E.M.G.J. de Jong

Psoriasis of the nails associated with disability in a large number of patients : Results of a recent interview with 1,728 patients

BACKGROUND AND OBJECTIVE Occurrence rates of clinical features of nail psoriasis vary considerably in the literature. Little information is available on subjective complaints of patients affected by psoriasis of the nails. METHOD Interviews with 1,728 psoriatic patients concerning their nail changes and complaints are reviewed. RESULTS The results indicate that pitting and deformation are the most common clinical aberrations in psoriatic nails, with a positive association between the duration of skin lesions and nail psoriasis. No relation was found between age and nail psoriasis in this group. Remarkably, 51.8% of patients suffered from pain-caused by the nail changes, and a large group of patients was restricted in their daily activities, housekeeping and/or profession (58.9, 56.1, 47.9%). Treatment was disappointing: only 19.3% showed marked improvement during treatment. CONCLUSION This indicates that psoriasis of the nails is a more important individual and social-economic problem than previously assumed and that development of new treatments is needed.

European S3-Guidelines on the systemic treatment of psoriasis vulgaris - Update 2015 - Short version - EDF in cooperation with EADV and IPC

European S3-Guidelines on the systemic treatment of psoriasis vulgaris – Update 2015 – Short version – EDF in cooperation with EADV and IPC A. Nast,* P. Gisondi, A.D. Ormerod, P. Saiag, C. Smith, P.I. Spuls, P. Arenberger, H. Bachelez, J. Barker, E. Dauden, E.M. de Jong, E. Feist, A. Jacobs, R. Jobling, L. Kem eny, M. Maccarone, U. Mrowietz, K.A. Papp, C. Paul, K. Reich, S. Rosumeck, T. Talme, H.B. Thio, P. van de Kerkhof, R.N. Werner, N. Yawalkar Division of Evidence Based Medicine, Department of Dermatology, Charit e – Universit€ atsmedizin Berlin, Berlin, Germany Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy Department of Dermatology, Aberdeen Royal Infirmary, Aberdeen, UK Service de Dermatologie, Hôpital Ambroise Par e Universit e Paris V, Boulogne, France Clinical Lead for Dermatology, St Johns Institute of Dermatology, St Thomas’ Hospital, London, UK Department of Dermatology, Academic Medical Center, Amsterdam, The Netherlands Third Faculty of Medicine, Department of Dermatology, Charles University, Prague, Czech Republic Department of Dermatology, Hôpital Saint-Louis, Paris, France St. Johns Institute of Dermatology, St. Thomas’ Hospital, London, UK Hospital Universitario de la Princesa, Madrid, Spain University Medical Center Nijmegen St Radboud, Nijmegen, The Netherlands Medizinische Klinik mit Schwerpunkt Rheumatologie u. klinische Immonologie, Charit e – Universit€atsmedizin Berlin, Berlin, Germany Cambridge, UK SZTE Borgyogyaszati Klinika, Szeged, Hungary Roma, Italy Department of Dermatology, Psoriasis-Center University Medical Center Schleswig Holstein, Kiel, Germany Waterloo, Canada Department of Dermatology, Paul Sabatier University, Toulouse, France Dermatologikum Hamburg, Hamburg, Germany Section of Dermatology and Venereology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden Department of Dermatology, Erasmus University, Rotterdam, The Netherlands Department of Dermatology, University Hospital Nijmegen, Nijmegen, The Netherlands Department of Dermatology, Inselspital, Universit€ atsklinik f€ ur Dermatologie, Bern, Switzerland *Correspondence: A. Nast. E-mail: alexander.nast@charite.de Received: 22 June 2015; Accepted: 7 July 2015

Memory effector (CD45RO+) and cytotoxic (CD8+) T cells appear early in the margin zone of spreading psoriatic lesions in contrast to cells expressing natural killer receptors, which appear late

Background  An influx of immunocytes, increased epidermal proliferation and abnormal keratinization are hallmarks of the psoriatic lesion. T‐lymphocyte subsets in particular activated effector memory T cells and natural killer (NK) T cells have been suggested to play an important role in the pathogenesis of psoriasis.

Three-year registry data on biological treatment for psoriasis: the influence of patient characteristics on treatment outcome

Background  The course of biological treatment in clinical practice may be highly different from treatment schedules in clinical trials. Treatment modifications and patient characteristics may influence treatment safety and efficacy. So far, long‐term results from the use of biological treatment in clinical practice are lacking.

Keratin 17: a useful marker in anti-psoriatic therapies.

The investigation of changes that take place during development or therapeutical regression of psoriatic lesions can give us a clearer insight into processes that are of importance in the pathogenesis and treatment of this disease. In previous studies, different parameters have been used to investigate increased epidermal cell proliferation and disturbed differentiation in psoriasis. The histological appearance [6, 10, 11], percentage of cells in SG2Mphase [1], incorporation of 3H-thymidine [2], or BrdUrd [13], Ki-67-staining [3, 13], and upor down-regulation of distinct keratins [7] have been used as parameters. The aim of the present study was to investigate further the effect of anti-psoriatic therapies on keratin expression in human epidermis. In psoriasis, keratins are expressed that are only found in small amounts or not at all in normal human skin. Also down-regulation of keratins that are related to differentiation takes place [14]. Assessing the amount of keratin numbers 2, 10, 16 and 18 in psoriatic skin has proved to be a useful approach in monitoring therapies. Keratin 16, especially, correlates well with progression or regression of the lesions [4, 7]. Keratin 17 is not present in normal human epidermis; it is restricted to the lower part of the outer root sheath of the hair follicle, and to myoepithelial cells of the sebaceous gland. It is expressed by basal cell carcinomas, which has led to the hypothesis that basal cell carcinomas have a follicular origin [8, 12]. A correlation of keratin 17 expression and hyperproliferation has also previously been suggested [8, 12]. Recently the expression of keratin 17 has been shown in lesional psoriatic epidermis of the scalp [16]. In this study the presence and localization of keratin 17 in psoriatic lesions was investigated further and the

How stress gets under the skin: cortisol and stress reactivity in psoriasis

Background  Psychological stressors might contribute to the severity of chronic inflammatory diseases such as psoriasis by dysregulating hypothalamic–pituitary–adrenal (HPA) axis activity.

A consensus report on appropriate treatment optimization and transitioning in the management of moderate-to-severe plaque psoriasis.

There is limited information on systemic and biological treatment optimization and transitioning in routine clinical practice.

The Impact of Chronic Skin Disease on Daily Life (ISDL): a generic and dermatology-specific health instrument

Background  In dermatological research and clinical practice, there is a need for comprehensive self‐report instruments that assess a broad spectrum of health implications of chronic skin diseases, including generic and skin‐specific aspects of disease‐related quality of life. The advantages of dermatology‐specific, multidimensional instruments over generic instruments or single‐dimensional quality‐of‐life measures are in the detailed and specific information they provide about health areas that are affected by the skin condition and that may change through therapeutic intervention.

Etanercept combined with methotrexate for high-need psoriasis.

Background  For some high‐need psoriatic patients, the efficacy of etanercept monotherapy is insufficient. In these cases it might be indicated to combine etanercept with other conventional treatments.

Effectiveness, side-effects and period of remission after treatment with methotrexate in localized scleroderma and related sclerotic skin diseases: an inception cohort study.

Background  Detailed information is lacking on effectiveness of methotrexate (MTX) in sclerotic skin diseases, side‐effects, and duration of remission after discontinuation.