A case-control study was performed to assess the serum levels of TNF-α, IL-12/23p40, and IL-17 in patients with plaque psoriasis, compare them with healthy controls, and correlate them with disease severity, as represented by Psoriasis Area Severity Index (PASI). 32 consecutively selected, untreated patients with active, chronic plaque psoriasis were recruited and compared to 32 age- and sex-matched healthy controls. Serum cytokine levels were determined by solid phase sandwich enzyme linked immunosorbent assay (R&D Systems Europe, Ltd.). The mean serum levels of TNF-αwere significantly higher in psoriatic patients compared to those of controls (Mann-WhitneyUtest;P=0.000). However, the median serum levels of neither IL-12/23p40 nor IL-17 differ significantly between the 2 groups (Mann-WhitneyUtest;P=0.968andP=0.311, resp.). No significant correlations were found between PASI and any of the cytokine serum levels (Spearman’s rank test;P>0.05). Despite the well-evidenced therapeutic efficacy of biologic agents targeting TNF-α, IL-12/23p40, and IL-17, serum levels of TNF-α, IL-12/23p40, and IL-17 do not seem to correlate with the severity of psoriatic skin disease in untreated patients, as represented by PASI. Further investigation may add more data on the pathogenetic cascade of psoriasis.

Background: Ustekinumab has been most recently approved for psoriasis treatment and its efficacy on nail psoriasis is still underreported. Methods: Twenty-seven patients suffering from moderate-to-severe plaque psoriasis with nail involvement were enrolled in this open-label, uncontrolled, nonrandomized study to evaluate the therapeutic potential of ustekinumab. Participants were scheduled to receive subcutaneous injections of ustekinumab at a dose of 45 mg at baseline and week 4 and every 12 weeks thereafter. Nail Psoriasis Severity Index (NAPSI) and Psoriasis Area Severity Index (PASI) were assessed apart from baseline at weeks 16, 28, and 40. Results: NAPSI median score significantly decreased from 73.0 (range: 12.0–151.0) at baseline to 37.0 (range: 7.0–92.0) at week 16, to 9.0 (range: 0.0–32.0) at week 28, and to 0.0 (range: 0.0–12.0) at week 40. Median PASI score decreased from 23.9 (range: 10.6–45.5) at baseline to 0.0 (range: 0.0–5.2) at week 40. NAPSI median improvement was of 42.5% (range: 21.9–64.9%) at week 16, 86.3% (range: 75.0–100.0%) at week 28, and 100.0% (range: 91.0–100.0%) at week 40. PASI score showed a significant median improvement of 76.9% (range: 10.3–90.3%) and 100.0% (range: 71.7–100.0%), at weeks 16 and 40, respectively. Conclusion: Although this study may be considered as preliminary, data suggest that ustekinumab is very effective in nail psoriasis.

Hidradenitis suppurativa (HS) is a relapsing, inflammatory disease characterized by painful nodules, abscesses, sinuses track formation and scarring. HS has a great impact on patients’ quality of life and its treatment may be really challenging. Adalimumab provides a new therapeutic option for HS. Our aim was to assess the therapeutic potential of adalimumab on patients with HS based on the data from the daily clinical practice of an HS Outpatient Clinic. 19 patients with clinically evident moderate to severe HS, under adalimumab treatment for at least 24 week, participated in this observational, retrospective study. The Hidradenitis Suppurativa Physician’s Global Assessment scale, Modified Santorius scale and Dermatology Life Quality Index (DLQI) at baseline, week 4, week 12 and week 24 were retrieved from the records. Both Modified Santorius score and DLQI were significantly decreased during the weeks of evaluation (Friedman’s test; P < 0.001). The proportion of patients who achieved clinical response was 10.5% (n = 2) at week 4, 42.1% (n = 8) at week 12 and 63.2% (n = 12) at week 24. Treatment with adalimumab was linked with both clinical remission of HS and improvement of patients’ quality of life.

Background:Occurrence rates of specific features of psoriatic nails, as well as the influence of variable clinical parameters on nail involvement in psoriasis, are not determined. Objective:To evaluate the frequency and characteristics of nail involvement in patients with psoriasis and determine the relationship between nail psoriasis and clinical parameters (age, gender, family history, clinical type, age of onset, duration, joint involvement). Methods: 228 psoriatic patients, who had not received any systematic or topical antipsoriatic treatment for at least a year, were consecutively selected to participate in this cross-sectional study. Results: 66.7% of patients had nail psoriasis. A logistic regression model showed that none of the clinical covariates were statistically significant in predicting nail psoriasis. Conclusion: The majority of psoriatic patients presented nail psoriasis. The most common feature was oil drop. There was a difference in the prevalence of each feature between fingernails and toenails. In correlation with clinical parameters, nail psoriasis evolves independently.

Background: Anti-tumor necrosis factor (TNF) agents' effect on psoriatic nails is still under investigation. Objective: To evaluate the therapeutic potentials of anti-TNF agents on psoriatic nails of patients suffering from moderate-to-severe plaque psoriasis. Materials and methods: A retrospective study was conducted based on the medical records of 12 patients treated with infliximab, 14 with adalimumab and 13 with etanercept in daily practice. The Nail Psoriasis Severity Index (NAPSI) was recorded at baseline, week 12, 24 and 48. Results:At week 12, NAPSI was improved compared to baseline by 48.0% (range: 40.2–66.6%) with infliximab, 35.0% (range: 25.0–52.6%) with adalimumab and 41.7% (range: 39.5–46.4%) with etanercept. At week 24, NAPSI was improved by 80.4% (range: 66.6–90.2%) with infliximab, 70.2% (66.6–80.2%) with adalimumab and 76.1% (62.5–85.5%) with etanercept. At week 48, NAPSI was improved by 95.1% (range: 89.5–97.3%) with infliximab, 89.5% (75.0–94.8%) with adalimumab and 92.8% (84.3–96.0%) with etanercept. NAPSI percentage improvement was statistically significant across follow-up period (p = 0.000) for each anti-TNF treatment, as well as among treatments at all time points (week 12, p = 0.000; week 24, p = 0.001; week 48, p = 0.000). Conclusion: All anti-TNF agents result in a significant improvement of NAPSI score, with infliximab given the precedence and followed by etanercept and adalimumab.