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Psoriasis: HELP
Articles from US Mountain Zone
Based on 297 articles published since 2009
||||

These are the 297 published articles about Psoriasis that originated from US Mountain Zone during 2009-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12
1 Guideline Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with biologics. 2019

Menter, Alan / Strober, Bruce E / Kaplan, Daniel H / Kivelevitch, Dario / Prater, Elizabeth Farley / Stoff, Benjamin / Armstrong, April W / Connor, Cody / Cordoro, Kelly M / Davis, Dawn M R / Elewski, Boni E / Gelfand, Joel M / Gordon, Kenneth B / Gottlieb, Alice B / Kavanaugh, Arthur / Kiselica, Matthew / Korman, Neil J / Kroshinsky, Daniela / Lebwohl, Mark / Leonardi, Craig L / Lichten, Jason / Lim, Henry W / Mehta, Nehal N / Paller, Amy S / Parra, Sylvia L / Pathy, Arun L / Rupani, Reena N / Siegel, Michael / Wong, Emily B / Wu, Jashin J / Hariharan, Vidhya / Elmets, Craig A. ·Baylor Scott and White, Dallas, Texas. · University of Connecticut, Farmington, Connecticut; Probity Medical Research, Waterloo, Ontario, Canada. · University of Pittsburgh, Pittsburgh, Pennsylvania. · University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma. · Emory University School of Medicine, Atlanta, Georgia. · University of Southern California, Los Angeles, San Francisco. · University of Alabama, Birmingham, Alabama. · University of California, San Francisco School of Medicine, Department of Dermatology, San Francisco, California. · Mayo Clinic, Rochester, Minnesota. · University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. · Medical College of Wisconsin, Milwaukee, Wisconsin. · Department of Dermatology, Icahn School of Medicine at Mt. Sinai, New York. · University of California San Diego, San Diego, California. · National Psoriasis Foundation, Portland, Oregon. · University Hospitals Cleveland Medical Center, Cleveland, Ohio. · Massachusetts General Hospital, Boston, Massachusetts. · Central Dermatology, St. Louis, Missouri. · Department of Dermatology, Henry Ford Hospital, Detroit, Michigan. · National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland. · Northwestern University Feinberg School of Medicine, Chicago, Illinois. · Dermatology and Skin Surgery, Sumter, South Carolina. · Colorado Permanente Medical Group, Centennial, Colorado. · San Antonio Uniformed Services Health Education Consortium, Joint-Base San Antonio. · Dermatology Research and Education Foundation, Irvine, California. · American Academy of Dermatology, Rosemont, Illinois. Electronic address: vhariharan@aad.org. ·J Am Acad Dermatol · Pubmed #30772098.

ABSTRACT: Psoriasis is a chronic, inflammatory multisystem disease that affects up to 3.2% of the US population. This guideline addresses important clinical questions that arise in psoriasis management and care, providing recommendations based on the available evidence. The treatment of psoriasis with biologic agents will be reviewed, emphasizing treatment recommendations and the role of the dermatologist in monitoring and educating patients regarding benefits as well as associated risks.

2 Guideline Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with awareness and attention to comorbidities. 2019

Elmets, Craig A / Leonardi, Craig L / Davis, Dawn M R / Gelfand, Joel M / Lichten, Jason / Mehta, Nehal N / Armstrong, April W / Connor, Cody / Cordoro, Kelly M / Elewski, Boni E / Gordon, Kenneth B / Gottlieb, Alice B / Kaplan, Daniel H / Kavanaugh, Arthur / Kivelevitch, Dario / Kiselica, Matthew / Korman, Neil J / Kroshinsky, Daniela / Lebwohl, Mark / Lim, Henry W / Paller, Amy S / Parra, Sylvia L / Pathy, Arun L / Prater, Elizabeth Farley / Rupani, Reena / Siegel, Michael / Stoff, Benjamin / Strober, Bruce E / Wong, Emily B / Wu, Jashin J / Hariharan, Vidhya / Menter, Alan. ·University of Alabama, Birmingham, Alabama. · Central Dermatology, St. Louis, Missouri. · Mayo Clinic, Rochester, Minnesota. · University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. · National Psoriasis Foundation, Portland, Oregon. · National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland. · University of Southern California, Los Angeles, California. · Department of Dermatology, University of California San Francisco School of MedicineSan Francisco, California. · Medical College of Wisconsin, Milwaukee, Wisconsin. · Department of Dermatology, Icahn School of Medicine at Mt. Sinai, New York, New York. · University of Pittsburgh, Pennsylvania. · University of California San Diego, San Diego, California. · Baylor Scott and White, Dallas, Texas. · University Hospitals Cleveland Medical Center, Cleveland, Ohio. · Massachusetts General Hospital, Boston, Massachusetts. · Department of Dermatology, Henry Ford Hospital, Detroit, Michigan. · Northwestern University Feinberg School of Medicine, Chicago, Illinois. · Dermatology and Skin Surgery, Sumter, South Carolina. · Colorado Permanente Medical Group, Centennial, Colorado. · University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma. · Icahn School of Medicine at Mount Sinai, New York, New York. · Emory University School of Medicine, Atlanta, Georgia. · University of Connecticut, Farmington, Connecticut; Probity Medical Research, Waterloo, Canada. · San Antonio Uniformed Services Health Education Consortium, Joint-Base San Antonio, Texas. · Dermatology Research and Education Foundation, Irvine, California. · American Academy of Dermatology, Rosemont, Illinois. Electronic address: vhariharan@aad.org. ·J Am Acad Dermatol · Pubmed #30772097.

ABSTRACT: Psoriasis is a chronic, inflammatory, multisystem disease that affects up to 3.2% of the US population. This guideline addresses important clinical questions that arise in psoriasis management and care, providing recommendations on the basis of available evidence.

3 Guideline Special Article: 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis. 2019

Singh, Jasvinder A / Guyatt, Gordon / Ogdie, Alexis / Gladman, Dafna D / Deal, Chad / Deodhar, Atul / Dubreuil, Maureen / Dunham, Jonathan / Husni, M Elaine / Kenny, Sarah / Kwan-Morley, Jennifer / Lin, Janice / Marchetta, Paula / Mease, Philip J / Merola, Joseph F / Miner, Julie / Ritchlin, Christopher T / Siaton, Bernadette / Smith, Benjamin J / Van Voorhees, Abby S / Jonsson, Anna Helena / Shah, Amit Aakash / Sullivan, Nancy / Turgunbaev, Marat / Coates, Laura C / Gottlieb, Alice / Magrey, Marina / Nowell, W Benjamin / Orbai, Ana-Maria / Reddy, Soumya M / Scher, Jose U / Siegel, Evan / Siegel, Michael / Walsh, Jessica A / Turner, Amy S / Reston, James. ·University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama. · McMaster University, Hamilton, Ontario, Canada. · University of Pennsylvania, Philadelphia. · University of Toronto and Toronto Western Hospital, Toronto, Ontario, Canada. · Cleveland Clinic, Cleveland, Ohio. · Oregon Health & Science University, Portland. · Boston Medical Center, Boston, Massachusetts. · New York, New York. · Premier Orthopaedics, Malvern, Pennsylvania. · Stanford University, Stanford, California. · Concorde Medical Group, New York, New York. · Swedish-Providence Health Systems and University of Washington, Seattle, Washington. · Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. · Comprehensive Therapy Consultants and Therapy Steps, Roswell, Georgia. · University of Rochester Medical Center, Rochester, New York. · University of Maryland School of Medicine, Baltimore. · Florida State University College of Medicine School of Physician Assistant Practice, Tallahassee. · Eastern Virginia Medical School, Norfolk. · American College of Rheumatology, Atlanta, Georgia. · ECRI Institute, Plymouth Meeting, Pennsylvania. · University of Oxford, Oxford, UK. · New York Medical College at Metropolitan Hospital, New York, New York. · Case Western/MetroHealth, Cleveland, Ohio. · Global Healthy Living Foundation, Nyack, New York. · Johns Hopkins University, Baltimore, Maryland. · New York University School of Medicine, New York, New York. · Arthritis & Rheumatism Associates, Rockville, Maryland. · National Psoriasis Foundation, Portland, Oregon. · University of Utah and George E. Wahlen VeteranS Affairs Medical Center, Salt Lake City, Utah. ·Arthritis Rheumatol · Pubmed #30499246.

