Family History Of Psoriasis Research Articles

E022 Effect of upadacitinib in a patient with primary Sjogren syndrome: a case report

Abstract Background/Aims Primary Sjogren syndrome (pSS) is a chronic autoimmune multi-system disease characterized by inflammation of exocrine glands, particularly the lacrimal and salivary glands, as well as multiple extra-glandular involvements. Treatment is often challenging, and until now, no disease-modifying anti-rheumatic drugs (DMARDs) have been approved for this condition. There is a lack of data about the efficacy of Janus kinase inhibitors in pSS. Here we report a patient with pSS successfully responding to upadacitinib. Methods A 68-year-old woman presented with pain in multiple joints for 16 years with intermittent use of NSAIDs. She had no low back pain and no self or family history of psoriasis or red eye. She denied dry mouth but required frequent water drinking during meals to aid swallowing and occasionally used artificial tears. MTX was started for her two-month articular flare and positive rheumatoid factor (RF). MTX caused severe vomiting and hyponatremia, and she was hospitalized. After the correction of hyponatremia, she was put on tofacitinib. We reevaluated the case when she came to us. She had grade 2-3 tenderness of most peripheral joints and was bedridden. Immunological parameters revealed RF 127 IU/ml (reference value <14), anti SSA antibody 147 U/ml (normal <3.2), anti SSB antibody 149 U/ml (reference value <8) and anti CCP antibody; ANA, anti-ds-DNA Ab were negative. There was no erosion on the X-ray hands. Schirmer's test was positive (3 mm bilaterally). Unstimulated salivary flow after five minutes was 0.04 ml/min (≤0.1 ml/min indicates salivary hypofunction). She fulfilled the 2016 ACR/EULAR classification criteria, and we diagnosed her with primary Sjogren syndrome. Hydroxychloroquine was initiated, but she discontinued it for anorexia. Considering her age, she was switched to upadacitinib, as European Medicines Agency restricted the use of tofacitinib beyond 65 years. Results Her EULAR Sjogren Syndrome's Disease Activity Index (ESSDAI) was six at baseline, indicating moderate disease activity. Her joint pain improved significantly within two months with infrequent use of pilocarpine in the sixth month. Six months after treatment with upadacitinib, ESSDAI came down to 2; the Patient's Global Assessment score was 02 and achieved STAR (Sjogren's Tool for Assessing Response) response 7 (STAR responder if score ≥5). Conclusion To our knowledge, this is the first case report on the efficacy of upadacitinib in pSS. Further high-quality clinical trials are required to confirm the benefit of upadacitinib in pSS. Disclosure M. Momen Majumder: None. S. Haq: None.

Psoriatic Arthritis: Differential Features at the Time of Clinical Presentation in a Large Cohort of Patients with Polyarthralgia.

Most patients with psoriatic arthritis begin with cutaneous psoriasis, which is why all early detection strategies are based on screening in the dermatological consultation and referral to a rheu matologist. However, there are cases of patients who consult initially for musculoskeletal symptoms, mostly joint pain, regardless of family and/or personal history of psoriasis. This study aimed to esti mate the frequency of psoriatic arthritis in a cohort of patients who consulted for polyarthralgia and to determine the differential features, at the time of clinical presentation, in relation to both patients with final diagnosis other than psoriatic arthritis and patients with diagnosis of rheumatoid arthritis. Consecutive patients with polyarthralgia (including arthralgia of the hands) were included. Clinical examination, laboratory tests, ultrasound with power Doppler of both hands, and radiography of both hands and feet were performed at baseline. All patients were followed up and the definitive diagnosis of psoriatic arthritis was established. A total of 1055 were included, 88 (8.3%) ended with diagnosis of psoriatic arthritis. Diagnosis of psoriatic arthritis was positively associated with a family history of psoriasis (odds ratio=4.14), pso riasis (odds ratio=78.94), radiographic erosions (odds ratio=5.74), and ultrasound with at least 1 joint with positive power Doppler (odds ratio=7.11). In comparison with rheumatoid arthritis patients, diagnosis of psoriatic arthritis was positively associated with psoriasis (odds ratio=433.42) and family history of psoriasis (odds ratio=41.63). On the other hand, it was negatively associated with positivity, for both rheumatoid factor (odds ratio=0.03) and anti-cyclic citrullinated peptide antibodies (odds ratio=0.06). The frequency of psoriatic arthritis was 8.3% and was associated with a personal and/or family history of psoriasis, radiographic erosions, and inflammatory involvement by Power Doppler Ultrasound (PDUS). In comparison with rheumatoid arthritis patients, psoriatic arthritis was associated with a personal and/or family history of psoriasis, while the presence of both rheumatoid factor and/ or anti-cyclic citrullinated peptide antibodies was shown to be a protective factor for the diagnosis of psoriatic arthritis.

