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From the Masterclasses in Dermatology 2024 Meeting: Updates in Psoriasis Treatments.

J Clin Aesthet Dermatol

February 2025

Ms. Romanelli and Dr. Gottlieb are with the Department of Dermatology and Department of Medicine, Division of Rheumatology at Icahn School of Medicine at Mount Sinai in New York, New York.

Psoriasis (PsO) is an immune-mediated, chronic inflammatory skin disease that significantly impairs quality of life. Its treatment landscape is rapidly evolving, providing better disease control. Here, we highlight updates in biologics, obtaining coverage for biologics under Medicare, the PsO-to-psoriatic arthritis (PsA) transition, and orally administered drugs, as presented at the 2024 Masterclass in Dermatology in Puerto Rico.

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Psoriatic arthritis (PsA) is a chronic, inflammatory disease with heterogeneous clinical features. The pathogenesis of PsA involves a complex interplay of genetic, immunologic, and environmental factors, leading to the activation of the immune system and subsequent inflammation. Over the past decade, the understanding of the immune mechanisms underlying PsA has advanced significantly, particularly regarding the role of the interleukin-23/T helper 17 pathway in the disease process.

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Using a bioassay-guided fractionation approach, the most potent anti-psoriatic components of Aster squamatus herb, Aster chinensis stalks, and Aster chinensis flowers, cultivated in Egypt, were identified and evaluated against Imiquimod (IMQ)-induced psoriasis in female BALB/c mice and compared to standard drug, mometasone. The topical application of A. chinensis stalk methanolic extract exhibited the strongest anti-psoriatic effects against IMQ-induced psoriasis model, as evidenced by improvements in psoriasis area severity index (PASI) score, histopathological analysis, and spleen index.

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Erythrodermic psoriasis (EP) is a severe and challenging variant of psoriasis that often shows poor drug survival. While risankizumab, an IL-23 inhibitor, has demonstrated efficacy in patients with moderate-to-severe plaque psoriasis, its effectiveness in patients with a history of EP is less explored. This study aimed to evaluate treatment response to risankizumab and identify potential predictors influencing the treatment response.

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Background And Objective: Targeting the interleukin (IL)-23 axis is an emerging treatment target for ulcerative colitis (UC), with several positive randomized controlled trials (RCTs). We aim to investigate the safety and efficacy of IL-23 inhibitors for the induction and maintenance treatment of moderate to severe UC.

Methods: A systematic review and meta-analysis synthesizing evidence from RCTs obtained from PubMed, Cochrane, Scopus, and Web of Science from inception to August 2024.

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