ABSTRACT: OBJECTIVE: To develop an evidence-based guideline for the pharmacologic and nonpharmacologic treatment of psoriatic arthritis (PsA), as a collaboration between the American College of Rheumatology (ACR) and the National Psoriasis Foundation (NPF). METHODS: We identified critical outcomes in PsA and clinically relevant PICO (population/intervention/comparator/outcomes) questions. A Literature Review Team performed a systematic literature review to summarize evidence supporting the benefits and harms of available pharmacologic and nonpharmacologic therapies for PsA. GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used to rate the quality of the evidence. A voting panel, including rheumatologists, dermatologists, other health professionals, and patients, achieved consensus on the direction and the strength of the recommendations. RESULTS: The guideline covers the management of active PsA in patients who are treatment-naive and those who continue to have active PsA despite treatment, and addresses the use of oral small molecules, tumor necrosis factor inhibitors, interleukin-12/23 inhibitors (IL-12/23i), IL-17 inhibitors, CTLA4-Ig (abatacept), and a JAK inhibitor (tofacitinib). We also developed recommendations for psoriatic spondylitis, predominant enthesitis, and treatment in the presence of concomitant inflammatory bowel disease, diabetes, or serious infections. We formulated recommendations for a treat-to-target strategy, vaccinations, and nonpharmacologic therapies. Six percent of the recommendations were strong and 94% conditional, indicating the importance of active discussion between the health care provider and the patient to choose the optimal treatment. CONCLUSION: The 2018 ACR/NPF PsA guideline serves as a tool for health care providers and patients in the selection of appropriate therapy in common clinical scenarios. Best treatment decisions consider each individual patient situation. The guideline is not meant to be proscriptive and should not be used to limit treatment options for patients with PsA.

4 Guideline 2017 American College of Rheumatology/American Association of Hip and Knee Surgeons Guideline for the Perioperative Management of Antirheumatic Medication in Patients With Rheumatic Diseases Undergoing Elective Total Hip or Total Knee Arthroplasty. 2017

Goodman, Susan M / Springer, Bryan / Guyatt, Gordon / Abdel, Matthew P / Dasa, Vinod / George, Michael / Gewurz-Singer, Ora / Giles, Jon T / Johnson, Beverly / Lee, Steve / Mandl, Lisa A / Mont, Michael A / Sculco, Peter / Sporer, Scott / Stryker, Louis / Turgunbaev, Marat / Brause, Barry / Chen, Antonia F / Gililland, Jeremy / Goodman, Mark / Hurley-Rosenblatt, Arlene / Kirou, Kyriakos / Losina, Elena / MacKenzie, Ronald / Michaud, Kaleb / Mikuls, Ted / Russell, Linda / Sah, Alexander / Miller, Amy S / Singh, Jasvinder A / Yates, Adolph. ·Susan M. Goodman, MD, Lisa A. Mandl, MD, MPH, Peter Sculco, MD, Barry Brause, MD, Kyriakos Kirou, MD, Ronald MacKenzie, MD, Linda Russell, MD: Hospital for Special Surgery/Weill Cornell Medicine, New York, New York. Electronic address: goodmans@hss.edu. · Bryan Springer, MD: OrthoCarolina Hip and Knee Center, Charlotte, North Carolina. · Gordon Guyatt, MD: McMaster University, Hamilton, Ontario, Canada. · Matthew P. Abdel, MD: Mayo Clinic, Rochester, Minnesota. · Vinod Dasa, MD: Louisiana State University, New Orleans. · Michael George, MD: University of Pennsylvania, Philadelphia. · Ora Gewurz-Singer, MD: University of Michigan, Ann Arbor. · Jon T. Giles, MD, MPH: Columbia University, New York, New York. · Beverly Johnson, MD: Albert Einstein College of Medicine, Bronx, New York. · Steve Lee, DO: Kaiser Permanente, Fontana, California. · Susan M. Goodman, MD, Lisa A. Mandl, MD, MPH, Peter Sculco, MD, Barry Brause, MD, Kyriakos Kirou, MD, Ronald MacKenzie, MD, Linda Russell, MD: Hospital for Special Surgery/Weill Cornell Medicine, New York, New York. · Michael A. Mont, MD: Cleveland Clinic, Cleveland, Ohio. · Scott Sporer, MD: Midwest Orthopaedics at Rush, Chicago, Illinois. · Louis Stryker, MD: University of Texas Medical Branch, Galveston. · Marat Turgunbaev, MD, MPH, Amy S. Miller: American College of Rheumatology, Atlanta, Georgia. · Antonia F. Chen, MD, MBA: Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania. · Jeremy Gililland, MD: University of Utah, Salt Lake City. · Mark Goodman, MD, Adolph Yates, MD: University of Pittsburgh, Pittsburgh, Pennsylvania. · Arlene Hurley-Rosenblatt, ANP: Rockefeller University, New York, New York. · Elena Losina, PhD: Brigham and Women's Hospital, Boston, Massachusetts. · Kaleb Michaud, PhD: National Data Bank for Rheumatic Diseases, Wichita, Kansas and University of Nebraska Medical Center, Omaha. · Ted Mikuls, MD, MSPH: University of Nebraska Medical Center, Omaha. · Alexander Sah, MD: Dearborn-Sah Institute for Joint Restoration, Fremont, California. · Jasvinder A. Singh, MBBS, MPH: University of Alabama at Birmingham. ·J Arthroplasty · Pubmed #28629905.

