Objective: To update guidance regarding the management of psoriatic disease during the COVID-19 pandemic.Study Design: The task force (TF) includes 18 physician voting members with expertise in dermatology, rheumatology, epidemiology, infectious diseases, and critical care. The TF was supplemented by nonvoting members, which included fellows and National Psoriasis Foundation staff. Clinical questions relevant to the psoriatic disease community were informed by inquiries received by the National Psoriasis Foundation. A Delphi process was conducted.

PURPOSE Atypical, non-V600 BRAF ( aBRAF) mutations represent a rare molecular subtype of metastatic colorectal cancer (mCRC). Preclinical data are used to categorize aBRAF mutations into class II (intermediate to high levels of kinase activity, RAS independent) and III (low kinase activity level, RAS dependent). The clinical impact of these mutations on anti-EGFR treatment efficacy is unknown. PATIENTS AND METHODS Data from 2,084 patients with mCRC at a single institution and from an external cohort of 5,257 circulating tumor DNA (ctDNA) samples were retrospectively analyzed. Overall survival (OS) was calculated using Kaplan-Meier and log-rank tests. Statistical tests were two-sided. RESULTS BRAF mutations were harbored by 257 patients, including 36 with aBRAF mutations: 22 class III, 10 class II, four unclassified. For patients with aBRAF mCRC, median OS was 36.1 months, without a difference between classes, and median OS was 21.0 months for patients with BRAFV600E mCRC. In contrast to right-sided predominance of tumors with BRAFV600E mutation, 53% of patients with aBRAF mCRC had left-sided primary tumors. Concurrent RAS mutations were noted in 33% of patients with aBRAF mCRC, and 67% of patients had microsatellite stable disease. Among patients with aBRAF RAS wild-type mCRC who received anti-EGFR antibodies (monotherapy, n = 1; combination therapy, n = 10), no responses to anti-EGFR therapy were reported, and six patients (four with class III aBRAF mutations, one with class II, and one unclassified) achieved stable disease as best response. Median time receiving therapy was 4 months (range, 1 to 16). In the ctDNA cohort, there was an increased prevalence of aBRAF mutations and subclonal aBRAF mutations ( P < .001 for both) among predicted anti-EGFR exposed compared with nonexposed patients. CONCLUSION Efficacy of anti-EGFR therapy is limited in class II and III aBRAF mCRC. Detection of aBRAF mutations in ctDNA after EGFR inhibition may represent a novel mechanism of resistance.

Objective To provide guidance about management of psoriatic disease during the COVID-19 pandemic. Study Design A task force (TF) of 18 physician voting members with expertise in dermatology, rheumatology, epidemiology, infectious diseases, and critical care was convened. The TF was supplemented by non-voting members which included fellows and National Psoriasis Foundation (NPF) staff. Clinical questions relevant to the psoriatic disease community were informed by questions received by the NPF. A Delphi process was conducted. Results The TF approved 22 guidance statements. The average of the votes was within the category of agreement for all statements. All guidance statements proposed were recommended, 9 with high consensus, 13 with moderate consensus. Limitations The evidence behind many guidance statements is limited in quality. Conclusion These statements provide guidance for the management of patients with psoriatic disease on topics ranging from how the disease and its treatments impact COVID-19 risk and outcome, how medical care can be optimized during the pandemic, what patients should do to lower their risk of getting infected with SARS-CoV-2 and what they should do if they develop COVID-19. The guidance is intended to be a living document that will be updated by the TF as data emerge.

We thank the MDACC Cytogenetics and Cell Authentication Core for technical assistance in the cytogenetic analysis.

This study was supported by a grant from Pfizer, Inc. to the Trustees of the University of Pennsylvania (J.M.G.). The funder played no role in the study design, data collection, data analysis or manuscript preparation. Conflicts of interestJ.W. has received research and fellowship funding from Pfizer, Inc. (paid to the University of Pennsylvania). M.N.S. has received fellowship funding from Pfizer, Inc. (paid to the University of Pennsylvania). K.A. has received research funding from Pfizer, Inc. and L'Or eal (paid to UCSF), and receives consulting fees for serving on the academic steering committee for TARGET RWE. A.R.L. is an employee of Pfizer, Inc. J.M.G. has served as a consultant for and received honoraria from Abcentra, AbbVie, Bristol Myers Squibb, Boehringer Ingelheim, GSK, Eli Lilly and Company (data monitoring committee), Janssen Biotech, Novartis, UCB (data and safety monitoring board), Neuro-Derm (data and safety monitoring board), Trevi Therapeutics Inc., and MiNDERA Dx (Mindera Health); he receives research grants (to the trustees of the University of Pennsylvania) from Boehringer Ingelheim and Pfizer Inc.; he has received payment for continuing medical education work related to psoriasis that was supported indirectly by pharmaceutical sponsors; he is a co-patent holder of resiquimod for treatment of cutaneous T-cell lymphoma; he serves as a deputy editor for the SummaryBackground Staphylococcal and herpes simplex virus (HSV) infections are commonly recognized in atopic dermatitis (AD), but less is known about other types of infections. Objectives To determine the risk of herpesvirus infections, serious infections and opportunistic infections in patients with AD. Methods We conducted a population-based cohort study using UK-based electronic medical records data. Patients with AD were each matched to up to five unaffected patients on age, practice and index date. AD severity was defined using treatments as a proxy. Outcomes were incident herpesvirus infections [cytomegalovirus (CMV), Epstein-Barr virus (EBV), HSV or varicella zoster virus (VZV)], serious infections and opportunistic infections. Results Among 409 431 children and 625 083 adults with AD matched to 1 809 029 children and 2 678 888 adults without AD, respectively, adjusted Cox regression models showed children and adults with AD had a 50-52% greater risk of HSV and 18-33% greater risk of VZV, with risk increasing in parallel with AD severity. CMV risk was elevated among children with AD [hazard ratio (HR) 2Á50, 95% confidence interval (95% CI) 1Á38-4Á54] and adults with severe AD (HR 4Á45, 95% CI 1Á76-11Á25). Patients with AD had a 26-40% increase in risk of serious infections, with severe AD carrying the greatest risk. Although rare, opportunistic infections were associated with all severities of AD in adults (overall HR 1Á31, 95% CI 1Á20-1Á42), but were not associated with AD in children. All estimates remained consistent after excluding patients receiving immunosuppressive treatments for AD. Conclusions AD is significantly associated...