An Observational Study from the Czech Republic BIOREP Registry.

The aim of this observational, multicenter study was to assess the real-world use of brodalumab for the treatment of moderate-to-severe plaque psoriasis in patients in the Czech Republic, using data from the BIOREP registry. The study included 273 patients aged≥18years with moderate-to-severe psoriasis who received brodalumab. Endpoints were drug survival (time from treatment initiation to discontinuation), effectiveness [Psoriasis Area and Severity Index (PASI)], and health-related quality-of-life [Dermatology Life Quality Index (DLQI)]. Predicted drug survival probability was 92.4% [95% confidence interval (CI): 89.1, 95.7%] at 6months and 84.2% (95% CI 79.5, 89.1%) at 12months; this was maintained at 24months [80.4% (95% CI 74.5, 86.8%)]. Younger age, higher body mass index, and no previous biologic treatment were significantly associated with longer drug survival. Absolute PASI≤3 after 3months was achieved by 89.8% of patients; 92.4%, 77.8%, and 59.1% reached PASI 75, PASI 90, and PASI 100, respectively. After 12months, 96.5% of 141 patients had an absolute PASI≤3. The proportion of patients achieving DLQI 0/1 was 87.3% at 12months. This study demonstrated high and sustained drug survival with high rates of skin clearance and improved quality of life in patients with relatively severe disease treated with brodalumab. Improvements were observed as early as 3months post-treatment initiation and were sustained for up to 24months in a real-life setting.

Serum selenium, selenoprotein P and glutathione peroxidase 3 in rheumatoid, psoriatic, juvenile idiopathic arthritis, and osteoarthritis

IntroductionSelenoprotein P (SELENOP) controls selenium transport, and glutathione peroxidase 3 (GPx3) elicits antioxidant activity in blood. Inflammation associates with Se deficiency, but knowledge concerning selenoproteins in inflammatory rheumatic musculoskeletal diseases (iRMD) is limited. We compared three Se biomarkers in patients with rheumatoid (RA), psoriatic (PsA), and juvenile idiopathic arthritis (JIA) in comparison to osteoarthritis (OA) and healthy subjects, to improve the data base on selenoprotein expression in iRMD. MethodsThe cross-sectional study enrolled n=272 patients with RA (n=131), PsA (n=67), JIA (n=22) and OA (n=52). Serum Se was quantified by total reflection X-ray fluorescence, SELENOP by ELISA and GPx3 by an enzymatic test. Data from the EPIC trial served as reference. Impairment of daily life was assessed by the Functional Ability Questionnaire (FfbH). ResultsSerum SELENOP and Se concentrations correlated linearly in all groups and were below the average measured in EPIC. Se concentration was not different between the patient groups. Compared to controls, SELENOP levels were low in iRMD patients. GPx3 activity was particularly low in JIA and PsA. Seropositive but not seronegative RA patients displayed a disrupted interaction between GPx3 and Se or SELENOP. SELENOP associated with the functional status measured by the FfbH, most pronounced in OA (R=0.76, p<0.01). DiscussionThe data indicate selenoprotein deficiency in the majority of patients with iRMD, and a positive relation of SELENOP with functional status in OA. Since increased Se supply improves selenoprotein biosynthesis, a personalized correction of diagnosed deficiency merits consideration to improve Se transport and ameliorate disease burden.

Genome-wide DNA methylation regulated by AHCY through SAM / SAH axis promotes psoriasis pathogenesis

BackgroundPsoriasis is a chronic inflammatory skin disease that affects a significant proportion of the global population. The involvement of S-adenosine homocysteine hydrolase (AHCY) in psoriasis and its impact on DNA methylation have not been extensively studied. ObjectiveThis study aimed to investigate the role of AHCY and its impact on DNA methylation in psoriasis pathogenesis. MethodsIn the present study, we investigated the expression of AHCY in psoriatic lesions and assessed its association with the severity of the disease. Moreover, knockdown experiments were conducted to elucidate the impact of AHCY on psoriatic symptoms, keratinocyte proliferation, and aberrant differentiation. Furthermore, alterations in DNA methylation patterns resulting from AHCY knockdown were analyzed. ResultsOur findings revealed that AHCY was upregulated in psoriatic lesions and exhibited a positive correlation with disease severity. Knockdown of AHCY alleviated psoriatic symptoms, inhibited keratinocyte proliferation, and prevented abnormal differentiation. Moreover, AHCY knockdown led to reduced levels of DNA methylation and alterations in methylation patterns. Notably, differential methylation was observed at specific gene loci associated with psoriasis-related inflammation. ConclusionThis study highlights the potential role of AHCY in psoriasis development through its influence on DNA methylation. The findings underscore the complex interaction among AHCY, epigenetic modifications, and inflammation in the pathogenesis of psoriasis. Consequently, AHCY may serve as a promising therapeutic target for psoriasis treatment.