ABSTRACT: OBJECTIVE: This collaboration between the American College of Rheumatology and the American Association of Hip and Knee Surgeons developed an evidence-based guideline for the perioperative management of antirheumatic drug therapy for adults with rheumatoid arthritis (RA), spondyloarthritis (SpA) including ankylosing spondylitis and psoriatic arthritis, juvenile idiopathic arthritis (JIA), or systemic lupus erythematosus (SLE) undergoing elective total hip (THA) or total knee arthroplasty (TKA). METHODS: A panel of rheumatologists, orthopedic surgeons specializing in hip and knee arthroplasty, and methodologists was convened to construct the key clinical questions to be answered in the guideline. A multi-step systematic literature review was then conducted, from which evidence was synthesized for continuing versus withholding antirheumatic drug therapy and for optimal glucocorticoid management in the perioperative period. A Patient Panel was convened to determine patient values and preferences, and the Grading of Recommendations Assessment, Development and Evaluation methodology was used to rate the quality of evidence and the strength of recommendations, using a group consensus process through a convened Voting Panel of rheumatologists and orthopedic surgeons. The strength of the recommendation reflects the degree of certainty that benefits outweigh harms of the intervention, or vice versa, considering the quality of available evidence and the variability in patient values and preferences. RESULTS: The guideline addresses the perioperative use of antirheumatic drug therapy including traditional disease-modifying antirheumatic drugs, biologic agents, tofacitinib, and glucocorticoids in adults with RA, SpA, JIA, or SLE who are undergoing elective THA or TKA. It provides recommendations regarding when to continue, when to withhold, and when to restart these medications, and the optimal perioperative dosing of glucocorticoids. The guideline includes 7 recommendations, all of which are conditional and based on low- or moderate-quality evidence. CONCLUSION: This guideline should help decision-making by clinicians and patients regarding perioperative antirheumatic medication management at the time of elective THA or TKA. These conditional recommendations reflect the paucity of high-quality direct randomized controlled trial data.

5 Guideline 2017 American College of Rheumatology/American Association of Hip and Knee Surgeons Guideline for the Perioperative Management of Antirheumatic Medication in Patients With Rheumatic Diseases Undergoing Elective Total Hip or Total Knee Arthroplasty. 2017

Goodman, Susan M / Springer, Bryan / Guyatt, Gordon / Abdel, Matthew P / Dasa, Vinod / George, Michael / Gewurz-Singer, Ora / Giles, Jon T / Johnson, Beverly / Lee, Steve / Mandl, Lisa A / Mont, Michael A / Sculco, Peter / Sporer, Scott / Stryker, Louis / Turgunbaev, Marat / Brause, Barry / Chen, Antonia F / Gililland, Jeremy / Goodman, Mark / Hurley-Rosenblatt, Arlene / Kirou, Kyriakos / Losina, Elena / MacKenzie, Ronald / Michaud, Kaleb / Mikuls, Ted / Russell, Linda / Sah, Alexander / Miller, Amy S / Singh, Jasvinder A / Yates, Adolph. ·Hospital for Special Surgery/Weill Cornell Medicine, New York, New York. · OrthoCarolina Hip and Knee Center, Charlotte, North Carolina. · McMaster University, Hamilton, Ontario, Canada. · Mayo Clinic, Rochester, Minnesota. · Louisiana State University, New Orleans. · University of Pennsylvania, Philadelphia. · University of Michigan, Ann Arbor. · Columbia University, New York, New York. · Albert Einstein College of Medicine, Bronx, New York. · Kaiser Permanente, Fontana, California. · Cleveland Clinic, Cleveland, Ohio. · Midwest Orthopaedics at Rush, Chicago, Illinois. · University of Texas Medical Branch, Galveston. · American College of Rheumatology, Atlanta, Georgia. · Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania. · University of Utah, Salt Lake City. · University of Pittsburgh, Pittsburgh, Pennsylvania. · Rockefeller University, New York, New York. · Brigham and Women's Hospital, Boston, Massachusetts. · National Data Bank for Rheumatic Diseases, Wichita, Kansas, and University of Nebraska Medical Center, Omaha. · University of Nebraska Medical Center, Omaha. · Dearborn-Sah Institute for Joint Restoration, Fremont, California. · University of Alabama at Birmingham. ·Arthritis Rheumatol · Pubmed #28620948.

ABSTRACT: OBJECTIVE: This collaboration between the American College of Rheumatology and the American Association of Hip and Knee Surgeons developed an evidence-based guideline for the perioperative management of antirheumatic drug therapy for adults with rheumatoid arthritis (RA), spondyloarthritis (SpA) including ankylosing spondylitis and psoriatic arthritis, juvenile idiopathic arthritis (JIA), or systemic lupus erythematosus (SLE) undergoing elective total hip (THA) or total knee arthroplasty (TKA). METHODS: A panel of rheumatologists, orthopedic surgeons specializing in hip and knee arthroplasty, and methodologists was convened to construct the key clinical questions to be answered in the guideline. A multi-step systematic literature review was then conducted, from which evidence was synthesized for continuing versus withholding antirheumatic drug therapy and for optimal glucocorticoid management in the perioperative period. A Patient Panel was convened to determine patient values and preferences, and the Grading of Recommendations Assessment, Development and Evaluation methodology was used to rate the quality of evidence and the strength of recommendations, using a group consensus process through a convened Voting Panel of rheumatologists and orthopedic surgeons. The strength of the recommendation reflects the degree of certainty that benefits outweigh harms of the intervention, or vice versa, considering the quality of available evidence and the variability in patient values and preferences. RESULTS: The guideline addresses the perioperative use of antirheumatic drug therapy including traditional disease-modifying antirheumatic drugs, biologic agents, tofacitinib, and glucocorticoids in adults with RA, SpA, JIA, or SLE who are undergoing elective THA or TKA. It provides recommendations regarding when to continue, when to withhold, and when to restart these medications, and the optimal perioperative dosing of glucocorticoids. The guideline includes 7 recommendations, all of which are conditional and based on low- or moderate-quality evidence. CONCLUSION: This guideline should help decision-making by clinicians and patients regarding perioperative antirheumatic medication management at the time of elective THA or TKA. These conditional recommendations reflect the paucity of high-quality direct randomized controlled trial data.

6 Editorial Atopic dermatitis: Age and race do matter! 2015

Leung, Donald Y M. ·Department of Pediatrics, National Jewish Health, Denver, Colo. Electronic address: leungd@njhealth.org. ·J Allergy Clin Immunol · Pubmed #26549637.

ABSTRACT: -- No abstract --

7 Editorial Targeted therapy for allergic diseases: at the intersection of cutting-edge science and clinical practice. 2015

Boguniewicz, Mark / Leung, Donald Y M. ·Division of Allergy-Immunology, Department of Pediatrics, National Jewish Health and the University of Colorado School of Medicine, Denver, Colo. Electronic address: boguniewiczm@njhealth.org. · Division of Allergy-Immunology, Department of Pediatrics, National Jewish Health and the University of Colorado School of Medicine, Denver, Colo. ·J Allergy Clin Immunol · Pubmed #25662304.

ABSTRACT: -- No abstract --

8 Review The Significance of IL-36 Hyperactivation and IL-36R Targeting in Psoriasis. 2019

Madonna, Stefania / Girolomoni, Giampiero / Dinarello, Charles A / Albanesi, Cristina. ·Laboratory of Experimental Immunology, IDI-IRCCS, via Monti di Creta, 104, 00167 Rome, Italy. s.madonna@idi.it. · Section of Dermatology, Department of Medicine, University of Verona, P.zza Stefani, 1, 37126 Verona, Italy. · Department of Medicine, Radboud University Medical Center, 6525 HP Nijmegen, The Netherlands. · Department of Medicine, School of Medicine, University of Colorado, Denver 80045, Anschutz Campus, Aurora, CO, USA. · Laboratory of Experimental Immunology, IDI-IRCCS, via Monti di Creta, 104, 00167 Rome, Italy. ·Int J Mol Sci · Pubmed #31284527.

