Targeted Treatment for Erythrodermic Psoriasis: Rationale and Recent Advances

Shao, Shuai; Wang, Gang; Maverakis, Emanual; Guðjónsson, Jóhann E.

doi:10.1007/s40265-020-01283-2

Cited by 24 publications

(43 citation statements)

References 95 publications

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“…70,125,126 Anti-TNF agents, such as infliximab and etanercept can be combined with traditional immunosuppressive agents for better efficacy, 125 while anti-IL12/23 agents and anti-IL17 agents are usually given as monotherapy for EP due to their superior efficacy, and are therefore used as first-line treatments for EP, including ustekinumab, secukinumab, ixekizumab, guselkumab and brodalumab. 70,125,126 In particular, anti-IL17 agents can control the symptoms of EP within weeks, 92-94,107,109-111, which may be considered in patients who need rapid control. Furthermore, an ongoing trial for risankizumab revealed promising results for 16 weeks, 90 but the longerduration efficacy remains to be published.…”

Section: Discussionmentioning

confidence: 99%

Updates on the Treatment of Erythrodermic Psoriasis

Lo¹,

Tsai

2021

PTT

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Erythrodermic psoriasis (EP) is a rare variant of psoriasis, which is potentially life threatening and often resistant to conventional therapy. Biologics have revolutionized the treatment of plaque-type psoriasis, and shown promise in EP. However, due to the lack of head-to-head studies and the rarity of EP, no high level evidence-based treatment guidelines for EP have been established, and the evidence of treatment of EP is limited to case reports or small case series. Here, we present a narrative review focusing on the up-to-date information for the treatment of EP.

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Section: Discussionmentioning

confidence: 99%

Updates on the Treatment of Erythrodermic Psoriasis

Lo¹,

Tsai

2021

PTT

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“…These results were also found in psoriasis patients that a previous epidemiological study identified obesity as a risk factor for psoriasis progression ( 29 ). Importantly, agents targeting tumor necrosis factor-α signaling were effective for EP treatment, suggesting that the pathophysiology of EP and obesity shared some cytokines that are known to contribute to features of the MetS, such as hypertension, dyslipidemia, and insulin resistance ( 30 , 31 ).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Metabolic Syndrome in Chinese Patients With Erythrodermic Psoriasis: A Case-Control Study

Liu

Wang

et al. 2021

Front. Endocrinol.

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Erythroderma psoriasis (EP) is a rare and severe form of psoriasis, which is a chronic inflammatory skin disease that usually occurs simultaneously with cardiovascular disease (CVD). Metabolic syndrome (MetS) is a significant precursor of CVD. This study was to investigate the association between EP and MetS in the Chinese population. We conducted a retrospective study on 86 consecutive patients with EP and 100 healthy controls from Huashan Hospital between 2013 and 2018. Demographic, biochemical parameters for MetS, and other relevant data including the severity of EP, family history of EP, age of onset, and treatment history involved in those individuals were recorded. The prevalence of MetS in erythrodermic psoriatic patients was 88.37%, which was significantly higher than that of controls (P < 0.0001). Erythrodermic psoriatic patients also had a higher prevalence of MetS components, including abdominal obesity, dyslipidemia and hypertension, whereas hyperglycemia was similar. Adjusted for confounding factors, MetS, abdominal obesity, hypertension, smoking and alcohol use were positive independent predictors of EP (odds ratio > 1, P < 0.05). The area under the receiver operating characteristic curve calculated from determined risk factors for predicting the EP’s incidence was 0.934 (95% CI 0.902-0.966). There was no correlation between the severity of EP and the prevalence of MetS. Compared with patients with mild EP, patients with moderate-to-severe EP had higher body mass index, waist circumstance and blood pressure (P < 0.05). We concluded that the prevalence of MetS and its components was higher in patients with EP. MetS an independent predictor of EP, which can favor CVD and should be encouraged to correct these cardiovascular risk factors aggressively for managing EP.

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Section: Erythrodermic Psoriasis: Erythrodermic Psoriasis (Ep)mentioning

confidence: 99%

“…is a very serious and rare manifestation of psoriasis, often classified as a dermatologic emergency (Shao et al, 2020). Patients frequently present in the emergency department (Shao et al, 2020). EP is characterized by widespread generalized erythema and scaly plaques on the skin and is also often associated with systemic symptoms (Saeki et al, 2017;Weigle and McBane, 2013).…”

Section: Erythrodermic Psoriasis: Erythrodermic Psoriasis (Ep)mentioning

confidence: 99%