Psoriatic Foot Involvement is the Most Significant Contributor to the Inconsistency Between PASI and DLQI: A Retrospective Study from China.

The Psoriasis Area and Severity Index (PASI) and the Dermatology Life Quality Index (DLQI) are important evaluation tools for assessing psoriasis severity and guiding treatment options. However, the scores of PASI and DLQI are often inconsistent. This study aimed to identify the factors affecting the consistency between PASI and DLQI. The retrospective study was based on 4125 patients. We collected the PASI, DLQI, demographic and clinical characteristics data. DLQI has a weak correlation with PASI (r=0.37; P<0.001). For the DLQI >10 groups, DLQI has almost no correlation with PASI (r=0.16; P<0.001). There are 43.60% of mild-to-moderate patients (PASI<10) in the DLQI>10 groups. Our adjusted model showed that foot (OR=2.109; 95% CI:1.581-2.815) involvement led to the greatest impairment of QoL except for PASI≥10 (OR=5.547; 95% CI:3.477-8.845). Furthermore, DLQI impairment was associated with female (OR=1.336; 95% CI:1.071-1.667); the age of 20-39 subgroup (OR=1.795; 95% CI:1.100-2.930); psoriatic arthritis (OR=1.718; 95% CI:1.208-2.443); higher income (OR = 1.408; 95% CI: 1.067-1.858); family history of psoriasis (OR=1.460; 95% CI:1.131-1.885). Moreover, the influence of exposed lesions (such as scalp; face; neck; nails; and hands) were positively associated with severely impaired QoL. Dermatologists should recognize the underestimated disease burden of psoriasis patients and actively identify and treat mild-to-moderate patients with high burden. In particular, the foot was a significant contributor to the burden.

PSORIASIFORM DRUG ERUPTION INDUCED BY ANTI-TUBERCULOSIS MEDICATION: A CASE REPORT

Objective: Psoriasiform drug eruptions can be induced by several drugs. Psoriasis is a chronic inflammatory disease characterized by T-cell-mediated cytokine production that drives the hyperproliferation and abnormal differentiation of keratinocytes. Drugs can cause new lesions when there is no prior history or family history of psoriasis. Based on the psoriatic drug eruption probability score, β‐blockers, synthetic anti‐malarial drugs, non‐steroidal anti‐inflammatory drugs (NSAIDs), lithium, digoxin and tetracycline antibiotics are relevant in psoriasis.&#x0D; Methods: A 58-year-old male was admitted to the Department of Respiratory Medicine at B. P. S G. M. C, Khanpur Kalan, Sonepat as a case of pulmonary tuberculosis and was put on anti-tubercular drugs CAT-I (according to RNTCP guidelines). The patient had a history of diabetes mellitus and hypertension for the past six years. On the third day of initiation of ATT, the patient started developing a psoriasiform rash. The psoriasiform rash began to improve within a few days after discontinuing the ATT. A causality assessment was done as per the WHO-UMC scale, which showed that the adverse events were likely caused due to the ATT.&#x0D; Results: Psoriasiform rash is a severe adverse drug reaction characterized by widespread lesions. Among all the various adverse drug reactions, lichenoid drug eruption is commonly associated with anti-tuberculosis medication and needs to be differentiated from psoriasiform eruption. The underlying pathomechanism of drug-induced psoriasiform eruptions remains uncertain, although several immunological interactions have been hypothesized.&#x0D; Conclusion: ATT has been reported to cause psoriasiform rash, and its drug component needs to be reconsidered in view of safer alternatives available.