ABSTRACT: Psoriasis is an immune-mediated inflammatory skin disease that involves mainly T helper (Th)17, Th1 and Th22 lymphocytes, which cause hyper-proliferation of the epidermis with aberrant differentiation of keratinocytes, and local production of chemokines and cytokines. These fuel a self-amplifying loop where these products act on T cells to perpetuate cutaneous inflammatory processes. Among the various inflammatory mediators involved, interleukin (IL)-36 cytokines are important for the recruitment and activation of neutrophils and Th17 cells in psoriatic skin. In particular, IL-36s induce chemokines and cytokines interfere with differentiation/cornification programs in the epidermis, as well as promote pathological angiogenesis and endothelial cell activation. IL-36 cytokines belong to the IL-1 family, and comprise IL-36α, IL-36β, and IL-36γ agonists as well as IL-36 receptor antagonist and IL-38 antagonists. IL-36 cytokines are up-regulated in psoriatic epidermis, and their expression is strongly induced by TNF-α and IL-17. Contrarily, IL-38 antagonist is downregulated, and its impaired expression may be relevant to the dysregulated inflammatory processes induced by IL-36. Here, we discuss on the pathogenic mechanisms leading to the altered balance of IL-36 agonists/antagonists and the significance of this dysregulation in psoriasis. Collection of the information will provide a theoretical basis for the development of novel therapeutic strategies based on IL-36 agonist/antagonist manipulation in psoriasis.

9 Review Therapeutic Effects of Synthetic Antimicrobial Peptides, TRAIL and NRP1 Blocking Peptides in Psoriatic Keratinocytes. 2019

Ryu, Sunhyo / Broussard, Lindsey / Youn, Chakyung / Song, Brendon / Norris, David / Armstrong, Cheryl A / Kim, Beomjoon / Song, Peter I. ·Department of Dermatology, University of Colorado Denver School of Medicine, Aurora, CO, USA. · Department of Biomedical Science and Research Center for Proteinaceous Materials, Chosun University School of Medicine, Gwangju, Korea. · Department of Biology, University of Denver, Denver, CO, USA. · Department of Dermatology, Chung-Ang University School of Medicine, Seoul, Korea. ·Chonnam Med J · Pubmed #31161119.

ABSTRACT: Psoriasis is a chronic, recurrent, heterogeneous, cutaneous inflammatory skin disease for which there is no cure. It affects approximately 7.5 million people in the United States. Currently, several biologic agents that target different molecules implicated in the pathogenic processes of psoriasis are being assessed in diverse clinical studies. However, relapse usually occurs within weeks or months, meaning there is currently no cure for psoriasis. Therefore, recent studies have discovered diverse new potential treatments for psoriasis: inhibitors of bacteria such as

10 Review Special Article: 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis. 2019

Singh, Jasvinder A / Guyatt, Gordon / Ogdie, Alexis / Gladman, Dafna D / Deal, Chad / Deodhar, Atul / Dubreuil, Maureen / Dunham, Jonathan / Husni, M Elaine / Kenny, Sarah / Kwan-Morley, Jennifer / Lin, Janice / Marchetta, Paula / Mease, Philip J / Merola, Joseph F / Miner, Julie / Ritchlin, Christopher T / Siaton, Bernadette / Smith, Benjamin J / Van Voorhees, Abby S / Jonsson, Anna Helena / Shah, Amit Aakash / Sullivan, Nancy / Turgunbaev, Marat / Coates, Laura C / Gottlieb, Alice / Magrey, Marina / Nowell, W Benjamin / Orbai, Ana-Maria / Reddy, Soumya M / Scher, Jose U / Siegel, Evan / Siegel, Michael / Walsh, Jessica A / Turner, Amy S / Reston, James. ·University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama. · McMaster University, Hamilton, Ontario, Canada. · University of Pennsylvania, Philadelphia. · University of Toronto and Toronto Western Hospital, Toronto, Ontario, Canada. · Cleveland Clinic, Cleveland, Ohio. · Oregon Health & Science University, Portland. · Boston Medical Center, Boston, Massachusetts. · New York, New York. · Premier Orthopaedics, Malvern, Pennsylvania. · Stanford University, Stanford, California. · Concorde Medical Group, New York, New York. · Swedish-Providence Health Systems and University of Washington, Seattle, Washington. · Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. · Comprehensive Therapy Consultants and Therapy Steps, Roswell, Georgia. · University of Rochester Medical Center, Rochester, New York. · University of Maryland School of Medicine, Baltimore. · Florida State University College of Medicine School of Physician Assistant Practice, Tallahassee. · Eastern Virginia Medical School, Norfolk. · American College of Rheumatology, Atlanta, Georgia. · ECRI Institute, Plymouth Meeting, Pennsylvania. · University of Oxford, Oxford, UK. · New York Medical College at Metropolitan Hospital, New York, New York. · Case Western/MetroHealth, Cleveland, Ohio. · Global Healthy Living Foundation, Nyack, New York. · Johns Hopkins University, Baltimore, Maryland. · New York University School of Medicine, New York, New York. · Arthritis & Rheumatism Associates, Rockville, Maryland. · National Psoriasis Foundation, Portland, Oregon. · University of Utah and George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, Utah. ·Arthritis Care Res (Hoboken) · Pubmed #30499259.

ABSTRACT: OBJECTIVE: To develop an evidence-based guideline for the pharmacologic and nonpharmacologic treatment of psoriatic arthritis (PsA), as a collaboration between the American College of Rheumatology (ACR) and the National Psoriasis Foundation (NPF). METHODS: We identified critical outcomes in PsA and clinically relevant PICO (population/intervention/comparator/outcomes) questions. A Literature Review Team performed a systematic literature review to summarize evidence supporting the benefits and harms of available pharmacologic and nonpharmacologic therapies for PsA. GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used to rate the quality of the evidence. A voting panel, including rheumatologists, dermatologists, other health professionals, and patients, achieved consensus on the direction and the strength of the recommendations. RESULTS: The guideline covers the management of active PsA in patients who are treatment-naive and those who continue to have active PsA despite treatment, and addresses the use of oral small molecules, tumor necrosis factor inhibitors, interleukin-12/23 inhibitors (IL-12/23i), IL-17 inhibitors, CTLA4-Ig (abatacept), and a JAK inhibitor (tofacitinib). We also developed recommendations for psoriatic spondylitis, predominant enthesitis, and treatment in the presence of concomitant inflammatory bowel disease, diabetes, or serious infections. We formulated recommendations for a treat-to-target strategy, vaccinations, and nonpharmacologic therapies. Six percent of the recommendations were strong and 94% conditional, indicating the importance of active discussion between the health care provider and the patient to choose the optimal treatment. CONCLUSION: The 2018 ACR/NPF PsA guideline serves as a tool for health care providers and patients in the selection of appropriate therapy in common clinical scenarios. Best treatment decisions consider each individual patient situation. The guideline is not meant to be proscriptive and should not be used to limit treatment options for patients with PsA.

