Real-life data over 36 weeks of guselkumab treatment in psoriasis patients: A single-center study from Turkey

BACKGROUND

Psoriasis is an important health problem responsible for morbidity and workforce loss. In recent years, anti-IL-23 drugs have become essential in psoriasis treatment.

OBJECTIVES

This study aimed to investigate the efficacy and safety of guselkumab therapy, recently used in Turkey, by examining real-life data over 36 weeks.

METHODS

A total of 39 psoriasis patients (>18 years old) who received guselkumab treatment between December 2021 and December 2022 in the dermatology department of our hospital were included in the study. Patients" ages, sexes, body mass index (BMI), comorbidities, duration of illness, drugs used before guselkumab treatment, clinical response to guselkumab treatment, and side effects, if any, were recorded. Psoriasis Area and Severity Index (PASI) scores at baseline and Weeks 4, 12, 24, and 36 were evaluated, as well as the Dermatology Life Quality Index (DLQI) at the beginning and end of the study.

RESULTS

The PASI scores at Weeks 4, 12, 24, and 36 and the DLQI at Week 36 decreased statistically compared with baseline (p < 0.05). The PASI score at baseline and Weeks 4, 24, and 36 did not differ between groups based on IL-17 use (p > 0.05). No significant correlation was observed between BMI, disease duration, and PASI scores at baseline and Weeks 4, 12, 24, and 36. No side effects were observed in any of the patients during treatment.

CONCLUSION

This study includes real-life data on the use of guselkumab therapy for psoriasis in the Turkish population. Based on the results, guselkumab is a highly effective and safe treatment.

The role of new inflammatory markers in determining disease activation and severity in patients with hidradenitis suppurativa

Hidradenitis suppurativa (HS) is a chronic inflammatory disease. Recently published studies have suggested the use of markers of inflammation to monitor HS patients. These studies discuss the platelet/lymphocyte ratio (PLR), neutrophil/lymphocyte ratio (NLR), pan-immune-inflammation value (PIV), and systemic immune-inflammation index (SIII), which are also used in other inflammatory diseases. This study aimed to compare the blood parameters, including NLR, PLR, SIII, and PIV, in HS patients and healthy individuals, and determine their correlation with disease severity. The study included 81 HS patients and 61 healthy volunteers. The patients' medical records and laboratory values of the control group were reviewed retrospectively. HS severity was assessed using Hurley staging. NLR, PLR, SIII, and PIV values were calculated based on complete blood counts. NLR, SIII, and PIV values were significantly higher in HS patients compared to the healthy control group and were positively associated with disease severity. There was no significant difference observed in PLR values concerning disease severity. This study suggests that NLR, SIII, and PIV values can be utilized as simple and cost-effective tests to monitor disease activity and severity in HS patients. However, larger and more comprehensive studies are needed to establish diagnostic cutoff values, and further evaluation of sensitivity and specificity is required.

Cutaneous reactions after COVID-19 vaccination in Turkey: A multicenter study

OBJECTIVES

In this study covering all of Turkey, we aimed to define cutaneous and systemic adverse reactions in our patient population after COVID-19 vaccination with the Sinovac/CoronaVac (inactivated SARS-CoV-2) and Pfizer/BioNTech (BNT162b2) vaccines.

METHODS

This prospective, cross-sectional study included individuals presenting to the dermatology or emergency outpatient clinics of a total of 19 centers after having been vaccinated with the COVID-19 vaccines. Systemic, local injection site, and non-local cutaneous reactions after vaccination were identified, and their rates were determined.

RESULTS

Of the 2290 individuals vaccinated between April 15 and July 15, 2021, 2097 (91.6%) received the CoronaVac vaccine and 183 (8%) BioNTech. Systemic reactions were observed at a rate of 31.0% after the first CoronaVac dose, 31.1% after the second CoronaVac dose, 46.4% after the first BioNTech dose, and 46.2% after the second BioNTech dose. Local injection site reactions were detected at a rate of 35.6% after the first CoronaVac dose, 35.7% after the second CoronaVac dose, 86.9% after the first BioNTech dose, and 94.1% after the second BioNTech dose. A total of 133 non-local cutaneous reactions were identified after the CoronaVac vaccine (2.9% after the first dose and 3.5% after the second dose), with the most common being urticaria/angioedema, pityriasis rosea, herpes zoster, and maculopapular rash. After BioNTech, 39 non-local cutaneous reactions were observed to have developed (24.8% after the first dose and 5% after the second dose), and the most common were herpes zoster, delayed large local reaction, pityriasis rosea, and urticaria/angioedema in order of frequency. Existing autoimmune diseases were triggered in 2.1% of the patients vaccinated with CoronaVac and 8.2% of those vaccinated with BioNTech.

