For over 50 years, health systems the world over have failed people with type 2 diabetes mellitus (T2DM). The WHO documents a quadrupling of people with diabetes in a 34-year period to 422 million in 2014, the overwhelming majority of whom were T2DM. This happened despite extensive scientific literature on the causes of, as well as proven treatments for, this disease. Using a health systems prism to review the extensive medical and nutritional T2DM published research, we identified three main shortcomings of health systems in T2DM: (i) failure in early detection; (ii) failure in understanding the actionable lifestyle drivers; and (iii) subsidizing the causes of the disease. Although small-scale success stories in T2DM control exist, the lack of documented evidence of any country-wide health system's successful attempt to address this epidemic is alarming. The immense and ever-growing health and economic burdens of T2DM should provide all the motivation needed for national and global efforts to counteract the political-economy constraints standing in the way of successful whole-of-system approaches to T2DM.

The occurrence of comorbid metabolic syndrome and psoriasis (MS-P) is owing to the complex interplay between metabolic dysregulation and inflammatory responses. However, current treatments have shown limited efficacy in improving the symptoms of both conditions simultaneously.

This study aimed to investigate the therapeutic efficacy of Fufang Longdan Mixture (FLM) in treating MS-P comorbidity, elucidate its mechanism through the miR-29a-5p/IGF-1R axis and evaluate treatment responses between APOE-/- and C57BL/6 mice.

UPLC-Q-exactive-MS/MS analysis was used to characterise FLM's chemical composition. Metabolic syndrome was induced in APOE-/- and C57BL/6 mice using a high-fat, high-sugar diet, while psoriasis-like lesions were induced in the mice via the administration of imiquimod. The mice were randomised into control, model, Yinxieling (8 g/kg/d) and FLM (0.5 mL/d) groups. We assessed the treatment efficacy through metabolic parameters, hematoxylin and eosin (H&E) staining and inflammatory cytokine profiling. The direct targeting of IGF-1R by miR-29a-5p was verified via dual-luciferase reporter assays. We analysed the expression patterns and interactions of miR-29a-5p/IGF-1R using RT-qPCR, Western blotting and fluorescence in situ hybridisation.

Chemical analysis identified 2,665 compounds in FLM, which were predominantly shikimates and phenylpropanoids (32%), alkaloids (20%) and terpenoids (13%). FLM significantly improved metabolic parameters in MS-P mice, including fasting glucose levels, insulin resistance indices and lipid profiles (p < 0.05), with more pronounced effects observed in the C57BL/6 mice (p < 0.05). FLM demonstrated superior metabolic regulatory effects compared with Yinxieling (p < 0.05). The treatment significantly reduced Psoriasis Area and Severity Index (PASI) scores and inhibited epidermal hyperplasia (p < 0.05). Furthermore, FLM suppressed the pro-inflammatory cytokines, such as GM-CSF, IFN-γ, IL-9 and IL-17, while elevating the anti-inflammatory IL-10 levels (p < 0.05). Dual-luciferase assays confirmed that IGF-1R is a direct target of miR-29a-5p. Mechanistic studies revealed that FLM upregulated miR-29a-5p expression while downregulating IGF-1R (p < 0.05), with evident co-localisation in lesional tissues.

Our findings demonstrate that FLM effectively ameliorates MS-P comorbidity through modulation of the miR-29a-5p/IGF-1R axis, showing significant therapeutic efficacy across different genetic backgrounds.

Metabolic syndrome (MetS) is a clinical syndrome associated with cardiovascular disease, diabetes, obesity, and dyslipidemia. Its primary features include dyslipidemia, hypertension, abdominal obesity, and insulin resistance (IR). Recently, research has revealed that MetS is not only a manifestation of internal metabolic disturbances but is also closely associated with various dermatological conditions, including inflammatory skin diseases, autoimmune skin diseases, and skin tumors. These studies have clarified the complex mechanisms underlying the interaction between MetS and these skin diseases, including IR, chronic inflammatory responses, and oxidative stress. This review summarizes the association between MetS and related dermatological conditions and their shared physiological mechanisms. It aims to provide clinicians with new therapeutic strategies and preventive measures to improve the treatment outcomes and quality of life of patients with skin conditions.

Tuberculosis (TB) is a socially significant disease caused by Mycobacterium tuberculosis. Latent TB represents a state of continuous immune response to stimulation by M tuberculosis and its antigens without the clinical signs of TB. Biologic agents could trigger latent TB into active TB, which is the reason why psoriasis patients should be screened for latent TB before initiating biologic therapy. The data of the efficacy of rifampicin in severe psoriasis patients treated for their coexisting active TB, along with the data of psoriasis remission after rifampicin therapy in subjects with no active TB, raise the question of whether there is a link between psoriasis and TB. There is also a question of the efficacy of the date from rifampicin, when used for treating patients having severe psoriasis as well as coexisting active TB. Is there a link between psoriasis and TB?

Psoriasis is a chronic inflammatory condition of the skin that can be related to a variety of other conditions, including cardiovascular disease and metabolic syndrome. Growth differentiation factor-15 (GDF-15) is a cytokine that reacts to cellular stress. GDF-15 serum levels may have clinical uses in a variety of inflammatory and cardiovascular conditions.

To determine the levels of GDF-15 in the serum of patients with generalized plaque psoriasis (GPP) and its correlation with the metabolic syndrome.

This case-control study included 50 patients with GPP and 50 age- and sex-matched healthy volunteers as controls. A general examination was performed, with a particular emphasis on measurements of body mass index, circumference of the waist, and blood pressure. Psoriasis severity was assessed using the Psoriasis Area and Severity Index (PASI) score. In addition, laboratory tests, including fasting blood sugar, lipid profile, and serum GDF-15 level measurement, were made.

Patients had significantly higher median GDF-15 levels compared to controls (P < 0.001). GDF-15 showed a substantial correlation with both disease duration and PASI score (P < 0.001 for each). GDF-15 levels were considerably greater in participants with metabolic syndrome compared with those without (P = 0.01).

The relatively small sample size could be a disadvantage and drawback of the study.

Serum GDF-15 levels are linked to the severity of psoriasis and the associated metabolic disorders.

Psoriasis is a chronic autoimmune disease affecting millions worldwide. This condition is characterized by scaly, red patches of skin that can be painful, itchy, and disfiguring. This non-contagious illness forms plaques and accelerates the dermal cell's life cycle. This review provides a comprehensive overview of the current knowledge on psoriasis, covering its definition, prevalence, causes, pathogenesis, clinical features, diagnosis, and treatment options. The psychosocial impact of psoriasis on patients and their coping mechanisms is also explored. Biologic agents, which target specific cytokines involved in psoriasis pathogenesis, have revolutionized psoriasis treatment and have significantly improved patient outcomes. However, effective and safe treatments for moderate to severe psoriasis are still needed. Future research directions include the development of biomarkers for predicting disease severity and treatment response, investigating new therapeutic targets like the microbiome and epigenetics, and leveraging advancements in technology and genomics for deeper insights into psoriasis pathogenesis and treatment. This study summarizes the key aspects of psoriasis, including its epidemiology, pathophysiology, clinical traits, disease burden, and management. However, further research is needed to improve treatment outcomes and enhance the quality of life for patients affected by this complex condition.

