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A 50-year-old man presented with a 2.5-cm, subcutaneous, freely mobile nodule on the occipital scalp that first appeared 35 years prior but recently had started enlarging. Histologically the lesion was well circumscribed. Immunohistochemical staining was positive for SRY-box transcription factor 10 in some of the spindle cells, and staining for epithelial membrane antigen was positive in a separate population of intermixed spindle cells. THE BEST DIAGNOSIS IS:a. desmoplastic melanoma b. hybrid schwannoma-perineurioma c. malignant peripheral nerve sheath tumor d. neurofibroma e. schwannoma

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Psoriasis is associated with numerous comorbid conditions, including psoriatic arthritis, metabolic syndrome, and cardiovascular disease, which often share a similar pathogenesis and follow a progressive pattern. Biologic agents, specifically those targeting tumor necrosis factor, constitute a relatively new, effective, and safe treatment modality for this disease. Because these agents are effective in suppressing the inflammation that occurs in psoriasis, they appear to play a key, but somewhat novel, role in preventing some comorbidities. This review article attempts to elucidate this concept through the currently available literature. We evaluate the possible effects of tumor necrosis factor antagonists on the natural history of psoriasis comorbidities in an effort to shed some light on this exciting frontier.