Clinicodemographic and laboratory features of 200 Egyptian psoriatic patients

Background Psoriasis is a common and complex multifactorial disease, in which both genetic and extrinsic factors contribute to activating an immunological reaction. Objectives This study aimed to evaluate the clinical, demographic, and laboratory characteristics of Egyptian psoriatic patients in Sohag, Upper Egypt. Patients and methods This study was a cross-sectional hospital-based study conducted on 200 Egyptian psoriatic patients. All the patients were subjected to complete demographic, clinical, and laboratory evaluations. Results Of the 200 Egyptian patients with psoriasis, the mean age was 42.83±17.3 years; 60% were males, 53% were from rural areas, 47% were smokers, 66% were with positive family history, 91% were with gradual onset, 75% were with a progressive course, and 6.99±3.9 months was the mean duration of the diseases. The main associated symptom with psoriasis was itching in 72%. Psoriasis vulgaris was the most common type in 69.5%. Upper limbs were the most commonly affected sites in 78% of the psoriatic patients. Seasonal variation was the most common exacerbating factor in 51.5% of psoriatic patients. Iron-deficiency anemia was detected in 31% of the psoriatic patients. Liver diseases were associated comorbidities with 29.5% of psoriatic patients and hepatitis C virus infection was presented in 4.5% of psoriatic patients. Metabolic syndrome and stress were detected in 36 and 21% of psoriatic patients, respectively. Conclusion The healthcare providers and patients should be aware of the early detection of associated comorbidities with psoriasis to avoid major complications. The recognition of stress and its specific treatment should be considered an integral part of the treatment of psoriatic patients. Screening for hepatitis is important in Egyptian psoriatic patients. Consanguineous marriage should be avoided in patients with a family history of psoriasis.

Overview on Juvenile Psoriatic Arthritis: A Review

Psoriatic juvenile idiopathic arthritis is a subtype of juvenile idiopathic arthritis that is characterized by both arthritis and psoriasis. juvenile idiopathic arthritis (JIA) is a heterogeneous category of idiopathic inflammatory arthritis that affects children under the age of 16 and lasts six weeks or more as it represents approximately 5% of the whole Juvenile Idiopathic Arthritis (JIA) population. The most prevalent rheumatic illness in children from Western countries is JIA. Chronic arthritis in JIA has an unknown etiology and causes. It is hypothetical if abnormal immune reactions may be brought on by the interplay of environmental elements in a person with a predisposed genetic makeup. Some environmental variables, such exposure to antibiotics and C-section births, provide significant dangers. If there are no characteristic psoriatic lesions present. According to International League of Associations of Rheumatology (ILAR) classification, JPsA is defined by the association of arthritis and psoriasis or, in the absence of typical psoriatic lesions, with at least two of the following: dactylitis, nail pitting, onycholysis or family history of psoriasis in a first-degree relative. In this review we will be looking at the disease etiology, epidemiology, treatment as well as some literature review.

Characterization of Generalized Pustular Psoriasis in Northwest China: A Single-Center Retrospective Study