Psoriasis is a prevalent inflammatory disease that shares chronic inflammation pathways with the pathophysiology of metabolic syndrome (MetS), type-2 diabetes mellitus and atherosclerosis. A high prevalence of steatosis and advanced liver fibrosis has been described in psoriasis. The influence of MetS and its compounds, patatin-like phospholipase domain containing 3 and transmembrane 6 superfamily member 2 gene polymorphisms and the cumulative dose of methotrexate (MTX) in the progression of steatotic disease are still under debate. A suitable new classification for psoriasis-related liver disease, under the umbrella of steatotic liver disease (SLD), might be evaluated due to the potential impact of MTX on liver steatosis. Considering the interplay between the MetS, steatosis and MTX, a new definition for this complex disease might be discussed since it is not entirely addressed under the umbrella of SLD and metabolic-dysfunction associated SLD. Hence, shortly, a discussion could be raised on the feasible term "Met-Drug SLD", metabolic and drug-induced SLD, which comprises both metabolic dysfunction and drug-related SLD. This review aims to report the best evidence to accurately classify liver disease in psoriasis, considering the new definition of SLD, allowing appropriate management once it is carefully defined.

Psoriasis is a chronic disease with elusive pathogenesis linked to genetic, and immune factors. Studies have shown most patients have experienced high levels of oxidative stress, which can lead to inflammation or damage. Withaferin A is a natural product with multiple pharmacological activities, including anti-tumor and anti-inflammatory effects. We investigated the effects of WA in treating Imiquimod (IMQ)-induced psoriasis mice. The epidermal pathology of mice was significantly improved after treatment. WA inhibited inflammation by decreasing the production of IL-1β, IL-6, and IFN-γ, which were induced by epidermal oxidative stress. Additionally, WA can shift the macrophage status from pro-inflammatory to anti-inflammatory.

Obesity and psoriasis are two closely related chronic diseases and share multiple comorbidities. The common etiopathogenic basis would be a low-grade chronic inflammation, with a cross talk between adipose tissue and the skin. Obesity in patients with psoriasis results in a worse prognosis of the lesions and reduces the effectiveness of treatment.

To assess the mid-term effect of liraglutide 3mg on anthropometric and morphofunctional, biochemical, and dermatological parameters in patients with psoriasis and obesity.

48 patients were included (52.1%♀, age 48.7±11.8 years, BMI 37.9±5.6kg/m2, psoriasis duration 17.8±11.1 years). The severity of the lesions was evaluated with the PASI (Psoriasis Area Severity Index) and the VAS (pain visual analog scale), and DLQI (Dermatology Quality Index) and the Beck depression test (BDI). Also, biochemical and anthropometric determinations were performed baseline and after 6 months.

There was a reduction in BMI (37.9±5.6 vs 35±4.9; p<0.001), waist circumference (111.6±7 vs 104.7±9.3cm; p=0.001) and preperitoneal fat (1.6±0.6 vs 1.2±0.6cm; p<0.0001). PASI (12±8.4 to 4.3±2.9; p<0.0001), VAS (4.4±1.9 vs 2.2±1.6; p=0.003), DLQI (11.9±6.2 vs 4.8±3.4; p<0.0001) and BDI (15.5±3.6 vs 7.6±2.5; p<0.0001) improved significantly. C-reactive protein (3.9±3.1 vs 1.8±3.2mg/L; p<0.0001), homocysteine (13±3.3 vs 9.6±2.5μmol/L; p<0.0001), and plasma cortisol (12.5±4 vs 8.9±3.7μg/dL; p=0.001). In multiple regression analysis, dermatological improvement was independent of weight loss.

Liraglutide exerts beneficial effects not only on BMI and visceral fat, but also reduces inflammatory parameters in patients with psoriasis and obesity, improving skin lesions and quality of life.

Psoriasis, a prevalent autoimmune skin condition, considerably impairs the quality of life of those who are affected by it. Several studies have demonstrated that obesity significantly contributes to both the onset and progression of psoriasis. Relative fat mass (RFM), a novel obesity index, provides a more precise measure by incorporating both height and waist circumference (WC). The aim of this study was to investigate the association between RFM and psoriasis risk, taking into account the intermediary role played by the systemic inflammation response index (SIRI).

The cross-sectional study assessed data from 8,479 adults who participated in the NHANES cycles from 2003 to 2006 and 2009 to 2014. To examine the association between RFM and psoriasis, both multivariate logistic regression model and restricted cubic spline (RCS) analyses were conducted. A mediation analysis was used to clarify the role of SIRI in the association between RFM and psoriasis.

Higher RFM was significantly associated with a 5% higher risk of developing psoriasis (odds ratio [OR] = 1.05, 95% confidence interval [CI]:1.02-1.08), with RFM quartiles indicating a significant trend (P for trend < 0.05). The SIRI demonstrated a significant mediating effect on the RFM-psoriasis relationship (mediation effect ratio = 5.02%).

Elevated RFM are associated with an increased prevalence of psoriasis. RFM has the potential to be a beneficial anthropometric measure for more accurately predicting psoriasis risk.

Psoriasis is a chronic, multi-system inflammatory disease frequently associated with metabolic syndrome and lipid disturbances. Apolipoproteins, as essential regulators of lipid metabolism, may play a critical role in these metabolic abnormalities, potentially influencing disease severity and systemic inflammation. The aim of this study was to compare serum concentrations of chosen apolipoproteins in patients with psoriasis before and after treatment with acitretin or narrowband UVB (NB-UVB).

This study was conducted on 39 patients with psoriasis. The concentration of nine apolipoproteins and C-reactive protein was quantified using the Bio-Plex Immunoassay Kit.

The serum concentrations of ApoA2, ApoC1, ApoD, ApoE, and ApoJ were higher in the acitretin group compared to the NB-UVB group before treatment, while the ApoA1/ApoA2 ratio was lower. We also observed a negative association between the Psoriasis Area and Severity Index (PASI) and ApoA1/ApoA2 ratio in the patients before the treatment.

The results of this study confirm the presence of metabolic disturbances in psoriatic patients. The treatment with NB-UVB or acitretin did not cause any significant changes in the apolipoproteins profile. Thus, we found no detrimental impact of acitretin on the apolipoproteins profile, despite the observed rise in total cholesterol concentration after the treatment. Further research is needed to explore whether specific therapeutic approaches can modify these disturbances and potentially improve long-term cardiovascular outcomes in this population.