11 Review Biologic therapy in psoriasis: navigating the options. 2018

McKay, Cather / Kondratuk, Katherine E / Miller, John P / Stumpf, Brittany / Boh, Erin. ·Department of Dermatology, Tulane University School of Medicine, New Orleans, Louisiana, USA. · University of South Dakota Sanford School of Medicine, Vermillion, South Dakota. USA. · Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA. ·Cutis · Pubmed #30566551.

ABSTRACT: Psoriasis is a T cell-mediated inflammatory disease associated with comorbidities impacting the overall health and quality of life of those affected. This article offers a brief overview of treatment classes available and an approach to choosing biologic treatments based on individual patient characteristics, including disease severity, comorbidities, and ultimate treatment goals.

12 Review Update on the pathophysiology of psoriasis. 2018

Hugh, Jeremy M / Weinberg, Jeffrey M. ·Department of Dermatology, University of Colorado, Aurora, Colorado, USA. · Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA. ·Cutis · Pubmed #30566550.

ABSTRACT: Psoriasis is a genetically programmed pathologic interaction among skin cells, immunocytes, and numerous biologic signaling molecules that is triggered by environmental stimuli. The immune response is a cellular one; type 1 (TH1) and type 17 (TH17) T cells are activated by IL-12 and IL-23 secreted by antigen-presenting cells (APCs) in the skin. Through various cytokines, such as tumor necrosis factor (TNF) α, these cells cause a chronic inflammatory state and alter epidermal hyperproliferation, differentiation, apoptosis, and neoangiogenesis that produce the cutaneous findings seen in this disease. The newer biologic therapies target the immunologic signaling pathways and cytokines identified in the pathogenesis of psoriasis and provide notable clinical improvement. Further study in the pathogenesis of psoriasis can help identify targets for future therapies.

13 Review Cannabinoids in dermatology: a scoping review. 2018

Eagleston, Lauren R M / Kalani, Nazanin Kuseh / Patel, Ravi R / Flaten, Hania K / Dunnick, Cory A / Dellavalle, Robert P. ·University of Colorado School of Medicine, Department of Dermatology, Aurora, Colorado Denver Veterans Affairs Medical Center (VAMC), Department of Dermatology, Denver, Colorado. Robert.Dellavalle@ucdenver.edu. ·Dermatol Online J · Pubmed #30142706.

ABSTRACT: The therapeutic applications of cannabis and cannabinoids are an increasingly conspicuous topic as de-criminalization and legalization of these products continues to expand. A limited number of cannabinoid compounds have been approved for a specific set of conditions. However, the current role of cannabinoids for the treatment of dermatologic conditions remains to be defined. We conducted a review of the current literature to determine the applications of cannabinoids for the therapy of various skin diseases. After conducting our analysis, we found that cannabinoid products have the potential to treat a variety of skin conditions, including acne vulgaris, allergic contact dermatitis, asteatotic dermatitis, atopic dermatitis, hidradenitis suppurativa, Kaposi sarcoma, pruritus, psoriasis, skin cancer, and the cutaneous manifestations of systemic sclerosis. However, the majority of available data on these compounds are pre-clinical and there is a corresponding lack of high-quality randomized, controlled trials that evaluate their effects. Cannabinoids have shown some initial promise as therapy for a variety of skin diseases. However, there is a requirement for thorough pre-clinical research and large-scale, randomized, controlled trials before cannabinoids can be considered safe and effective treatments for these conditions.

14 Review Psoriatic arthritis and the dermatologist: An approach to screening and clinical evaluation. 2018

Zhang, Arianna / Kurtzman, Drew J B / Perez-Chada, Lourdes M / Merola, Joseph F. ·Department of Dermatology, Brigham and Women's Hospital, Harvard University, Cambridge, Massachusetts, USA. · Division of Dermatology, The University of Arizona College of Medicine, Tucson, Arizona, USA; Division of Dermatology, St. Elizabeth Physicians, Florence, Kentucky, USA. Electronic address: drewkurtzman@gmail.com. · Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. · Department of Dermatology, Division of Rheumatology, and Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. ·Clin Dermatol · Pubmed #30047437.

ABSTRACT: Psoriatic arthritis is a common form of inflammatory arthritis that frequently accompanies psoriasis of the skin-up to 30% of patients with psoriasis are affected. Recognition of the clinical features of psoriatic arthritis is critical, as delayed detection and untreated disease may result in irreparable joint injury, impaired physical function, and a significantly reduced quality of life. Recent epidemiologic studies have also supported that psoriatic arthritis is associated with cardiometabolic and cerebrovascular comorbidities, including coronary heart disease, diabetes mellitus, hypertension, dyslipidemia, and cerebrovascular accidents, further highlighting the importance of identifying affected patients. Dermatologists are poised for the early detection of psoriatic arthritis, as psoriasis predates its development in as many as 80% of patients. In an effort to further acquaint dermatologists and other clinicians with psoriatic arthritis, this review provides a detailed overview, emphasizing its salient clinical features, and discusses classification criteria, validated screening tools, and simple musculoskeletal examination maneuvers that may facilitate earlier detection and treatment of the disorder.

15 Review Psoriasis and Psoriatic Spectrum Disease: A Primer for the Primary Care Physician. 2018

Bilal, Jawad / Malik, Saad Ullah / Riaz, Irbaz Bin / Kurtzman, Drew J B. ·Department of Medicine, University of Arizona, Tucson. Electronic address: jawad.bilal@hotmail.com. · Department of Medicine, University of Arizona, Tucson. · Department of Medicine, Mayo Clinic, Rochester, Minn. · Complex Medical Dermatology Clinic, St. Elizabeth Physicians, Florence, Ky. ·Am J Med · Pubmed #29864415.

ABSTRACT: Psoriasis is a chronic, immune-mediated disorder that affects approximately 7.5 million people in the United States. Individuals with psoriasis may develop cutaneous, articular, and systemic manifestations, which are a source of significant morbidity and a heightened risk of mortality, and may adversely impact patient-reported quality of life measures. Psoriasis is now recognized as a risk factor for cardiovascular disease, metabolic syndrome, peripheral vascular disease, inflammatory bowel disease, certain malignancies, and chronic renal disease. Therefore, it has become increasingly relevant that primary care physicians have a basic working knowledge and an understanding of fundamental management principles of psoriasis. This review highlights the salient clinical features of psoriasis and psoriatic spectrum disease, emphasizing key updates with respect to systemic disease and associated conditions, and briefly outlines a therapeutic algorithm for the primary care physician.

16 Review Dactylitis: A hallmark of psoriatic arthritis. 2018

Kaeley, Gurjit S / Eder, Lihi / Aydin, Sibel Z / Gutierrez, Marwin / Bakewell, Catherine. ·University of Florida College of Medicine, 653-1 West 8th St., LRC 2nd Floor L-14, Jacksonville, FL 32209. Electronic address: Gurjit.Kaeley@jax.ufl.edu. · Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, Canada. · University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. · Division of Musculoskeletal and Rheumatic Diseases, Instituto Nacional de Rehabilitación, Mexico City, Mexico. · Intermountain Healthcare, Salt Lake City, UT. ·Semin Arthritis Rheum · Pubmed #29573849.