Objective: This study was performed to investigate the clinical characteristics of patients with generalized pustular psoriasis (GPP) in Northwest China. Methods: The clinical data of patients with GPP were retrospectively collected in the Second Affiliated Hospital of Xi’an Jiaotong University from January 1, 2017, to December 31, 2021 and analyzed using the chi-square test and Mann-Whitney U test. Results: In total, 179 hospitalized patients were included. The male:female ratio was 1.16:1.00, and the mean age at onset was 35.05 ± 19.11 years. Psoriasis vulgaris was also present in 76.0% of patients, and a family history of psoriasis was present in 15.6%. The mean duration of hospitalization was 10.67 ± 4.31 days, and the mean duration of flares was 29.58 ± 24.32 days. Infections and suspected drugs were predisposing factors. A fever developed in 54.7% of patients, and pruritus developed in 70.9%. Some patients had involvement of the nails (38.0%), scalp (46.9%), and tongue (4.5%). Cardiovascular disease, hypertension, and gallbladder-related disease were common comorbidities. The efficacy of acitretin was 84.7%, that of methotrexate was 66.7%, and that of cyclosporine was 100%. Fifteen patients were treated with secukinumab or adalimumab and responded well. The mean response time was 6.34 ± 2.91 days based on the combination treatments. The mean duration of the treatment regimen was 111.35 ± 94.25 days, and approximately 46.6% (n = 131) of patients developed recurrence. Conclusion: Our retrospective study showed that most cases of GPP were accompanied by psoriasis vulgaris and associated with fever or pruritus. Acitretin had good therapeutic efficacy, but recurrence should be noted. Biologics are increasingly becoming effective treatments, but their superiority and safety need further research.

Epidemiologic characteristics and burden of psoriasis: A multicenter, cross-sectional study.

Although psoriasis burden and treatment have been well characterized in developed countries, there are scarce in-depth epidemiological studies in Latin American countries. To describe the sociodemographic and clinical features and the economic burden of psoriasis among children and adult patients from Colombia. This cross-sectional study included patients from dermatology private practice offices, health provider institutions and hospitals in seven Colombian cities. We collected data on disease distribution, weight, height, body mass index, waist-hip ratio, disease severity, therapy, personal history of comorbidities, and direct costs. Multiple logistic regression analyses were conducted to assess the associations between severity scales and sociodemographic and clinical variables. Two-hundred-three patients (43.8% women, 56.2% men) with an age range between 7 to 89 years old were included. The main subtype was psoriasis vulgaris and mean age of diagnosis was 37.1 years. The most common comorbidities were obesity, hypertension, psoriatic arthritis, dyslipidemia and diabetes. Women had a significant increased odds of presenting with psoriatic arthritis. Body-mass-index and hypertension were significantly associated with a higher psoriasis severity, whereas being female and non-obese was associated with a lower risk. A third of the patients had a family history of psoriasis and sleeping disorders. Forty-one percent of participants either had no income or had an income below 224 US dollars per month and >20% of their income was spent on their disease. This study is supported by robust scientific data and contributes to understanding the burden of psoriasis in Latin America. This study adds well-supported data through an in-depth clinical and economical characterization of Colombian children and adult patients with psoriasis and shows the high impact and burden of the disease on patients and their families.

Secukinumab Therapy on Psoriasis at Dr. Mohammad Hoesin General Hospital Palembang

Background: Psoriasis is a chronic inflammatory skin disease mediated by T lymphocytes. IL-17 or IL-22 plays an important role in the chronic inflammatory process. Secukinumab is an effective biological agent therapy with a molecular target, IL-17A. This study aimed to describe PASI improvement and safety of using secukinumab in psoriasis patients at the Dermatology and Venereology Clinic Dr. Mohammad Hoesin General Hospital Palembang.&#x0D; Methods: This study was a retrospective, descriptive-analytic study. The inclusion criteria of this study were all medical record data of patients diagnosed with cutaneous psoriasis through anamnesis, clinical and histopathology examination, treated with secukinumab from January 2018 to December 2020.&#x0D; Results: Psoriasis patients with secukinumab therapy were 15 people. The number of male patients was 8 people, the mean age (+ SD) was 40.4, + 12.34 years, and the age range was 19-64 years. A family history of psoriasis was present in 2 patients (13.4%). Psoriasis vulgaris was the most prevalent type of psoriasis and was treated with secukinumab in 8 patients (53.3%). Another type was pustular psoriasis (20%) and erythrodermic psoriasis (26,7%). The triggers of exacerbations obtained in this study include occupation, hypertension, diabetes mellitus, obesity, smoking, and infections. PASI 75 was achieved by 13 patients (86.7%) at week 12, and all patients achieved DLQI&lt;5. There were no adverse events during the use of secukinumab.&#x0D; Conclusion: The improvement of PASI and DLQI scores were achieved at week 12 in accordance with previous studies. Risk factors do not reduce the therapeutic effect of secukinumab in achieving PASI 75.