The risk of psoriasis in diabetic patients has rarely been explored. This study aims to compare the risk of incident psoriasis in patients with Type 2 diabetes (T2D) who initiate dipeptidyl peptidase-4 inhibitors (DPP-4is) or thiazolidinediones (TZDs) with those who initiate sulfonylureas, the most common second-line glucose-lowering therapy, in addition to metformin monotherapy. This sequential, propensity-score-matched, new-user comparative effectiveness study utilized a target trial emulation framework. It included adults with T2D receiving metformin monotherapy, using data from 2006 to 2015 from a general population database in Taiwan. The primary outcome was the incidence of psoriasis, determined through diagnoses recorded in urgent care, hospital, and outpatient department records. Cox proportional hazards and Poisson regressions with 1:4 propensity score matching was employed to evaluate the risk factors for psoriasis after adjusting for comorbidities and the use of other medications. In 49,810 propensity score-matched adults with T2D (27,630 men [55.4%]; mean age 57.5 years) identified in the database, the incidence rate of psoriasis in DPP-4i users was 188 cases per 100,000 person-years, lower than in sulfonylurea users (467 cases per 100,000 person-years), with a hazard ratio(HR) of 0.422 (95% CI, 0.273-0.716). For the TZD vs. sulfonylurea comparison, the HR was 0.35, but the smaller matched dataset resulted in wide confidence intervals. The findings suggest that the use of DPP-4is is associated with a lower risk of psoriasis compared to sulfonylureas in patients with T2D. These results can guide the selection of glucose-lowering therapies in T2D patients who are at risk of developing psoriasis.

Genital involvement and sexual dysfunction are common amongst patients with psoriasis. However, the effects of genital psoriasis on quality of life (QOL) and sexual health of psoriasis patients are not well understood. We performed an observational study on adult Asian psoriasis patients attending psoriasis subspecialty clinics in a tertiary dermatology centre in Singapore over 1 year. Participants underwent clinical examination of the whole-body surface, with particular attention to the genitalia and questionnaires to evaluate QOL and psychosexual health were administered. A total of 62 patients participated. Most participants were male (82.3%) with a mean age of 41.7 years (SD 12.5). The mean Psoriasis Area and Severity Index (PASI) score was 7.0 (SD 4.3) with a mean Dermatology Life Quality Index (DLQI) score of 9.8 (SD 6.7), indicating moderately impaired QOL. Higher PASI scores were associated with increasing QOL impairment on DLQI (p = 0.021). The commonest site involved was the suprapubic region (61.3%). Males in whom genital psoriasis prevented sexual intercourse or diminished their libido reported more sexual dysfunction. Females reported a greater severity impact of genital psoriasis in terms of symptoms and embarrassment (p = 0.038) yet were less likely to be on treatment (37.5% vs. 45.0%). Perceived efficacy of treatment was low, and younger patients fared poorly on the Patient Health Questionnaire-9 depression questionnaire (p = 0.047). Clinicians should proactively evaluate for and treat genital psoriasis, as patients may be reluctant to discuss their genital rashes if not prompted, leading to under-recognition and undertreatment.

Psoriasis is a prevalent inflammatory dermatosis with possible systemic involvement. Metabolomics defines as an extensive study of all low molecular weight metabolites in human body which has recently led to better understanding of the pathogenesis of different disease. To evaluate the targeted lipidomics in sera of patients versus healthy controls. The study included 64 patients with psoriasis and 64 age- and sex-matched healthy controls. All the participants underwent a targeted lipidomics on their sera using Gas Chromatography with flame-ionization detection (GC-FID). The clinical importance of serum level of lipids was also dealt with. Serum level of all tested fatty acids (except for METHYL VACCENATE) in patients was higher than healthy controls, though this difference was significant only for METHYL PALMITATE, METHYL OLEATE and METHYL LINOLEATE (P values: 0.002, 0.001 and 0.001 respectively). Based on our results, the serum levels of METHYL OLEATE, METHYL LINOLEATE, METHYL PALMITATE and METHYL STEARATE could significantly be used for predicting the disease severity (P values: 0.009, < 0.005, 0.02 and 0.001, respectively). METHYL MYRISTOLEATE, METHYL 11-14-17-EICOSATRIENOATE and METHYL LINOLEATE were the fatty acids which their serum levels were significantly predictive of duration of disease (P values: 0.018, < 0.005 and 0.009, respectively). Our findings suggest that circulating specific lipids have different serum levels in psoriasis patients in comparison with healthy controls. We suggest the serum METHYL LINOLEATE as a potential biomarker to evaluate psoriasis severity and prognosis. However, comprehensive, long-term studies are essential for validating its prognostic value.

Psoriasis is a chronic inflammatory autoimmune disease with important systemic and psychosocial impacts. The association with metabolic syndrome (MS) impairs disease severity and negatively influences patient-reported outcomes, particularly their quality of life as measured by the Dermatology Life Quality Index (DLQI). This study aims to investigate the relationship between systemic inflammation, DLQI scores and disease severity, focusing on the persistent impact of MS on patient outcomes after one year of treatment.

This retrospective cross-sectional study included 150 psoriasis patients, with 74 also meeting the diagnostic criteria for MS. Clinical and inflammatory markers such as systemic immune-inflammatory index (SII), cytokines (IL-17A, IL-23), leptin, BMI and triglycerides were analyzed alongside PASI and DLQI scores.

Patients with MS had significantly higher PASI and DLQI scores compared to those without MS, reflecting worse disease severity and quality of life (p < 0.01). Elevated SII levels were strongly associated with higher DLQI scores (p < 0.01). Despite considerable reductions in PASI scores over one year of treatment, DLQI scores indicated a persistent negative impact of MS on quality of life. Notably, markers of systemic inflammation, such as SII, leptin and cytokines, correlated positively with both PASI and DLQI scores, highlighting the role of systemic inflammation in disease burden.

This study underlines the significant role of systemic inflammation and metabolic comorbidities in amplifying the burden of psoriasis. The persistent impact of MS on quality of life despite clinical improvement underscores the need for comprehensive treatment approaches targeting systemic inflammation, metabolic health and psychosocial factors to improve long-term outcomes.

Psoriasis is a chronic immune-mediated disease with complex pathogenesis. The altered proliferation and differentiation of keratinocytes, together with the activity of dendritic cells and T cells, are crucial drivers of psoriasis progression. Long non-coding RNAs (lncRNAs) are composed of over 200 nucleotides and exert a large variety of functions, including the regulation of gene expression. Under pathological conditions, the expression of lncRNAs is frequently dysregulated. Recent studies demonstrated that lncRNAs significantly affect major cellular processes, and their aberrant expression is likely involved in the pathogenesis of various disorders. In this review, we will discuss the role of lncRNAs in the pathophysiology of psoriasis. We will summarize recent studies that investigated the relationships between lncRNAs and keratinocyte proliferation and pro-inflammatory responses.

