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Medicina
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Diagnosis and Management of Psoriasis
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Diagnosis and Management of Psoriasis

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Dermatology".

Deadline for manuscript submissions: closed (1 November 2020) | Viewed by 8814

Special Issue Editors

Prof. Dr. Jorge Santos-Juanes

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Guest Editor
Department of Dermatology, University of Oviedo, Oviedo, Spain
Interests: dermatopathology; skin cancer; dermoscopy; dermatology
Prof. Dr. Francisco Vázquez López

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Guest Editor
Department of Dermatology, University of Oviedo, Oviedo, Spain
Interests: skin cancer nonmelanoma; dermoscopy; inflammatory skin diseases; psoriasis; cutaneous semiology
Dr. Cristina Galache Osuna

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Guest Editor
Department of Dermatology, Hospital Universitario Central de Asturias, Oviedo, Spain
Interests: psoriasis; psoriasis treatment; skin cancer nonmelanoma; cancer; merkel cell carcinoma

Special Issue Information

Dear Colleagues,

Psoriasis (Ps) is an autoimmune, chronic inflammatory skin disease affecting around a total of 2% of the general population in Europe and North America. Ps is associated with increased risk for comorbidities, including Ps arthritis, cardiovascular disease, diabetes mellitus, obesity, inflammatory bowel disease, and nonalcoholic fatty liver disease, compared with the general population. Currently, Ps is considered a systemic disease. For decades, the treatment of Ps has been directed toward the improvement of skin manifestations with topical preparations, phototherapy, and systemic medications. The introduction of monoclonal antibodies (biological drugs) that selectively block proinflammatory cytokines has revolutionized the treatment of Ps and other immune-mediated inflammatory diseases. Prospective studies are needed to provide the role of biologic agents in treating systemic inflammation associated with Ps. In the same way, studies are necessary to know which the best biological treatment for each patient is. Given the importance of Ps in the field of medicine and research, the journal Medicina is launching this Special Issue. The purpose of this Special issue is to update knowledge on diagnosis, Ps comorbidities, and treatments of Ps. These new advances in understanding will be evidenced by the submission of original work or a review to this Special Issue.

Prof. Dr. Jorge Santos-Juanes
Prof. Dr. Francisco Vázquez López
Dr. Cristina Galache Osuna
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Psoriasis
  • Psoriasis diagnosis
  • Psoriasis treatment
  • Psoriasis biologics
  • Psoriasis comorbidities
  • Psoriasis review

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Published Papers (3 papers)