Differentiating psoriatic arthritis sine psoriasis from seronegative rheumatoid arthritis—Experiences from five patients

Psoriatic arthritis (PsA) without skin lesions is frequently confused with seronegative rheumatoid arthritis (RA). In this study, we aimed to promote diagnostic accuracy. Five PsA patients with no skin lesions were reviewed. We analyzed the clinical characteristics of these patients. All patients had multiple peripheral arthritis as well as axial involvement, and had been misdiagnosed with RA for several years initially. They developed severe deformation as a result of delayed diagnosis and inadequate treatment. Four patients had nail changes and one had a family history of psoriasis. They had hallmarks of PsA such as dactylitis, enthesitis, and distal interphalangeal arthritis. Ultrasound detection frequently revealed inflammation in the enthesis and extra-synovial areas. Nail psoriasis, dactylitis, enthesitis, distal interphalangeal arthritis, and extra-synovial inflammation would help to differentiate PsA from seronegative RA.

A case of persistent psoriasis occurring after influenza vaccination

Sir, A thirty-year-old male received influenza vaccination in the upper arm. Several days later, erythema appeared on the vaccinated site and spread to the trunk and extremities. He had no family history of psoriasis. He was treated with a topical corticosteroid for three months, which yielded no effects and, thus, he was referred to our hospital. A physical examination revealed numerous erythematous, scaly macules scattered on the trunk and upper extremities and erythema with thick scales scattered on the lower extremities (Figs. 1a and 1b). The psoriasis area and severity index (PASI) score was 9.7. We performed a skin biopsy from the left lower leg. Histopathology revealed a regularly elongated epidermis, an absent granular cell layer of the epidermis, parakeratosis in the corneal layer, and subcorneal neutrophil infiltration (Fig. 1c). Immunohistochemistry revealed that CD4- and CD8-positive T-cells infiltrated into the epidermis and upper dermis, and IL-17, CD123, and TNF-a were also detected in the inflammatory cells below the epidermis. He was diagnosed with psoriasis and was started on a treatment with topical betamethasone and calcipotriol formula (Dovobet) ointment and oral cyclosporine (300 mg/day). An improvement in the skin lesions other than those in the lower extremities was observed after two months. However, the scaly, erythematous lesions on the lower legs were resistant to therapy. The treatment was continued thereafter.

Associations between family history of psoriatic disease and clinical characteristics on patients with psoriatic arthritis: a nationwide study from the Chinese Registry of Psoriatic Arthritis (CREPAR II).

The study aimed to identify clinical characteristics in Chinese patients with psoriatic arthritis (PsA) with or without a family history of psoriasis and/or PsA. Patients with PsA were recruited based on Chinese REgistry of Psoriatic ARthritis (CREPAR) between December 2018 and June 2021. The demographics, clinical information relating to PsA, laboratory variables and comorbidities were collected. The association between family history of psoriatic disease and clinical characteristics on PsA was analysed using logistic regression analysis. Among 1074 eligible patients with PsA, 313 (29.1%) had a family history of psoriasis and/or PsA. Compared with patients without a family history, notably, patients with a family history of psoriasis and/or PsA had an earlier age of onset of psoriasis and PsA, higher proportions of enthesitis and nail involvement, a higher prevalence of positive human leukocyte antigen-B27 (HLA-B27), lower disease activity score 28-erythrocyte sedimentation rate, higher proportions of hyperlipidaemia, lower proportions of hypertension and diabetes. Furthermore, after adjusting for confounding factors, logistic regression analysis demonstrated that a positive family history of psoriasis and/or PsA was associated with more females (OR 1.514, 95% CI 1.088-2.108, p=0.014), earlier age at psoriasis onset (OR 0.971, 95%CI 0.955-0.988, p=0.001), a higher prevalence of HLA-B27 (OR 1.625 95%CI 1.089-2.426, p=0.018), more presence of nail involvement (OR 1.424, 95%CI 1.007-2.013, p=0.046) and enthesitis (OR 1.393, 95%CI 1.005-1.930, p=0.046), a higher proportion of hyperlipidaemia (OR 2.550, 95%CI 1.506-4.317, p=0.001) in PsA patients. This was first nationwide study to characterize patients with and without a family history of psoriatic disease in China. The findings from the present study revealed that family history of psoriasis and/or PsA had greater effects on disease phenotypes of PsA, especially nail disease and enthesitis.