While several studies have suggested a connection between Metabolic Syndrome (MetS) and Hidradenitis Suppurativa (HS), a definitive analysis confirming the association between lipid abnormalities and HS based on actual lipid values is lacking. Previous research, using odds ratios from ICD codes, indicates links between elevated triglycerides and low high-density lipoprotein levels with HS. However, these findings may not fully represent real-life situations, as no comprehensive analysis using actual lipid measurements has been performed.

To examine the relationship between lipid profile values-total cholesterol, triglycerides (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL)-and HS.

A comprehensive search of PubMed, Cochrane Library, and Embase was conducted to identify studies reporting lipid profiles in HS patients. A meta-analysis using standardized mean differences (SMDs) was performed to assess the association between lipid abnormalities and HS.

The meta-analysis found that HS patients had significantly higher TG levels (SMD = 0.28, 95% CI: 0.09-0.47, P = 0.004) and lower HDL levels (95% CI: -0.53 to -0.16, P < 0.001) compared to healthy controls. No significant differences were observed in total cholesterol (SMD = 0.01, 95% CI: -0.19-0.21, P = 0.93) and LDL levels (SMD = 0.04, 95% CI: -0.10-0.17, P = 0.61). These results corroborate earlier studies linking HS with dyslipidemia, particularly hypertriglyceridemia and hypo-HDL cholesterolemia, with the added strength of using actual lipid values.

This study confirms the association between hypertriglyceridemia and low HDL cholesterol in HS patients, highlighting the broader systemic association of the condition. Dermatologists should monitor lipid profiles in HS patients to mitigate potential cardiovascular risks through early detection and management.

Over the world, millions of individuals suffer from psoriasis, a chronic inflammatory skin disease. It is caused by a multifaceted mixture of environmental, immunological, and genetic factors. This review explores the many aspects of psoriasis, where the introduction gives a context background, emphasizing the prevalence and difficulties that people encounter with this dermatological ailment. Further, the pathogenesis complex systems involving immunological dysregulation, genetic susceptibility, and triggers are clarified, providing insights into the disease's fundamental mechanisms. Examining drugs shows how, over time, therapy modalities have evolved, moving from traditional topical treatments to the introduction of biologics and small molecules. The continuous efforts to control symptoms, reduce inflammation, and improve patient outcomes are highlighted in this section. Furthermore, a thorough review of patents reveals the creative advancements made in the sector, highlighting encouraging advancements in treatment modalities and potential paths forward. This manuscript is a review article and is based on various research and review articles. We have summarized the salient features and findings from different articles and prepared this manuscript.

Metabolic syndrome (MetS) is a common comorbidity in psoriasis. However, the associations between MetS, psoriasis and mortality remain largely unclear.

To investigate the synergistic effect of MetS and psoriasis on total and cardiovascular disease (CVD) mortality in a representative sample of US adults.

In total, 14 930 participants from the 2003-2006 and 2009-2014 National Health and Nutrition Examination Survey were included in this prospective, nationwide cohort study. Participants were stratified into the psoriasis-/MetS- (reference) group, psoriasis-/MetS+ group, psoriasis+/MetS- group and psoriasis+/MetS+ group.

Overall, 14 930 participants, 50.71% were male, with a mean age of 43 years, were included in the final analysis. The weighted percentages of participants in the psoriasis-/MetS-, psoriasis-/MetS+, psoriasis+/MetS- and psoriasis+/MetS+ groups were 72.77%, 24.36%, 1.94% and 0.93%, respectively. In total, 874 deaths (246 of which were related to CVD) occurred during a median follow-up of 110 months. Compared with the reference group, the hazard ratios in the psoriasis-/MetS+, psoriasis+/MetS- and psoriasis+/MetS+ groups were 1.788 [95% confidence interval (CI) 1.486-2.152], 0.858 (95% CI 0.431-1.707) and 2.050 (95% CI 1.028-4.092), respectively, for all-cause mortality, and 1.856 (1.350-2.552), 1.229 (95% CI 0.292-5.181) and 4.571 (95% CI 1.724-12.119), respectively, for CVD mortality. Subgroup analysis showed that this association was not influenced by participants' age, sex, physical activity, smoking, estimated glomerular filtration rate, or urinary albumin/creatinine ratio. Similar results were obtained in the sensitivity analysis of the main results.

Presence of comorbid MetS significantly increases all-cause and CVD mortality in patients with psoriasis. Dermatologists can potentially aid in reducing mortality rates in patients with psoriasis through targeted screening for MetS.

Psoriasis is a chronic inflammatory skin disease with complex pathogenesis and variable severity. Performed studies have indicated the impact of vitamin D3 deficiency on the pathogenesis of psoriasis and its severity. However, there is no clear evidence of the influence of the mucosal microbiome on the onset and progression of psoriasis. This review aims to present the current evidence on the role of vitamin D3 and colonization of the oral mucosa by Candida yeast-like fungi in the pathogenesis of psoriasis. Candida albicans is a common yeast that can colonize the skin and mucosal surfaces, particularly in individuals with weakened immune systems or compromised skin barriers. In psoriasis, the skin's barrier function is disrupted, potentially making patients more susceptible to fungal infections such as Candida. Since patients with psoriasis are at increased risk of metabolic syndrome, they may experience the vicious circle effect in which chronic inflammation leads to obesity. Vitamin D3 deficiency is also associated with microbiological imbalance, which may promote excessive growth of Candida fungi. Under normal conditions, the intestinal and oral microflora support the immune system. Vitamin D3 deficiency, however, leads to disruption of this balance, which allows Candida to overgrow and develop infections.

In clinical practice, psoriasis is a prevalent chronic inflammatory cutaneous disease featured with the development of red plaque with silvery scales, which considerably affects cutaneous health and quality of life of those afflicted.

This research aimed to examine the association between the body roundness index (BRI) and psoriasis, using data sourced from the National Health and Nutrition Examination Survey (NHANES).

Our study used a cross-sectional design, including 8,479 adults, of whom 234 were diagnosed with psoriasis. Multivariable logistic regression was used to analyze the relationship between BRI and psoriasis, with stepwise adjustments for covariables.

Results from multivariable logistic regression analyses indicated a significant positive relationship between BRI and the risk of developing psoriasis; specifically, after comprehensive adjustment for covariables, per 1 unit increase in BRI was linked to an 11% rise in psoriasis risk (OR = 1.11, 95% CI = 1.05-1.17). Furthermore, psoriasis patients exhibited higher average BRI compared to non-psoriasis patients and a greater prevalence of comorbidities such as hypertension and smoking.

These findings suggest that higher BRI is positively correlated with the risk of psoriasis in the adult population in the US. BRI could potentially act as a practical anthropometric index for more accurately predicting the risk of developing psoriasis.

