The Role of Pharmacogenetics in Chronic Plaque Psoriasis: Update of the Literature.

Psoriasis is a chronic inflammatory disease triggered by both genetic and environmental factors. Systemic and biologic therapies used to treat moderate-to-severe psoriasis show significant variability in efficacy, are associated with various degrees of toxicity, and, for biologic therapies, are expensive. There is a great need for non-invasive biomarkers to predict treatment outcomes of these therapies and to individualize care for patients with psoriasis. This article reviews currently recognized pharmacogenetic targets related to the treatment of chronic plaque psoriasis, in particular to biologic therapies. The use of pharmacogenetic and pharmacogenomic approaches to genetically profile patients will allow therapies to be targeted more precisely and safely to individual patients, to optimize the treatment of psoriasis, and minimize unnecessary costs. Characterizing patients with psoriasis according to common molecular mechanisms rather than by clinical phenotype may also allow more selective therapeutic agents to be targeted to genetically distinct groups of patients.

Alexithymia and Plaque Psoriasis: Preliminary Investigation in a Clinical Sample of 250 Patients.

BACKGROUND/AIMS: Psoriasis as a dermatological disorder has complex effects on mental health and the psychological status of the patient. Many authors proposed that assessing how psoriasis affects a patient's life is better than a body surface area measurement for delineating psoriasis severity. Alexithymia is a personality dimension characterized by difficulty identifying feelings, difficulty describing feelings, and externally oriented thinking observed in many clinical conditions, especially in psychosomatic disorders. This study aimed to determine the prevalence of alexithymia in patients with plaque psoriasis compared with healthy participants, while taking into consideration demographic and clinical variables. METHODS: We enrolled 250 patients with chronic plaque psoriasis, naïve to any systemic treatment, and 215 healthy individuals. The 20-item Toronto Alexithymia Scale (TAS-20) was used to assess alexithymia. Data analysis was done. RESULTS: The mean TAS score was 53.5 (±15.3) for the patient group and 45.1 (±10.8) for controls (p < 0.0001). Compared to controls, the psoriasis group showed significant alexithymic features (32.4 vs. 9.3%), and no significant differences of alexithymia between patients with severe and mild psoriasis were observed. A significant relationship was determined between alexithymia and female gender and sensitive area involvement, such as the face, hands, and genital area. CONCLUSION: This study suggests that the assessment of alexithymia should be a part of the comprehensive care of patients with moderate to severe psoriasis. For this purpose, the TAS-20 is a useful and simple tool to be used in daily clinical practice.