THE DYNAMIC OF SERUM CYTOKINES IN PSORIASIS PATIENTS TREATED WITH SECUKINUMAB

Introduction: Immunological mechanisms of psoriasis have been discussed widely in literature, including cytokines. There are relationships between serum IL-17A, IL-12, and TNF-α with psoriasis, and IL-17A is one of the target cytokines novel biologic therapies. The efficacy, safety, and mechanism of secukinumab were well known while the actual dynamic of circulatory cytokines is less well studied. &#x0D; Objectives: To study the dynamic of serum IL-17A, IL-12, and TNF-α in adult moderate-to-severe plaque psoriasis patients being treated with secukinumab in Ho Chi Minh City Hospital of Dermato-Venereology from July 2019 to May 2020.&#x0D; Subjects and methods: We performed a case series on 35 patients in Ho Chi Minh City Hospital of Dermato-Venereology in the aforementioned period.&#x0D; Results: Despite the patients’ well response to the secukinumab, the concentration of the three cytokines of interest at baseline did not relate to age, sex, age of onset, family history of psoriasis, BMI, metabolic syndrome, history of treatment, or achieving IGA 0/1 at week 12 (p ≥ 0.05). IL-17A and IL-12 correlation at the baseline was statistically significant (p=0.029, r = 0.37). Serum IL-17A and IL-12 were higher at week 12 compared to one at week 4. TNF-α increased at week 12 comparing to one at the baseline. All increases were statistically significant (p&lt;0.05).&#x0D; Conclusion: The paradoxical dynamics of the cytokines while treating psoriasis with secukinumab might potentially cause relapse and/or flare of psoriasis after stop using this agent. Although anti-IL-17A has high efficacy in the treatment of psoriasis, measuring the serum concentration of IL-17A at baseline may not have any essential role in predicting the response of psoriasis to secukinumab.

New Insights on Juvenile Psoriatic Arthritis.

Juvenile psoriatic arthritis (JPsA) is a relatively rare condition in childhood as it represents approximately 5% of the whole Juvenile Idiopathic Arthritis (JIA) population. According to International League of Associations of Rheumatology (ILAR) classification, JPsA is defined by the association of arthritis and psoriasis or, in the absence of typical psoriatic lesions, with at least two of the following: dactylitis, nail pitting, onycholysis or family history of psoriasis in a first-degree relative. However, recent studies have shown that this classification system could conceal more homogeneous subgroups of patients differing by age of onset, clinical characteristics and prognosis. Little is known about genetic factors and pathogenetic mechanisms which distinguish JPsA from other JIA subtypes or from isolated psoriasis without joint involvement, especially in the pediatric population. Specific clinical trials testing the efficacy of biological agents are lacking for JPsA, while in recent years novel therapeutic agents are emerging in adults. In this review, we summarize the clinical features and the current evidence on pathogenesis and therapeutic options for JPsA in order to provide a comprehensive overview on the clinical management of this complex and overlapping entity in childhood.

Exploring the Association Between History of Psoriasis (PSO) and Disease Activity in Patients with Psoriatic Arthritis (PsA).