Psoriasis (PsO) is a chronic, systemic, and autoimmune dermatologic condition characterized by dry, scaly, and erythematous plaques on the skin. PsO can present in various forms, including guttate (small, round lesions commonly over the upper trunk and extremities that can be raised and scaly), inverse (smooth plaques of inflamed skin within skin folds of the groin, buttock, and breasts), pustular (white painful pustules within red inflamed blotches widespread over the body), and erythrodermic (red rash present over most of the body). Individuals with PsO can present differently, with unique symptoms and patterns on the skin. These diverse manifestations make PsO a complex condition with mild to severe symptoms affecting different body areas. Researchers have identified intrinsic risk factors (and comorbidities) tied to PsO, including genetics, obesity, metabolic syndrome, infection, cardiovascular disease, stress, and type 2 diabetes mellitus (T2DM). In addition, several extrinsic risk factors have also been shown to be tied to PsO onset and progression, such as ultraviolet (UV) light, air pollution, and various pharmacological treatments. While these intrinsic and extrinsic factors have been tied to disease pathophysiology, the underlying mechanisms of disease activity have yet to be elucidated fully, making diagnosis and treatment cumbersome. Currently, PsO is diagnosed clinically with no definitive test. Noninvasive tools such as dermoscopy aid in diagnosis, while the biopsy is reserved for difficult-to-characterize psoriatic-like lesions. The reliance on clinical presentation and the lack of diagnostic testing available have led to the underdiagnosis of PsO, particularly in minority communities. The goal of this study is to utilize data from the National Health and Nutrition Examination Survey (NHANES) to improve the diagnosis of PsO and target treatment more effectively, and biometric measurements associated with PsO should be studied to aid clinical practitioners in better understanding the disease pathophysiology and improve patient diagnosis, management, and prognosis. Using the dataset, we conducted a retrospective cohort study to find which variables are significantly associated with PsO. These objective measurements can complement clinical assessments by providing quantifiable data that could improve accuracy by detecting PsO in its early stages or distinguishing it from other skin conditions with similar presentations. This enables healthcare providers to adjust management strategies based on measurable changes in disease markers, rather than relying solely on subjective clinical observations.

Chronic inflammatory skin conditions such as psoriasis and atopic dermatitis (AD) impose a significant burden on both the skin and the overall well-being of individuals, leading to a diminished quality of life. Despite the use of conventional treatments like topical steroids, there remains a need for more effective and safer therapeutic options to improve the lives of patients with severe skin conditions. Molecular therapy has emerged as a promising approach to address disorders such as atopic dermatitis, psoriasis, and contact hypersensitivity. One strategy to counteract the disease processes involves targeting the transcriptional process. A novel form of gene therapy utilizes double-stranded oligodeoxynucleotides (ODNs), also known as decoys, that contain cis-elements. By introducing these decoy ODNs through transfection, the cis-trans interactions are disrupted, leading to the inhibition of trans-factors from binding to the intrinsic cis-elements and thus regulating gene expression. In this review, we have summarized studies investigating the therapeutic effects of decoy ODNs on inflammatory skin diseases. Various transcription factors, including NF-kB, STAT6, HIF-1α/STAT5, STAT1, and Smad, have been targeted and inhibited using designed decoy ODNs for the treatment of atopic dermatitis, psoriasis, hypertrophic scarring, and contact hypersensitivity. The findings of these studies confirm the significant potential of the decoy approach in the treatment of inflammatory skin diseases.

Psoriasis is linked to insulin resistance (IR). Nevertheless, the applicability of the METS-IR index, a new IR evaluation tool, for evaluating changes in insulin sensitivity in psoriasis populations is currently unknown. This study aimed to investigate the relationship between the METS-IR index and psoriasis in a US adult population. This cross-sectional study utilized data from adults aged 20 to 80 years from the U.S. National Health and Nutrition Examination Survey (NHANES) spanning 2003-2006 and 2009-2014. The associations between the METS-IR index and psoriasis were examined using multivariate logistic regression and smoothed curve fitting. Subgroup analyses and interaction tests were conducted to verify the stability of the association within the population. This study included 5,966 participants, of whom 182 had psoriasis. In the fully adjusted model, the METS-IR index was positively associated with psoriasis, showing a 1.7% increase in psoriasis prevalence for each one-unit increase in the METS-IR index (Model 2: OR 1.017, 95% CI 1.006-1.028). Participants in the highest quartile group were 91.9% more likely to develop psoriasis compared to those in the lowest quartile group (OR = 1.919, 95% CI 1.180-3.118). Smooth curve fitting revealed a nonlinear association between the METS-IR index and psoriasis, with an inflection point of 41.675. This positive association was more pronounced in females, non-obese individuals, those with light alcohol consumption, comorbid coronary heart disease and hyperlipidemia, non-hypertensive and non-diabetic individuals. The results of the study suggest that higher METS-IR scores are associated with an increased likelihood of psoriasis among U.S. adults. The METS-IR index is specifically recommended as a clinical indicator for the management and treatment of psoriasis in women, non-obese individuals, light alcohol consumers, individuals with comorbid coronary artery disease andhyperlipidemia, non-hypertensive and non-diabetic individuals. However, Considering the many known and unknown covariates that may be associated with psoriasis and influence theresults of the study, we remain cautious about the results obtained and look forward to the addition of subsequent studies.

Psoriasis is a chronic inflammatory skin disorder characterized by the hyperproliferation of keratinocytes and immune system dysregulation, with significant needs due to the limitations and adverse effects of current treatments. In this study, we sought to discover novel herbal candidates and their active compounds for psoriasis by leveraging a multiscale network analysis. We conducted a comprehensive analysis of data from 348 medicinal herbs and their active compounds, identifying Piperis longi fructus, Pini koraiensis semen, Schisandrae fructus, and Cnidi fructus as top candidates without reported evidence. Key active compounds, such as piperine, piperlongumine, α-humulene, schizandrin A, schizandrin II, and torilin, were prioritized for their ability to target psoriasis-associated proteins, including STAT3, TNF, IL-6, and NF-κB. These compounds are involved in the modulation of critical inflammatory pathways, notably the MAPK signaling cascade, which plays a central role in psoriasis pathogenesis. Our findings suggest that these herbal compounds may not only mitigate inflammation but also regulate keratinocyte hyperproliferation, addressing fundamental mechanisms underlying the disease. This approach highlights the utility of multiscale network analysis in identifying promising natural therapies, offering new insights and potential avenues for safer and more effective psoriasis management.

The relationship between systemic immune-inflammation index (SII) and psoriasis and its prognosis is not yet clear. In this study, the correlation between SII and psoriasis, psoriasis comorbidities, and all-cause mortality was investigated based on the National Health and Nutrition Examination Survey (NHANES).