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Research

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11 pages, 719 KiB  
Article
Ustekinumab Drug Survival in Patients with Psoriasis: A retrospective Study of Real Clinical Practice
by Cristina Galache Osuna, Borja Gómez-Vila, Javier Aubán Pariente, Beatriz Vázquez Losada, Celia Gómez de Castro, Sheila Requena López, Álvaro de Dios Velázquez, Laura Palacios García, Lucía Ordoñez Fernández, Santiago Gómez Diez, Francisco Vázquez López and Jorge Santos-Juanes
Medicina 2020, 56(11), 584; https://doi.org/10.3390/medicina56110584 - 30 Oct 2020
Cited by 8 | Viewed by 2574
Abstract
Background and objectives: The efficacy and safety of ustekinumab have been proved in clinical trials. In daily clinical practice, knowing the factors that determine survival differences of biological drugs allows psoriasis treatment to be optimized as a function of patient characteristics. The main [...] Read more.
Background and objectives: The efficacy and safety of ustekinumab have been proved in clinical trials. In daily clinical practice, knowing the factors that determine survival differences of biological drugs allows psoriasis treatment to be optimized as a function of patient characteristics. The main objectives of this work are to understand ustekinumab drug survival in patients diagnosed with plaque psoriasis in the Hospital Universitario Central de Asturias (HUCA Dermatology Department, and to identify the predictors of drug discontinuation. Materials and Methods: A retrospective hospital-based study, including data from 148 patients who were receiving ustekinumab (Stelara®) between 1 February 2009 and 30 November 2019, were collected. Survival curves were approximated through the Kaplan–Meier estimator and compared using the log-rank test. Proportional hazard Cox regression models were used for multivariate analyses while both unadjusted and adjusted hazard ratios (HR) were used for summarizing the studied differences. Results: The average duration of the treatment before discontinuation was 47.57 months (SD 32.63 months; median 41 months). The retention rates were 82% (2 years), 66% (5 years), and 58% (8 years). Median survival was 80 months (95% confidence interval. CI 36.9 to 123.01 months). The survival study revealed statistically significant differences between patients with arthritis (log-rank test, p < 0.001) and those who had previously received biological treatment (log-rank test, p = 0.026). The five-year prevalence in patients still under treatment was 80% (those without arthritis) and 54% (arthritis patients). In the multivariate analysis, only the patients with arthritis had a lower rate of drug survival. No statistically significant differences were observed for any of the other comorbidities studied. The first and second most frequent causes of discontinuation were secondary failure and arthritis inefficacy, respectively. Conclusion: Ustekinumab is a biological drug conferring high survival in plaque psoriasis patients. Ustekinumab survival is lower in patients with arthritis. Full article
(This article belongs to the Special Issue Diagnosis and Management of Psoriasis)
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9 pages, 312 KiB  
Article
The Number of Traditional Cardiovascular Risk Factors Is Independently Correlated with Disease Activity in Patients with Psoriatic Arthritis
by Iván Ferraz-Amaro, Diana Prieto-Peña, Natalia Palmou-Fontana, David Martínez-López, Laura de Armas-Rillo, Alicia García-Dorta, Belén Atienza-Mateo, Ricardo Blanco, Susana Armesto and Miguel Á. González-Gay
Medicina 2020, 56(8), 415; https://doi.org/10.3390/medicina56080415 - 18 Aug 2020
Cited by 9 | Viewed by 2319
Abstract
Background and objectives: Psoriatic arthritis (PsA) is associated with several comorbidities, including among others an increased risk of cardiovascular (CV) disease, atherosclerosis, metabolic syndrome, hypertension dyslipidemia, and diabetes. The purpose of the present study was to determine how the number of CV risk [...] Read more.
Background and objectives: Psoriatic arthritis (PsA) is associated with several comorbidities, including among others an increased risk of cardiovascular (CV) disease, atherosclerosis, metabolic syndrome, hypertension dyslipidemia, and diabetes. The purpose of the present study was to determine how the number of CV risk factors correlates with disease related data such as disease activity. Materials and Methods: Cross-sectional study that encompassed 305 patients who fulfilled the CASPAR criteria for PsA were assessed for lipid profile, disease activity measurements, and the presence of six traditional CV risk factors (diabetes mellitus, dyslipidemia, hypertension, obesity, chronic kidney disease, and smoking status). A multivariable regression analysis, adjusted for age, sex, and disease duration, was performed to evaluate if the number of classic CV risk factors was independently related with specific features of the disease, including disease activity. Results: Disease duration was found to be higher, after adjustment for age and sex, in patients with 1 or 2, and 3 or higher CV factors, compared to those patients without CV risk factors. Similarly, DAPSA (Disease Activity in PSoriatic Arthritis score) was found to be independently upregulated in patients with a higher number of CV risk factors. In this sense, as DAPSA score increases the odds ratio (OR) of having 1 or 2 (OR 1.12 (95% confidence interval (CI) 1.03–1.21), p = 0.010), and 3 or higher (OR 1.15 (95% CI 1.04–1.26), p = 0.004) CV factors was significantly higher compared to no CV risk factors category. This was independently found after adjustment for age, sex, and disease duration. Conclusions: PsA patients with a higher number of CV risk factors exhibit an upregulated disease activity compared to those without them. This is independent of disease duration and other demographics factors. Full article
(This article belongs to the Special Issue Diagnosis and Management of Psoriasis)

Review

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13 pages, 357 KiB  
Review
Pharmacogenetics Update on Biologic Therapy in Psoriasis
by Ester Muñoz-Aceituno, Luisa Martos-Cabrera, María Carmen Ovejero-Benito, Alejandra Reolid, Francisco Abad-Santos and Esteban Daudén
Medicina 2020, 56(12), 719; https://doi.org/10.3390/medicina56120719 - 20 Dec 2020
Cited by 13 | Viewed by 3447
Abstract
Background and objectives: Psoriasis is a chronic immune-mediated skin disease caused by several complex factors, both environmental and genetic, many of which are still not fully understood. Nowadays, several groups of biological drugs are being used for psoriasis treatment. Although these therapies are [...] Read more.
Background and objectives: Psoriasis is a chronic immune-mediated skin disease caused by several complex factors, both environmental and genetic, many of which are still not fully understood. Nowadays, several groups of biological drugs are being used for psoriasis treatment. Although these therapies are very effective, they show significant variability in efficacy among individuals. Therefore, there is a need for biomarkers to predict treatment outcomes in order to guide personalized therapeutic decisions. Pharmacogenetics is the study of variations in DNA sequences related to drug response. Materials and Methods: In this article, we review pharmacogenetics studies on the treatment of moderate-to-severe psoriasis focusing on anti-interleukin (IL) 12/23 (ustekinumab) and anti-IL17 drugs (secukinumab and ixekizumab), as well as recent studies concerning anti-TNF drugs. Results: Several polymorphisms have been studied over the years in reference to anti-TNF drugs; some of the most recent studies included the performance of a genome-wide association study (GWAS) and pharmacogenetics studies focused on the optimization of a treatment regimen. Various polymorphisms in different genes have been related to ustekinumab response; among them, the most commonly studied is the HLA-C*06:02 allele. Conclusions: Although not confirmed in some studies, most studies have shown that patients carrying this allele present a significantly higher response rate to ustekinumab. Some polymorphisms have been studied in patients treated with anti-IL17 drugs, mostly related to secukinumab; however, up to now, no association has been found between any of these polymorphisms and response. Nevertheless, further studies involving larger cohorts are needed in order to confirm these results before the implementation of this biomarker in clinical practice. Full article
(This article belongs to the Special Issue Diagnosis and Management of Psoriasis)
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