Current vaccination and immunization strategies in dermatology

Vaccinations are an important pillar of public health. They have high benefits for individuals and society as awhole by specifically preventing or mitigating infectious diseases. In many cases, they offer benefits that go beyond protection against the disease in question, e.g., protective cardiovascular effects. Vaccination recommendations in Germany are drawn up by the Standing Committee on Vaccination (STIKO), while the European Medicines Agency (EMA) is responsible for the approval of vaccines in the EU. Vaccinations may be carried out by physicians regardless of their specialty. In dermatology, vaccinations against varicella (chickenpox), herpes zoster, and human papillomavirus are established. The development of vaccines against other dermatologically relevant diseases and cancer vaccines is the subject of intensive research. Particularly in the case of immunosuppression, the physician must also take into consideration which vaccinations are possible and useful or contraindicated. TypeI or typeIV allergies to components of vaccinations are very rare, but reactions at the injection site often occur as adermatological side effect. Urticarial reactions are also possible, as does the worsening of underlying dermatological conditions such as psoriasis vulgaris.

JAK 1-3 inhibitors and TYK-2 inhibitors in dermatology: Practical pearls for the primary care physician

ABSTRACT Guidelines for primary care clinicians on monitoring and safety guidelines regarding Janus kinase and tyrosine kinase 2 inhibitors in the treatment of inflammatory skin conditions are often unclear. This review aims to provide the primary care physician with a review of clinically relevant and updated information regarding the monitoring and overall profile of these medications. To do so, a systematic review was conducted using the PubMed database and relevant Food and Drug Administration (FDA) approved drug inserts from manufacturers. Janus kinase and tyrosine kinase 2 inhibitors have recently gained FDA approval for the treatment of several inflammatory skin conditions including atopic dermatitis, plaque psoriasis, alopecia areata, and vitiligo. There is a known box warning associated with the Janus kinase inhibitors that create the need for monitoring and close follow-up while patients are undergoing these treatments. Although these medications are often prescribed by specialists, as their use becomes more prevalent and therapies continue to gain approval for the treatment of these commonly encountered conditions, it is important for the primary physician to be updated and aware of the current monitoring guidelines and safety profile for this class of medication. Both Janus kinase inhibitors and tyrosine kinase 2 inhibitors display significant efficacy in the treatment of their approved conditions and research continues to move forward with the approval of more medications from these classes.

[Artículo traducido] Eficacia y seguridad del risankizumab en pacientes con psoriasis en el mundo real: un estudio retrospectivo, multicéntrico y no intervencionista

Background and objectiveRisankizumab – a humanized monoclonal antibody that targets the p19 subunit of IL-23 – has been recently approved to treat moderate-to-severe plaque psoriasis. Real-world data based on a representative pool of patients are currently lacking. ObjectiveTo assess the mid- and long-term safety and efficacy profile of risankizumab in patients with moderate-to-severe psoriasis in the routine clinical practice. MethodsThis was a retrospective and multicenter study of consecutive psoriatic patients on risankizumab from April 2020 through November 2022. The primary endpoint was the number of patients who achieved a 100% improvement in their Psoriasis Area and Severity Index (PASI) (PASI100) on week 52. ResultsA total of 510 patients, 198 (38.8%) women and 312 (61.2%) men were included in the study. The mean age was 51.7±14.4 years. A total of 227 (44.5%) study participants were obese (body mass index [BMI] >30kg/m2). The mean baseline PASI score was 11.4±7.2, and the rate of patients who achieved PASI100 on week 52, 67.0%. Throughout the study follow-up, 21%, 50.0%, 59.0%, and 66% of the patients achieved PASI100 on weeks 4, 16, 24, and 40, respectively. The number of patients who achieved a PASI ≤2 was greater in the group with a BMI ≤30kg/m2 on weeks 4 (P=.04), 16 (P=.001), and 52 (P=.002). A statistically significantly greater number of patients achieved PASI100 in the treatment-naïve group on weeks 16 and 52 (P=.001 each, respectively). On week 16 a significantly lower number of participants achieved PASI100 in the group with psoriatic arthropathy (P=.04). Among the overall study sample, 22 (4.3%) patients reported some type of adverse event and 20 (3.9%) discontinued treatment. ConclusionsRisankizumab proved to be a safe and effective therapy for patients with moderate-to-severe psoriasis in the routine clinical practice.