The study population was derived from five NHANES cycles: 2003-2006, 2009-2014, and survival follow-up was as of December 31, 2019. The association between SII and psoriasis and its comorbidities was analyzed using weighted multivariate logistic regression models. Weighted COX regression was used to calculate hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs). Restricted cubic spline, subgroup and sensitivity analyses were also used. Logarithmic conversion was performed on SII(log2SII) to reduce the impact of outliers.

A total of 21,431 participants were included in this study. As a continuous variable, log2SII was significantly associated with psoriasis in the fully adjusted model [OR = 1.20(1.04-1.39), p = .01]. log2SII remained positively associated with psoriasis after excluding participants with a history of cancer or cardiovascular disease (CVD), or non-Hispanic black participants. Among psoriasis patients, log2SII was significantly associated with metabolic syndrome (MetS) [OR = 1.68(1.19,2.38), p = .004] and all-cause mortality [HR = 1.48(1.09,1.99), p = .01]. Similar results were consistently observed when SII was analyzed as a categorical variable (in quartiles).

This study suggested a positive association between SII and the prevalence of psoriasis. Among psoriasis patients, SII was positively correlated with MetS and all-cause mortality.

While vitiligo is primarily caused by melanocyte deficiency or dysfunction, recent studies have revealed a notable prevalence of metabolic syndrome (MetS) among patients with vitiligo. This suggests shared pathogenic features between the two conditions. Individuals with vitiligo often exhibit variations in triglyceride levels, cholesterol, and blood pressure, which are also affected in MetS. Given the similarities in their underlying mechanisms, genetic factors, pro-inflammatory signalling pathways, and increased oxidative stress, this study aims to highlight the common traits between vitiligo and metabolic systemic disorders. Serum analyses confirmed increased low-density lipoprotein (LDL) levels in patients with vitiligo, compared to physiological values. In addition, we reported significant decreases in folate and vitamin D (Vit D) levels. Oxidative stress is one of the underlying causes of the development of metabolic syndromes and is related to the advancement of skin diseases. This study found high levels of inflammatory cytokines, such as interleukin-6 (IL-6) and chemokine 10 (CXCL10), which are markers of inflammation and disease progression. The accumulation of insulin growth factor binding proteins 5 (IGFBP5) and advanced glycation end products (AGEs) entailed in atherosclerosis and diabetes onset, respectively, were also disclosed in vitiligo. In addition, the blood-associated activity of the antioxidant enzymes catalase (Cat) and superoxide dismutase (SOD) was impaired. Moreover, the plasma fatty acid (FAs) profile analysis showed an alteration in composition and specific estimated activities of FAs biosynthetic enzymes resembling MetS development, resulting in an imbalance towards pro-inflammatory n6-series FAs. These results revealed a systemic metabolic alteration in vitiligo patients that could be considered a new target for developing a more effective therapeutic approach.

Background Psoriasis is a chronic immune-mediated disease with a 2-3% prevalence. As with other diseases with cutaneous manifestations, psoriasis patients suffer from psychological issues and social isolation. The general population's misconceptions and prejudicial attitudes toward those patients are highly implicated in ensuing psychological issues. Accordingly, this study is the first to investigate the Jordanian population's knowledge about and attitude toward psoriasis. Methods Our cross-sectional study was conducted using a self-administered online questionnaire that 1,306 participants from the Jordanian population completed. The questionnaire constituted four sections addressing the sociodemographic characteristics, previous exposure to psoriasis, knowledge about psoriasis, and attitudes toward psoriasis. The data analysis was conducted using R and RStudio packages. Results The averages and standard deviations of knowledge and attitude scores of the total sample were 7.54 ± 2.38 and 3.45 ± 9.22, respectively. When further classified into categories, 73.81% appeared in the moderate knowledge category. Moreover, 61.49% had a positive total attitude score. Among the common misconceptions identified were thinking that psoriasis is a hereditary disease (30.09%), denying that psoriasis increases the risk of diabetes (51.68%) and heart disease (67.69%), and not knowing that it affects the social life of patients (26.11%). Of the prominent negative attitudes observed were those related to the intimate relationship status and sharing a swimming pool with a psoriasis patient. Conclusions Although the Jordanian population's overall knowledge level appeared sufficient, some critical misconceptions were identified. Moreover, this research revealed a high prevalence of negative attitudes toward psoriasis among the Jordanian public. Future research could link every negative behavior to their exact triggering misconception. This may further assist in the institutional effort to combat discriminatory behaviors.

Psoriasis is an increasingly common chronic immune-mediated skin disease recognized for its systemic effects that extend beyond the skin and include various cardiovascular diseases, neurological diseases, type 2 diabetes, and metabolic syndrome. This study aimed to explore the complex relationship between psoriasis and metabolic syndrome by analyzing clinical, biochemical, and immunological parameters in patients with psoriasis alone and in patients combining psoriasis and metabolic syndrome. A total of 150 patients were enrolled, 76 with psoriasis only (PSO) and 74 with psoriasis and metabolic syndrome (PSO-MS). Data collected included anthropometric measurements, blood tests, and inflammatory markers. Statistical analysis was performed using the independent t-test, Mann-Whitney U test, Kruskal-Wallis test, and chi-square test to compare the two groups. Patients in the PSO-MS group had a significantly higher body weight, abdominal circumference, BMI, and inflammatory markers compared to patients with PSO. In addition, increased levels of IL-17A, cholesterol, triglycerides, and glucose were observed in the PSO-MS group. This study highlights the increased metabolic risk and exacerbated systemic inflammation associated with the coexistence of psoriasis and metabolic syndrome. These findings demonstrate the need for a comprehensive therapeutic approach and early intervention to manage metabolic complications in patients with psoriasis and metabolic syndrome.

Introduction Psoriasis is a chronic, recurrent inflammatory skin condition that affects 1-3% of the global population. Increasing evidence suggests a higher prevalence of metabolic syndrome (MetS) among individuals with psoriasis. This study aims to investigate the prevalence of MetS in patients with psoriasis and compare the findings with existing literature. Methods This cross-sectional, hospital-based study included 311 patients with psoriasis. Data were retrospectively collected from hospital records. Results The study included 311 patients with psoriasis (144 females and 167 males), with a mean age of 41.6 years (range 18-87). The mean BMI was 27.13 ± 5.29 kg/m², and the average waist circumference was 93 cm. Mean fasting blood sugar levels were 100 mg/dL, mean high-density lipoprotein (HDL) cholesterol was 44 mg/dL, and mean triglycerides were 132 mg/dL. MetS was diagnosed in 60 patients (19.3%). Patients with MetS had significantly higher mean waist circumference, higher rates of hypertriglyceridemia, hyperglycemia, and hypertension, and lower mean HDL levels (p < 0.05). There was no significant association between MetS and psoriasis severity, disease duration, family history, smoking, or alcohol consumption habits. Conclusions In this study, the prevalence of MetS among patients with psoriasis was 19.3%. MetS prevalence was not linked to smoking status, alcohol consumption, family history of psoriasis, disease duration, or severity. It is crucial for dermatologists treating psoriasis patients to be aware of MetS, its components, and associated cardiovascular risks.