ABSTRACT: OBJECTIVE: Dactylitis-long considered a hallmark clinical feature of psoriatic arthritis (PsA)-occurs in 16-49% of patients with PsA. In this review, we discuss the pathology of dactylitis in PsA and clinical and imaging tools used to diagnose and monitor dactylitis. METHODS: PubMed literature searches were conducted using the terms psoriatic arthritis, dactylitis, pathology, imaging, ultrasound, magnetic resonance imaging, clinical, and indices. Articles were deemed relevant if they provided insight into the pathology, diagnosis, and/or monitoring of dactylitis in PsA, or if they discussed clinical or imaging indices used to assess dactylitis. RESULTS: Dactylitis in PsA often occurs asymmetrically, involves the feet more than the hands, and affects multiple digits simultaneously. Although dactylitis can be assessed clinically, imaging (radiography, ultrasound, magnetic resonance imaging, and bone scintigraphy) has provided key insights by documenting the various anatomic targets affected. Although inflammation can occur in most of the digital compartments, the nail has not been as well studied in dactylitic digits. Outcome measures for dactylitis range from dichotomous documentation to the Leeds dactylometer. Imaging outcome tools utilizing magnetic resonance imaging or ultrasound are under development. CONCLUSION: Dactylitis, which is associated with more erosive forms of PsA, is often the inaugural feature of PsA and may be the only feature for months to years. Early diagnosis and treatment of PsA favors better outcomes, possibly mitigating radiographic progression and destructive changes. Ultrasound and magnetic resonance imaging are useful tools that have not only shed light on the diverse tissues affected in dactylitis but can also be used to document ongoing inflammation. Ultrasound imaging dactylitis scores are being developed that will assist in diagnosing and documenting which compartments optimally respond to various treatment modalities.

17 Review A systematic review and meta-analysis of the efficacy and safety of the interleukin (IL)-12/23 and IL-17 inhibitors ustekinumab, secukinumab, ixekizumab, brodalumab, guselkumab and tildrakizumab for the treatment of moderate to severe plaque psoriasis. 2018

Bilal, Jawad / Berlinberg, Adam / Bhattacharjee, Sandipan / Trost, Jaren / Riaz, Irbaz Bin / Kurtzman, Drew J B. ·a Department of Medicine , University of Arizona , Tucson , AZ , USA. · b Department of Pharmacy Practice and Science , College of Pharmacy, University of Arizona , Tucson , AZ , USA. · c Department of General Internal Medicine , University of Arizona , Tucson , AZ , USA. · d Division of Dermatology , University of Arizona , Tucson , AZ , USA. ·J Dermatolog Treat · Pubmed #29532693.

ABSTRACT: OBJECTIVE: To systematically analyze the efficacy and safety of interleukin (IL)-12/23, IL-17, and selective IL-23 inhibitors in moderate to severe plaque psoriasis. METHODS AND RESULTS: Twenty-four randomized placebo-controlled trials were included. Compared to placebo, risk ratios (RR) of achieving PASI-75 and PGA/IGA 0/1 respectively were 20.20 (95% CI 13.82-29.54, p < .00001) and 14.55 (10.42-20.31, p < .00001) for ustekinumab 90 mg, 13.75 (8.49-22.28, p < .00001) and 9.81 (5.70-16.89, p < .00001) for ustekinumab 45 mg, 17.65 (12.38-25.17, p < .00001) and 26.13 (16.05-42.53, p < .00001) for secukinumab 300 mg, 15.36 (10.76-21.94, p < .00001) and 20.91 (12.82-34.13, p < .00001) for secukinumab 150 mg, 18.22 (10.63-31.23, p < .000001) and 18.82 (10.36-34.16, p < .00001) for ixekizumab 80 mg every 4 weeks, 19.83 (11.07-35.52, p < .00001) and 20.41 (11.01-37.81, p < .00001) for ixekizumab 80 mg every 2 weeks, 14.79 (9.86-22.16, p < .00001) and 21.93 (15.52-31.01, p < .00001) for brodalumab 210 mg, 11.55 (7.77-17.18, p < .00001) and 16.59 (11.72-23.49, p < .00001) for brodalumab 140 mg, 12.40 (8.87-17.34, p < .00001) and 10.84 (7.91-14.85, p < .00001) for guselkumab 100 mg, 11.45 (7.45-17.58, p < .00001) and 10.97 (6.44-18.69, p < .00001) for tildrakizumab 200 mg, 11.02 (7.17-16.93, p < .00001) and 10.03 (6.45-15.59, p < .00001) for tildrakizumab 100 mg. Similar outcomes were seen for PASI-90. Safety was satisfactory for each therapy at any dose, but a slightly increased risk of withdrawal due to toxicity was observed in individuals receiving ixekizumab compared to placebo. CONCLUSION: Ustekinumab, secukinumab, ixekizumab, brodalumab, guselkumab, and tildrakizumab were highly efficacious and generally well-tolerated when used as treatments for moderate to severe plaque psoriasis.

18 Review Treatment preferences and treatment satisfaction among psoriasis patients: a systematic review. 2018

Florek, Aleksandra G / Wang, Catherine J / Armstrong, April W. ·University of Colorado Denver School of Medicine, Denver, CO, USA. · Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. · Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. aprilarmstrong@post.harvard.edu. · University of Southern California, Los Angeles, CA, USA. aprilarmstrong@post.harvard.edu. ·Arch Dermatol Res · Pubmed #29442137.

ABSTRACT: A critical gap exists in determining treatment preferences and treatment satisfaction from patient perspectives, which is paramount to achieving therapeutic success. The objective of this systematic review is to determine factors influencing treatment preferences and treatment satisfaction among psoriasis patients. PubMed, EMBASE, and Web of Science databases were searched between November 1, 2010, and December 1, 2017. Observational and interventional research studies published in the English language that discussed patient preferences and patient satisfaction in the treatment of psoriasis were reviewed and synthesized. We utilized data on treatment preferences and treatment satisfaction from 35,388 psoriasis patients based on 60 articles from the years 2010 to 2017. Treatment preferences were heterogeneous and changed over time among psoriasis patients. Across all treatment modalities, the most important treatment attributes were treatment location, probability of improvement, and delivery method. For biologics specifically, the most important attributes were risk of adverse events and probability of treatment benefit. Factors that influenced patients' preferences for certain treatments included age, sex, comorbidities, disease duration, and prior treatments. Notably, some psoriasis patients placed higher importance on a treatment's process attributes (e.g., access and delivery) over its outcome attributes (e.g., efficacy). Overall, patient satisfaction with existing therapies remains modest; however, those treated with biologic agents exhibited highest treatment satisfaction over oral therapy, phototherapy, and topical therapy.

19 Review Enthesitis: A hallmark of psoriatic arthritis. 2018

Kaeley, Gurjit S / Eder, Lihi / Aydin, Sibel Z / Gutierrez, Marwin / Bakewell, Catherine. ·Division of Rheumatology, University of Florida College of Medicine, Jacksonville, 653-1 West 8th St., LRC 2nd Floor L-14, Jacksonville, FL, 32209. Electronic address: Gurjit.Kaeley@jax.ufl.edu. · Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, Canada. · University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. · Division of Musculoskeletal and Rheumatic Diseases, Instituto Nacional de Rehabilitación, Mexico City, Mexico. · Intermountain Healthcare, Salt Lake City, UT. ·Semin Arthritis Rheum · Pubmed #29429762.