IntroductionPsoriatic arthritis (PsA) is a common inflammatory disease affecting the peripheral and axial skeleton. History of psoriasis (PSO), either personal or family history, is an important factor in the diagnosis of PsA. We investigated the association between history of PSO and clinical characteristics of PsA.MethodsPsA patients were consecutive recruited from 2019 to 2020. These patients were subjected to clinical, biochemical, and radiographic examinations, and disease activity was evaluated. Continuous and categorical variables analyses were presented.ResultsAll registered patients (296 cases) met the classification criteria of PsA. They were divided into three groups based on the history of psoriasis (PSO), as: (1) 145 patients with PSO themselves (pPsA); (2) 96 patients with family history of PSO (fPsA); (3) 55 patients with family history and coexisting PSO themselves (fPsA/PSO). Compared to fPsA/PSO, the levels of CRP, ESR, uric acid, DAPSA, BASDAI, ASDAS, and BASFI were lower in fPsA, but similar to pPsA. The severity of sacroiliitis tended to be more severe in fPsA/PSO than fPsA (OR2 vs. 3 0.508; 95% CI 0.272 to 0.949, p < 0.05). No significant differences were found in HLA-B-27 and common inflammatory articular and extra-articular manifestations among the three groups. Furthermore, there were no differences in LEI, TJC, SJC, and DAS28CRP. Interestingly, a correlation was found between the ages of individuals with PSO and the onset of arthritis, and the earliest arthritis onset occurred in fPsA/PSO patients (p < 0.001).ConclusionsOur study demonstrates that currently existing cutaneous lesions in patients themselves are correlated with disease activity and severity of axial joint damage, whereas family history does not have an evident impact on the disease activity of PsA.

Association of NLRP1 (rs878329) and NLRP3 (rs10754558) genes polymorphism in psoriasis vulgaris patients with dyslipidemia

Introduction and aimNLRP inflammasome is intracellular sensors and not yet fully studied in psoriasis vulgaris. The aim was to investigate the association of NLRP1 (rs878329) and NLRP3 (rs10754558) genes polymorphism and psoriasis vulgaris, and their relations with the clinical and lipid profiles in psoriatic patients. Material and methodsThis study was involved 64 patients with psoriasis vulgaris and 64 healthy control group. Blood sample was taken for lipid profiles and genotypes NLRP1 and NLRP3 using single-nucleotide polymorphism (SNP) assay. ResultsTotal cholesterol and LDL-c were significantly increased in psoriatic patients compared to controls and their significantly correlation with PASI score (r = −0.296, −0.309 respectively; P < 0.05). On analyzing NLRP1 genotypes CG and GG; and the allele G showed significantly higher frequency in psoriatic patients with 4, 9 and 3 times increase in the risk of developing psoriasis vulgaris respectively; and was significantly associated with dyslipidemia. While on analyzing NLRP3 genotypes GC and CC; and the allele C showed significantly higher frequency in psoriatic patients with 6, 9 and 3 times increase in the risk of developing psoriasis vulgaris respectively. The genotype CC was significantly associated with family history of psoriasis (46.7%), site of affection distribution in extremities and axial (P = 0.015), and with severe form of psoriasis (40.0%) than genotypes GG and GC. However, NLRP3 genotypes was non-significantly associated with dyslipidemia. ConclusionsNLRP1 and NLRP3 genotypes polymorphism associated with more susceptibility to psoriasis vulgaris associated with dyslipidemia. NLRP3 genotypes polymorphism could assess severity and a pivotal therapeutic target in psoriasis vulgaris pathogenesis.

Incidence Rates of Psoriasis in Children With Inflammatory Bowel Disease and Juvenile Arthritis Treated With Tumor Necrosis Factor Inhibitors and Disease-Modifying Antirheumatic Drugs.