Several studies have indicated a potential causal relationship between plasma standard lipids, such as high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), triglycerides (TG), and total cholesterol (TC), and psoriasis. However, few studies have offered causal evidence of lipid species beyond these standard lipids. We conducted an analysis using a genome-wide association study (GWAS) dataset comprising 179 lipid species, including 13 types across four major categories, to identify instrumental variables (IVs) associated with plasma lipids. We utilized two GWAS datasets from the IEU and Finngen for psoriasis vulgaris as the outcome. A two-sample Mendelian randomization (MR) analysis was used to explore the causal relationship between 179 lipid species and psoriasis vulgaris in two datasets. Lipid species showing causal association in both psoriasis datasets were compared for overlap. Our study identified potential causal relationships between six lipid species and psoriasis vulgaris: phosphatidylcholine (16:1_18:2), phosphatidylcholine (18:0_18:2), phosphatidylcholine (18:1_20:4), phosphatidylethanolamine (16:0_18:2), phosphatidylinositol (18:0_20:3), and triacylglycerol (50:1). In summary, elevated plasma levels of phosphatidylcholine (16:1_18:2), phosphatidylcholine (18:0_18:2), phosphatidylethanolamine (16:0_18:2), phosphatidylinositol (18:0_20:3), and triacylglycerol (50:1) may increase the risk of psoriasis vulgaris. Conversely, plasma phosphatidylcholine (18:1_20:4) may play a protective role against psoriasis vulgaris.

In recent years, the incidence of metabolic syndrome (MS) has increased due to lifestyle-related factors in developed countries. MS represents a group of conditions that increase the risk of diabetes, cardiovascular diseases, and other severe health problems. Low-grade chronic inflammation is now considered one of the key aspects of MS and could be defined as a new cardiovascular risk factor. Indeed, an increase in visceral adipose tissue, typical of obesity, contributes to the development of an inflammatory state, which, in turn, induces the production of several proinflammatory cytokines responsible for insulin resistance. Psoriasis is a chronic relapsing inflammatory skin disease and is characterized by the increased release of pro-inflammatory cytokines, which can contribute to different pathological conditions within the spectrum of MS. A link between metabolic disorders and Psoriasis has emerged from evidence indicating that weight loss obtained through healthy diets and exercise was able to improve the clinical course and therapeutic response of Psoriasis in patients with obesity or overweight patients and even prevent its occurrence. A key factor in this balance is the gut microbiota; it is an extremely dynamic system, and this makes its manipulation through diet possible via probiotic, prebiotic, and symbiotic compounds. Given this, the gut microbiota represents an additional therapeutic target that can improve metabolism in different clinical conditions.

Psoriasis and obesity are chronic, inflammatory diseases, sharing certain pathophysiological factors. Psoriasis, increasingly viewed as a systemic inflammatory condition, may have various symptoms beyond the skin manifestations.

This research aimed to explore the connection between body mass index (BMI) and pediatric psoriasis, through a case-control study on 100 psoriasis cases and 100 controls who were matched in terms of age and sex. The percentiles of the BMI by age and sex determined the nutritional status of each patient and control. The severity of psoriasis was evaluated based on the psoriasis area and severity index (PASI), nail involvement based on the nail psoriasis severity index (NAPSI), and quality of life impairment with the dermatology life quality index (DLQI).

While no statistically significant relationship was identified between increased BMI and PASI (p = 0.074), the risk of being overweight and obesity was significantly higher in the psoriasis group (OR 6.93, p = 0.003; OR 12.6, p < 0.001, respectively). The BMI increased with the PASI for psoriasis vulgaris but not for psoriasis inverse. No connections were found between disease duration and BMI (p = 0.56) or between BMI and PASI based on sex (p = 0.26). The NAPSI increased significantly with increased BMI (p = 0.000015).

This study highlights the association between elevated BMI, psoriasis diagnosis, and severity of psoriatic onychopathy in pediatric patients, advocating for further large-scale studies to confirm these explorations and increasing awareness for better screening and management of such cases for overweight/obese patients.

Psoriasis is a common multisystem inflammatory disease, and arthritis is an essential component of the disorder, requiring early diagnosis and prompt treatment for successful management. In this study, we aimed to investigate the relationship between nail and scalp involvement and other covariates with psoriatic arthritis (PsA). This cross-sectional study, conducted from June 2021 through December 2021, included 763 patients from 11 different centers in Turkey. The severity of involvement was evaluated using psoriasis area severity index (PASI), nail psoriasis severity index (NAPSI), and psoriasis scalp severity index (PSSI) scores. Predictors for PsA were evaluated using univariate and multivariate logistic regression models. PsA (n = 155, 21.5%) was significantly more common in patients having a family history of psoriasis (43.2% vs 30.9%, P = .004), nail involvement (68.4% vs 52.3%, P < .001), and coexistence of nail and scalp involvement (53.7% vs 39.6%, P = .002). Furthermore, patients with PsA had considerably higher PASI (7 vs 5.6, P = .006), NAPSI (5 vs 2, P < .001), and PSSI scores (7 vs 4, P = .002) and longer disease duration (months) (126 vs 108, P = .009). In multivariate analysis, female gender [OR: 3.01, 95% CI (1.861-4.880), P < .001], nail involvement [OR: 2.06, 95% CI (1.293-3.302), P = .002)], and body mass index (BMI) [OR: 1.06, 95% CI (1.017-1.100), P = .005] were identified as independent predictors for PsA. Female gender, nail involvement, and high BMI are significant predictors for PsA and warrant detailed rheumatological assessment. Notably, being female is the strongest predictor of increased risk of PsA in our survey. Scalp involvement appears not to be associated with PsA. Also, the presence of PsA seems related to a more severe skin involvement phenotype.

To explore the clinical epidemiological characteristics of oral lichen planus (OLP) and risk factors for erosive/ulcerative OLP.

Patients diagnosed with OLP from 11 different hospitals were included in the study. Descriptive statistical methods were used to explore the clinical epidemiological characteristics and logistic regression, sensitivity analysis, and subgroup analysis were utilized to explore the risk factors for erosive/ulcerative OLP.

The average age of patients was 49.2 ± 13.3 years, and 61.4% of the patients were women. The ratios of patients with reticular, hyperemic/erythematous, and erosive/ulcerative lesions were 47.9%, 27.8%, and 24.2%, respectively. Analysis of risk factors for erosive/ulcerative OLP identified the following variables: age, course of disease of 12 months or more, II°-III° dental calculus, hypertension, diabetes, and heart disease, as well as regions of habitation. Subgroup analysis showed significant differences in risk factors for erosive/ulcerative OLP in patients with and without risk behaviors.