ABSTRACT: OBJECTIVE: To describe the growing importance of enthesitis in patients with psoriatic arthritis (PsA) and discuss the advantages and disadvantages of clinical and imaging methods currently used to assess enthesitis. METHODS: PubMed literature searches were conducted using the terms psoriatic arthritis, entheses, enthesitis, pathology, imaging, ultrasound, magnetic resonance imaging, clinical, and indices. Articles were deemed relevant if they provided insight into the pathology, monitoring, and/or diagnosis of enthesitis in PsA, or if they discussed clinical or imaging indices used to assess enthesitis. RESULTS: Enthesitis is an early manifestation of PsA that is associated with increased disease activity and reduced quality of life. A variety of clinical indices exist to assess enthesitis in PsA; however, the Leeds Enthesitis Index and Maastricht Ankylosing Spondylitis Enthesitis Score index have been the most frequently used indices in recent clinical trials. Limitations of these indices include an inability to discern structural involvement, risk of missing subclinical enthesitis, and lack of sensitivity in detecting enthesitis, especially in patients with central sensitization and/or pain amplification. Such limitations have led to the emergent importance of imaging techniques in the assessment of enthesitis. Although there have been recent advances in magnetic resonance imaging, ultrasound (US) appears to be the preferred method for detecting enthesitis because it allows for accurate assessment of the soft-tissue components of entheses and also for new bone formation. Hypoechogenicity, increased thickness of tendon insertion, calcifications, enthesophytes, erosions, and Doppler activity have been identified as important US characteristics of enthesitis. CONCLUSION: Enthesitis is thought to be integrally involved in the pathogenesis of PsA and is associated with worse prognostic outcomes in patients with PsA. A validated US index with entheses that are less confounded by mechanical factors and obesity would be the most effective measure of enthesitis in PsA. As imaging techniques continue to advance, our understanding of enthesitis and its involvement in PsA will also improve.

20 Review A Practical Guide About Tattooing in Patients with Chronic Skin Disorders and Other Medical Conditions. 2018

Kluger, Nicolas / De Cuyper, Christa. ·Dermatology, Venereology, Allergology, Skin and Allergies Hospital, University of Helsinki and Helsinki University Central Hospital, Meilahdentie 2, PO Box 160, 00029, Helsinki, Finland. nicolas.kluger@hus.fi. · «Tattoo» Consultation, Department of Dermatology, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris, 46 rue Henri Huchard, 75877, Paris Cedex 18, France. nicolas.kluger@hus.fi. · Department of Dermatology, AZ Sint-Jan Brugge-Oostende AV, 8000, Brugge, Belgium. ·Am J Clin Dermatol · Pubmed #28993993.

ABSTRACT: With tattoos becoming increasingly mainstream, dermatologists are more and more often consulted by patients who are considering getting an ornamental, cosmetic, or even a medical tattoo, and who subsequently ask for advice. This includes not only patients with chronic skin diseases such as psoriasis or atopic dermatitis but also patients with other medical conditions. This review first explores the reasons why patients may want to get a tattoo and aims to offer some key information to dermatologists on what they should know about tattooing and the main risks associated with this procedure. Second, the risks and recommendations of tattooing in patients with specific skin diseases are described more in detail, and the relative and strict contraindications discussed, including the necessity to discontinue certain treatments that could influence the outcome of the procedure and the final result. Our aim was to provide dermatologists with the current knowledge they need to help their patients make adequate and informed choices on skin art, focusing specifically on considerations in patients with chronic skin conditions. Finally, other aspects regarding some general systemic conditions and concomitant diseases that the patient could present are also addressed. In particular, the risks of tattooing in patients with diabetes, coagulation disorders, heart conditions, immunosuppressive treatments, and pregnancy are discussed.

21 Review The immunology of atopic dermatitis and its reversibility with broad-spectrum and targeted therapies. 2017

Brunner, Patrick M / Guttman-Yassky, Emma / Leung, Donald Y M. ·Laboratory for Investigative Dermatology, Rockefeller University, New York, NY. · Department of Dermatology and Laboratory for Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, NY. · Department of Pediatrics, National Jewish Health, Denver, Colo. Electronic address: leungd@njhealth.org. ·J Allergy Clin Immunol · Pubmed #28390479.

ABSTRACT: Atopic dermatitis (AD), the most common chronic inflammatory skin disease, is driven by both terminal keratinocyte differentiation defects and strong type 2 immune responses. In contrast to chronic plaque-type psoriasis, AD is now understood to be a much more heterogeneous disease, with additional activation of T

22 Review New Uses of AbobotulinumtoxinA in Aesthetics. 2017

Schlessinger, Joel / Gilbert, Erin / Cohen, Joel L / Kaufman, Joely. ·Dermatologist and cosmetic surgeon in private practice in Omaha, NE, USA. · Dermatologist in private practice in Brooklyn, NY, USA. · Dermatologist in private practice in Greenwood Village, CO, USA. · Dermatologist in private practice in Miami, FL, USA. ·Aesthet Surg J · Pubmed #28388720.

ABSTRACT: BotulinumtoxinA (BoNT-A) is now widely established for the main approved indication of reducing glabellar lines, and is also widely used off-label to improve the appearance of wrinkles and lines in other parts of the face. The number of aesthetic procedures continues to increase as the patient population becomes more diverse, in particular with increasing numbers of people of color and men. Further developments in treatment may continue to expand the audience for BoNT-A by making procedures more comfortable and by delivering a more natural, less static appearance. These may be achieved through use of combinations of BoNT-A with other aesthetic procedures, tailoring the dose of toxin to the patient's muscle mass or by using novel injection and application techniques. Beyond amelioration of facial lines, encouraging results have been seen with the use of BoNT-A to improve the appearance of hypertrophic and keloid scars and even to prevent them. Studies have been conducted with scars in various parts of the body and further research is ongoing. Dermatological and other medical uses for BoNT-A are also active areas of research. Injections of BoNT-A have been shown to reduce signs and symptoms of acne, rosacea, and psoriasis, to reduce neuromuscular pain, and to bring about significant improvements in a number of rare diseases that are caused or exacerbated by hyperhidrosis. This paper reviews these new uses for BoNT-A, looking at the rationale for their use and discussing the results of published case studies and clinical trials. These areas have shown great promise to date, but more and larger clinical studies will be required before these treatments become a clinical reality. To this end details are also provided of clinical trials currently listed in the main clinical trials database to highlight research areas of particular interest.