To estimate the differential effect of tumor necrosis factor inhibitor (TNFi) therapies and presence or absence of conventional synthetic disease-modifying antirheumatic drugs (DMARDs) on the incidence of psoriasis (PsO) in children with inflammatory bowel disease (IBD), juvenile idiopathic arthritis (JIA), and chronic nonbacterial osteomyelitis (CNO). This was a retrospective cohort study from 2008 to 2020. TNFi and DMARD exposures were dichotomized as ever/never. The primary outcome was incident PsO. Incidence rates (IRs) of PsO were stratified by underlying diagnosis, TNFi agent, and DMARD use. Poisson regression was used to assess the IR ratios (IRRs) between exposure groups. There were 5088 children who met the inclusion criteria: 3794 (75%) had IBD, 1189 (23%) had JIA, and 105 (2%) had CNO. Of the 2023 children with TNFi exposure, 613 (30%) and 1410 (70%) were with or without a DMARD, respectively. When controlling for DMARD, sex, and family history of PsO, the IRR of developing PsO in patients exposed to adalimumab (ADA) was 2.70 times higher (95% CI 1.53-4.75; P < 0.001) than those who did not receive any TNFi treatment. IRR was lower, but not significantly different, for patients exposed to infliximab (IFX; IRR 2.34, 95% CI 1.56-3.51; P < 0.001) and etanercept (ETN; IRR 2.21; 95% CI 1.17-4.21; P = 0.006) compared to TNFi-unexposed patients. IRR of TNFi exposure was lower by 0.25 (P < 0.001) in DMARD-exposed patients compared to non-DMARD-exposed patients. IRR of TNFi-induced PsO was not significantly different among ADA, IFX, and ETN. However, for patients with exposure to any of the TNFi evaluated, the IRR was significantly lower in those also exposed to a DMARD.

Psoriasis and family history of psoriasis may not affect disease severity of rheumatoid arthritis.

The incidence of psoriasis in patients with rheumatoid arthritis (RA) is higher than in the general population. In addition, psoriasis may negatively affect the severity of rheumatological diseases in patients with autoinflammatory or autoimmune diseases. In this study, we evaluated the effect of psoriasis or a family history of psoriasis on the characteristics of RA. This is a cross-sectional study. We included 737 RA patients who met the 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) RA Classification Criteria, but did not meet the CASPAR psoriatic arthritis criteria. Subsequently, we compared disease activity, the need for biologic therapy, the number of conventional synthetic disease-modifying anti-rheumatic drugs taken, the frequency of erosive disease and extra-articular involvement, glucocorticoid doses and the Stanford Health Assessment Questionnaire scores between patients with and without a history of psoriasis, and patients with and without a family history of psoriasis. Thirteen (1.8%) patients had psoriasis, while 58 (7.9%) had a family history of psoriasis in first- or seconddegree relatives. All outcome parameters were found to be similar between the groups. We show that concomitant psoriasis has no effect on the evaluated disease characteristics of RA.

Psoriasis in Patients Attending a Large HIV Clinic in Trinidad.

The data on psoriasis in persons infected with HIV in the Caribbean is sparse. A cross-sectional study was conducted on patients attending the HIV Clinic diagnosed with psoriasis where sociodemographic data and data on the pattern of psoriasis were collected and analysed using SPSS version 25. Over the period April 2002–December 2018, 37 persons attending the HIV clinic were diagnosed with psoriasis, age range at psoriasis diagnosis 13–70 years, mean age at diagnosis 37.7 years and 32 (86.5%) were male. Over the study period, 8916 patients were registered at the HIV Clinic and the prevalence of psoriasis among these patients was 0.42% which is less than the reported prevalence of psoriasis among persons infected with HIV of 2–3% in other studies. Severe/generalised psoriasis was present in 7 (18.9%) patients while 30 (81.1%) patients had mild/moderate psoriasis. A family history of psoriasis was present in 1 (2.7%) patient, psoriatic arthritis was present in 2 (5.4%) patients and 31 (83.8%) patients reported that there was improvement in the psoriasis with the topical therapy provided. The study makes an original contribution in the determination of the prevalence and pattern of psoriasis among patients attending a HIV Clinic in Trinidad.

Psoriasis rate is increased by the exposure to TNF inhibition in children with JIA

ObjectiveWe aimed to investigate the relationship between tumour necrosis factor inhibitors (TNFi) therapy and the onset of new psoriasis in children with juvenile idiopathic arthritis (JIA) using Childhood Arthritis and...