The clinical epidemiological characteristics of patients with OLP in the Chinese population in this study are basically consistent with existing reports in developed countries. And we identified clinical characteristics associated with erosive/ulcerative OLP through clinical epidemiological analysis.

A high prevalence of steatotic liver disease has been described in psoriasis. However, the influence of genetic polymorphisms has yet to be investigated in this scenario. This study aims to determine the frequency of steatosis, advanced liver fibrosis and PNPLA3/TM6SF2 genotypes in individuals with psoriasis and to evaluate the impact of genetic polymorphisms, metabolic parameters and cumulative methotrexate dose on steatosis and fibrosis.

Cross-sectional study that prospectively included psoriasis outpatients, submitted to clinical and laboratory analysis, transient elastography (FibroScan®, Fr) and PNPLA3/TM6SF2 genotyping. Steatosis was defined by CAP ≥275 dB/m and advanced liver fibrosis as transient elastography ≥10 kPa. Logistic regression analysis evaluated the independent variables related to steatosis and fibrosis; p-value< 0.05 was considered significant.

One hundred and ninety-nine patients were enrolled (age 54.6 ± 12.6 years, 57.3% female). Metabolic syndrome (MetS), steatosis and advanced liver fibrosis prevalence were 55.8%, 54.8% and 9%, respectively. PNPLA3 and TM6SF2 genotypes frequencies were CC 42.3%/CG 49.5%/GG 8.2% and CC 88.7%/ CT 11.3%/ TT 0%. MetS (OR3.01 95%CI 1.51-5.98; p = 0.002) and body mass index (OR1.17 95%CI 1.08-1.26; p < 0.01) were independently associated with steatosis. Diabetes Mellitus (T2DM) (OR10.76 95%CI 2.42-47.87; p = 0.002) and harboring at least one PNPLA3 G allele (OR5.66 95%CI 1.08-29.52; p = 0.039) were associated with advanced fibrosis, but not TM6SF2 polymorphism or cumulative MTX dose.

MetS and T2DM confer higher odds for steatosis and advanced fibrosis in individuals with psoriasis. PNPLA3 G allele, but not TM6SF2 polymorphism, impacts a 5-fold odds of advanced liver fibrosis.

Epidemiological data demonstrate strong associations between psoriasis and metabolic comorbidities, including obesity, hypertension, diabetes mellitus, dyslipidemia, and non-alcoholic fatty liver disease. The presence of metabolic comorbidities significantly influences the selection and effectiveness of pharmacological treatments. Some drugs should be prescribed with caution in patients with metabolic comorbidities because of an increased risk of adverse events, while others could have a reduced effectiveness. The aim of this narrative review is to highlight the challenges that healthcare professionals may face regarding the management of psoriasis in patients with metabolic comorbidities. In the first part of the article, the epidemiological association between psoriasis and metabolic comorbidities and their pathogenetic mechanisms is summarized. The second part describes the efficacy and safety profile of conventional and biologic drugs in patients with selected metabolic comorbidities including obesity, non-alcoholic fatty liver disease/hepatic steatosis, and diabetes. Finally, the role of pharmacological and non-pharmacological interventions, such as diet, alcohol abstinence, physical activity, and smoking avoidance is discussed. In conclusion, the choice of the best approach to manage patients with psoriasis with metabolic comorbidities should encompass both tailored pharmacological and individualized non-pharmacological interventions.

National guidelines define psoriasis as a risk enhancer for cardiovascular disease and recommend increased monitoring and more intense management of cardiovascular risk factors in these patients, who face an increased burden of cardiovascular disease morbidity and mortality. Screening for modifiable cardiovascular risk factors, including blood pressure, weight, cholesterol, glucose, and smoking, can be efficiently incorporated into routine dermatology clinical practice. Partnerships with primary care providers and preventive cardiologists are essential to improving management of cardiovascular risk in patients with psoriasis.

Patients with immune-mediated inflammatory diseases are prone to steatotic liver disease (SLD), which has been observed in patients with psoriasis and hidradenitis suppurativa. We aimed to assess whether systemic lupus erythematosus (SLE) was associated with SLD and to define factors associated with SLD in SLE. This was a cross-sectional study, we included 106 consecutive patients with SLE who were seen in the rheumatology clinic between June 2021 and March 2022 and we chose two sex-paired controls for each SLE. All the participants underwent FibroScan and anthropometric assessments. SLD was defined as a controlled attenuation parameter ≥ 275dB/m. Prevalence of SLD was lower in patients with SLE (21.7% vs 41.5%, p < 0.001). Patients with SLE and SLD had a lower frequency of hydroxychloroquine use (65% vs 84%, p = 0.04), and higher C3 levels [123mg/dl (IQR 102-136) vs 99mg/dl (IQR 78-121), p = 0.004]. Factors associated with SLD in SLE were body mass index (BMI), waist circumference, glucose, and C3; hydroxychloroquine use was a protective factor. On univariate analysis, SLE was associated with a reduced risk of SLD (OR 0.39, 95%CI 0.23-0.67); however, after adjusting for age, BMI, waist, glucose, triglycerides, high-density cholesterol, low-density cholesterol, leukocytes, and hydroxychloroquine, it was no longer associated (OR 0.43, 95%CI 0.10-1.91). In conclusion, the prevalence of SLD in patients with SLE was not higher than that in the general population, and SLE was not associated with SLD. The factors associated with SLD were anthropometric data, glucose, hydroxychloroquine, and C3 levels.

Psoriasis is a complex and recurrent chronic inflammatory skin disease, and the abnormal proliferation of keratinocytes plays a crucial role in the pathogenesis of psoriasis. Long non-coding RNAs (lncRNAs) play an indispensable role in regulating cellular functions. This research aims to explore the potential impact of lncRNA MIR181A2HG on the regulation of keratinocyte proliferation.

The expression level of MIR181A2HG and the mRNA level of KRT6, KRT16, and SOX6 were assessed using qRT-PCR. The viability and proliferation of keratinocytes were evaluated using CCK-8 and EdU assays. Cell cycle analysis was performed using flow cytometry. Dual-luciferase reporter assays were applied to test the interaction among MIR181A2HG/miR-223-3p/SOX6. Protein level was detected by Western blotting analysis.

The findings indicated that psoriasis lesions tissue exhibited lower levels of MIR181A2HG expression compared to normal tissue. The overexpression of MIR181A2HG resulted in the inhibition of HaCaT keratinocytes proliferation. The knockdown of MIR181A2HG promoted cell proliferation. The dual-luciferase reporter assay and rescue experiments provided evidence of the interaction among MIR181A2HG, SOX6, and miR-223-3p.

The lncRNA MIR181A2HG functions as a miR-223-3p sponge targeting SOX6 to regulate the proliferation of keratinocytes, which suggested that MIR181A2HG/miR-223-3p/SOX6 might be potential diagnostic and therapeutic targets for psoriasis.