23 Review From the Medical Board of the National Psoriasis Foundation: Treatment targets for plaque psoriasis. 2017

Armstrong, April W / Siegel, Michael P / Bagel, Jerry / Boh, Erin E / Buell, Megan / Cooper, Kevin D / Callis Duffin, Kristina / Eichenfield, Lawrence F / Garg, Amit / Gelfand, Joel M / Gottlieb, Alice B / Koo, John Y M / Korman, Neil J / Krueger, Gerald G / Lebwohl, Mark G / Leonardi, Craig L / Mandelin, Arthur M / Menter, M Alan / Merola, Joseph F / Pariser, David M / Prussick, Ronald B / Ryan, Caitriona / Shah, Kara N / Weinberg, Jeffrey M / Williams, MaryJane O U / Wu, Jashin J / Yamauchi, Paul S / Van Voorhees, Abby S. ·Keck School of Medicine, University of Southern California, Los Angeles, California. Electronic address: aprilarmstrong@post.harvard.edu. · National Psoriasis Foundation, Portland, Oregon. · Windsor Dermatology, East Windsor, New Jersey; University Medical Center of Princeton at Plainsboro, Plainsboro, New Jersey. · Tulane University School of Medicine, New Orleans, Louisiana. · University Hospitals Case Medical Center, Cleveland, Ohio. · University of Utah School of Medicine, Salt Lake City, Utah. · University of California, San Diego School of Medicine, La Jolla, California. · Northwell Health and Hofstra North Shore University Hospital, Long Island Jewish Medical Center School of Medicine, Manhasset, New York. · University of Pennsylvania, Philadelphia, Pennsylvania. · Tufts University School of Medicine, Boston, Massachusetts. · University of California San Francisco Medical Center, San Francisco, California. · Icahn School of Medicine at Mount Sinai, New York, New York. · St Louis University Medical School, St Louis, Missouri. · Northwestern University Feinberg School of Medicine, Chicago, Illinois. · Baylor University Medical Center and Texas A&M Health Science Center, Dallas, Texas. · Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. · Eastern Virginia Medical School, Norfolk, Virginia; Virginia Clinical Research Inc, Norfolk, Virginia. · George Washington University, Washington, District of Columbia. · Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. · Keck School of Medicine, University of Southern California, Los Angeles, California. · Kaiser Permanente Los Angeles Medical Center, Los Angeles, California. · Division of Dermatology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California. · Eastern Virginia Medical School, Norfolk, Virginia. ·J Am Acad Dermatol · Pubmed #27908543.

ABSTRACT: BACKGROUND: An urgent need exists in the United States to establish treatment goals in psoriasis. OBJECTIVE: We aim to establish defined treatment targets toward which clinicians and patients with psoriasis can strive to inform treatment decisions, reduce disease burden, and improve outcomes in practice. METHODS: The National Psoriasis Foundation conducted a consensus-building study among psoriasis experts using the Delphi method. The process consisted of: (1) literature review, (2) pre-Delphi question selection and input from general dermatologists and patients, and (3) 4 Delphi rounds. RESULTS: A total of 25 psoriasis experts participated in the Delphi process. The most preferred instrument was body surface area (BSA). The most preferred time for evaluating patient response after starting new therapies was at 3 months. The acceptable response at 3 months postinitiation was either BSA 3% or less or BSA improvement 75% or more from baseline. The target response at 3 months postinitiation was BSA 1% or less. During the maintenance period, evaluation every 6 months was most preferred. The target response at every 6 months maintenance evaluation is BSA 1% or less. LIMITATIONS: Although BSA is feasible in practice, it does not encompass health-related quality of life, costs, and risks of side effects. CONCLUSION: With defined treatment targets, clinicians and patients can regularly evaluate treatment responses and perform benefit-risk assessments of therapeutic options individualized to the patient.

24 Review The Challenge of Managing Psoriasis: Unmet Medical Needs and Stakeholder Perspectives. 2016

Feldman, Steven R / Goffe, Bernard / Rice, Gary / Mitchell, Matthew / Kaur, Mandeep / Robertson, Debbie / Sierka, Debra / Bourret, Jeffrey A / Evans, Tamara S / Gottlieb, Alice. ·Professor of Dermatology, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC. · Dermatologist, Dermatology Associates, and Division of Dermatology, University of Washington, Seattle. · Senior Vice President, Diplomat Specialty Pharmacy, Flint, MI. · Director, Pharmacy Services, SelectHealth, Murray, UT. · Senior Medical Director, Pfizer, Collegeville, PA. · Senior Director of Medical Affairs, Pfizer. · Director of Medical Affairs, Pfizer. · Senior Director, North America Medical Affairs, and Medical Lead, Specialty Payer & Channel Customer Strategy, Pfizer. · Field Medical Director, Pfizer, Indianapolis, IN. · Professor of Dermatology, Department of Dermatology, New York Medical College, Valhalla, NY. ·Am Health Drug Benefits · Pubmed #28465778.

ABSTRACT: BACKGROUND: Psoriasis is a debilitating chronic inflammatory autoimmune disease affecting approximately 7.4 million adults in the United States. Plaque psoriasis is the most common form, affecting 80% to 90% of patients. OBJECTIVES: To describe the impact and challenges that psoriasis presents for various stakeholders, and to provide nondermatologist healthcare decision makers with information to enhance their contributions to drug and pharmacy benefit design discussions. DISCUSSION: Psoriasis carries an increased risk for early mortality and an increased prevalence of comorbidities, including psoriatic arthritis, cardiovascular disease, and diabetes. It is also associated with anxiety, depression, and social isolation, and can negatively impact patients' relationships, productivity, and careers. The physical, psychologic, social, and economic impact of psoriasis, plus the associated stigma, result in cumulative impairment over a patient's lifetime. The current treatments for moderate-to-severe psoriasis include topical therapy, phototherapy, and systemic drugs (nonbiologic and biologic); however, patient satisfaction remains low, combination therapy and treatment switching are common, and many patients remain untreated or undertreated. Clinicians should consider the patient holistically, and should select treatment based on a range of factors, including disease severity (with physical and psychosocial manifestations), susceptibility to cumulative life-course impairment (considering personality, behavior, and cognition), comorbidities, concomitant medication, and patient preference. It is estimated that the total annual direct cost of treating psoriasis in the United States in 2015 exceeded $12.2 billion. CONCLUSION: Psoriasis is a complex disease, and appropriate management is correspondingly complex. Newer psoriasis treatments provide improved efficacy and safety versus traditional treatments, but challenges remain in ensuring patients access to these medications. An improved understanding of the barriers to appropriate treatment is needed, as well as clear and accessible information for payers and clinicians on current treatment options, to ensure that decision makers can control costs while providing patients with optimal care.

25 Review Lipoprotein Metabolism and Inflammation in Patients With Psoriasis. 2016

Armstrong, Ehrin J / Krueger, James G. ·Division of Cardiology, University of Colorado School of Medicine, Denver, Colorado. Electronic address: ehrin.armstrong@gmail.com. · Laboratory of Investigative Dermatology, The Rockefeller University, New York, New York. ·Am J Cardiol · Pubmed #27392508.

ABSTRACT: Psoriasis is a chronic inflammatory disease associated with a variety of co-morbid conditions, including cardiovascular disease. Advancements in our understanding of the cellular and molecular mechanisms of psoriasis have led to a better understanding regarding its pathogenesis, which in turn has stimulated ongoing research to identify the underlying pathophysiology responsible for the increased risk of cardiovascular events associated with psoriasis. Although not yet fully elucidated, emerging evidence points to immune-mediated inflammation as a process that contributes to endothelial cell dysfunction, dyslipidemia, and atherosclerosis as key processes influencing cardiovascular disease in psoriasis. In particular, the dyslipidemia present in psoriasis may be associated with altered lipoprotein function and increased atherogenicity. Here, we review how the cytokine networks involved in lipoprotein metabolism and inflammation could impact on the cardiovascular disease risk for patients with psoriasis.

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