CONCLUSIONS

There are no comprehensive data on cutaneous adverse reactions specific to the CoronaVac vaccine. We determined the frequency of adverse reactions from the dermatologist's point of view after CoronaVac and BioNTech vaccination and identified a wide spectrum of non-local cutaneous reactions. Our data show that CoronaVac is associated with less harmful reactions while BioNTech may result in more serious reactions, such as herpes zoster, anaphylaxis, and triggering of autoimmunity. However, most of these reactions were self-limiting or required little therapeutic intervention.

The impact of COVID-19 pandemic on psoriasis patients, and their immunosuppressive treatment: a cross-sectional multicenter study from Turkey

BACKGROUND

Immunosuppressive therapy has been a great concern during the pandemic. This study aimed to evaluate the pandemic's impact on psoriasis patients treated with immunosuppressive drugs.

MATERIAL AND METHODS

The multicenter study was conducted in 14 tertiary dermatology centers. Demographic data, treatment status, disease course, and cases of COVID-19 were evaluated in patients with psoriasis using the immunosuppressive treatment.

RESULTS

Of 1827 patients included, the drug adherence rate was 68.2%. Those receiving anti-interleukin (anti-IL) drugs were more likely to continue treatment than patients receiving conventional drugs (OR = 1.50, 95% CI, 1.181-1.895, p = .001). Disease worsening rate was 24.2% and drug dose reduction increased this rate 3.26 and drug withdrawal 8.71 times. Receiving anti-TNF or anti-IL drugs was associated with less disease worsening compared to conventional drugs (p = .038, p = .032; respectively). Drug withdrawal causes were 'unable to come' (39.6%), 'COVID concern' (25.3%), and 'physician's and patient's co-decision' (17.4%). Four patients had COVID-19 infection with mild symptoms. The incidence was 0.0022% while it was 0.0025% in the general population.

CONCLUSION

Our study shows that psoriasis patients using systemic immunosuppressive do not have a higher, but even lower COVID-19 risk than the general population, and treatment compliance with biological drugs is higher.

Coronavirus Disease 2019 (COVID-19) Accompanied by Maculopapular Rash: A Case Study

A new type of coronavirus (coronavirus disease 2019; COVID-19), which emerged in the People's Republic of China, spread all over the world over time and became a pandemic. Dermatological symptoms seen during the course of the disease have gained importance over time. Studies have shown that many dermatological findings such as erythematous rash, urticaria, pseudo-chilblain, maculopapular, livedo/necrosis, and vesicular lesions may accompany the disease. In this study, a 24-year-old female patient with maculopapular lesions who had no previous history of allergy or dermatological disease and regressed without any dermatological treatment is presented.

The relationship between the severity of coronary artery disease and skin measurement parameters

PURPOSE

This study aimed to investigate the relationship between skin parameters and CAD.

MATERIALS AND METHODS

The study included 50 patients diagnosed with coronary artery disease as the patient group and 45 volunteers without any known coronary artery disease as the control group. The participants' skin TEWL, pH, temperature, electrical capacitance, sebum, and elasticity values were measured using noninvasive methods at the forehead, back, and forearm.

FINDINGS

Skin temperature was significantly higher in the back and forehead regions in the patient group. No difference was found between the sebum values of the patient and control groups at the back and forehead. A significantly higher result was obtained for the forearm area. The pH was significantly lower in the patients' forearm, although the obtained values were within the normal range. The TEWL was significantly higher in patients in all three regions. In terms of flexibility, R2 was significantly higher in the back and forehead regions of the patient group, and the R6 was significantly higher in the patient group in all three regions. In addition, there was no correlation between skin parameter and SYNTAX score increase measurements.

CONCLUSION

It can be suggested that skin sebum and TEWL measurements can be accepted as cheap and noninvasive methods of predicting CAD.