Ethnicity affects the presenting severity of psoriasis

Abrouk, Michael; Lee, Kristina; Brodsky, Merrick; Nakamura, Mio; Singh, Rasnik; Zhu, Tian Hao; Farahnik, Benjamin; Liao, Wilson

doi:10.1016/j.jaad.2017.02.042

Cited by 30 publications

(23 citation statements)

References 2 publications

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“…Erythrodermic psoriasis is a potentially fatal presentation of psoriasis. A higher frequency of severe psoriasis was reported in Asian individuals, [52] as well as erythrodermic psoriasis (OR = 5.56, p = 0.018) [37]. In Chinese patients with erythrodermic psoriasis, HLA-C*01:02 was reported to be the most frequent HLA-C allele (34.4%).…”

Section: Hla-cw1 and Clinical Presentations Of Psoriasismentioning

confidence: 93%

HLA-Cw1 and Psoriasis

Huang

Tsai

2021

Am J Clin Dermatol

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Psoriasis is a chronic inflammatory skin condition with regional and ethnic differences in its prevalence and clinical manifestations. Human leukocyte antigen (HLA)-Cw6 is the disease allele conferring the greatest risk to psoriasis, but its prevalence is lower in Asian individuals. Recent studies have found associations between HLA-Cw1 and some Asian populations with psoriasis, especially Southern Chinese. HLA-Cw6 was associated with type I early-onset psoriasis, guttate psoriasis, Koebner phenomenon, and better response to methotrexate, interleukin (IL)-12/23, IL-17, and IL-23 targeting drugs. In contrast, HLA-Cw1 positivity has been associated with erythrodermic psoriasis, pustular psoriasis, and the axial type of psoriatic arthritis. Furthermore, HLA-Cw1 was more frequently associated with high-need patients who did not respond to conventional therapies. No known trigger factor nor autoantigen has been identified for HLA-Cw1 positivity. However, HLA-Cw1 has been linked to some viral agents. For example, cytotoxic T lymphocytes recognize multiple cytomegalovirus pp65-derived epitopes presented by HLA alleles, including HLA-C*01:02. In addition, cytomegalovirus can lead to severe exacerbation of psoriatic skin disease. The proposed interaction between viral infection, HLA-Cw1, and psoriasis is through the killer cell immunoglobulin-like receptors of natural killer cells. Given the diverse nature of psoriasis pathogenesis and the difference in HLA-Cw prevalence in different racial groups, more studies are needed to confirm the role of HLA-Cw1 in psoriasis. Key PointsHuman leukocyte antigen (HLA)-Cw1 is a less recognized but important HLA-Cw allele associated with psoriasis in some Asian ethnicities.Patients carrying HLA-Cw1 tend to show higher disease activity, have an increased risk of developing erythrodermic psoriasis, and are more refractory to treatments.

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Section: Hla-cw1 and Clinical Presentations Of Psoriasismentioning

confidence: 93%

HLA-Cw1 and Psoriasis

Huang

Tsai

2021

Am J Clin Dermatol

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“…1 Accordingly, dermatology societies worldwide advocate vaccination for this high-risk population. [2][3][4] The current COVID-19 crisis has raised substantial concerns among patients with psoriasis, particularly those who are immunosuppressed. 5 However, the promising results of COVID-19 vaccines seem to be turning SARS-CoV-2 infection into a preventable disease.…”

Section: Covid-19 Vaccination Intention Among Patients With Psoriasis Compared With Immunosuppressed Patients With Other Skin Diseases Anmentioning

confidence: 99%

Biologics utilization for psoriasis is lower in black compared with white patients

et al. 2021

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provided by hair styles in women. Human papillomavirus infection and/or systemic immunosuppression are additional risk factors for SCC; however, it is unclear whether they influence SCC development differently regarding face region or sex. 2 Melanoma distribution on the face may differ by sex. In two studies, 59Á8% and 71Á8% of facial melanoma cases were distributed on the cheek in female patients as compared with 48Á8% and 43Á6%, respectively, in male patients. 6,7 Although protection from hair can help decrease melanoma occurrence on the external face in women, the higher incidence of melanoma on the cheek may involve other factors, including hormone-related UV sensitivity and habitual friction. 7,8 Larger studies with detailed anatomical mapping are needed to confirm our results.The present study was a descriptive, single-centre study that contained a limited number of patients, and did not adjust for confounders. However, the unique nonoverlapping distributions of BCC, SCC and melanoma on the face surface indicates the presence of disease-specific aetiological factors other than UV exposure.

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“…settings, patient diversity, differences in ethnicity, gender, age, psychosocial factors, nutritional status, smoking, and environmental factors as mentioned in other studies. [21][22][23][24] On the other hand, in recent years PDT has been described to be effective in the treatment of plaque-type psoriasis, 9,25 while there are not enough prior studies reporting the treatment of nail psoriasis with PDT. Fernández-Guarino et al showed the efficacy of PDT and the pulsed dye laser in the treatment of nail psoriasis, although the reduction in the NAPSI score in both treatment groups was not significant; they revealed 21% improvement in the NAPSI score after 3 months and 54% improvement after 6 months of treatment with PDT.…”

Section: Discussionmentioning

confidence: 99%

A Comparison of The Effects of Clobetasol 0.05% and Photodynamic Therapy Using Aminolevulinic Acid With Red Light in the Treatment of Severe Nail Psoriasis

et al. 2020

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Introduction: The treatment of nail psoriasis is often difficult and unsatisfactory due to therapy resistance. This study aimed to compare the efficacy of clobetasol 0.05% ointment and photodynamic therapy (PDT) using aminolevulinic acid (ALA) and red light in the treatment of severe nail psoriasis. Methods: This open-trial study included 69 nails of 8 patients with severe nail psoriasis. Thirty-four nails were treated with clobetasol 0.05% ointment and 35 nails were treated with ALA-PDT. ALAPDT treatment was performed every 3 weeks for 5 cycles; the nails were treated with clobetasol under occlusion every day during the study. All the patients were followed up after 24 weeks. The severity of nail involvement was measured by the Nail Psoriasis Severity Index (NAPSI) scores at the baseline and during the treatment. Results: There were no significant differences in the NAPSI scores between the treatment groups in the baseline and weeks 3, 6 and 9 (all P>0.05), although significant differences were found in weeks 12, 15 and 24 (follow-up) (P<0.001). A significant time-effect improvement was found in all the nailmatrix, nail-bed and total NAPSI scores in both treatment groups (all P<0.001). The patients did not report intense pain and discomfort during irradiation. Conclusion: Clobetasol 0.05% ointment seems to be effective in treating nail psoriasis after a treatment period of 15 weeks. However, the efficacy of ALA-PDT at a 24-week follow-up was greater than that of clobetasol.

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Ethnicity affects the presenting severity of psoriasis

Cited by 30 publications

References 2 publications

HLA-Cw1 and Psoriasis

HLA-Cw1 and Psoriasis

Biologics utilization for psoriasis is lower in black compared with white patients

A Comparison of The Effects of Clobetasol 0.05% and Photodynamic Therapy Using Aminolevulinic Acid With Red Light in the Treatment of Severe Nail Psoriasis

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