Effectiveness and safety of tildrakizumab for the treatment of psoriasis in real-world settings at 24 weeks: A retrospective, observational, multicentre study by the Spanish Psoriasis Group.

BACKGROUND: Tildrakizumab is a humanized, IgG1/κ antibody that interacts with the p19 subunit of interleukin 23. It is approved for the treatment of moderate-to-severe plaque psoriasis. Real-world evidence on the effectiveness and safety of tildrakizumab is limited. OBJECTIVES: To assess the effectiveness and safety of tildrakizumab at 24 weeks in patients with moderate-to-severe plaque psoriasis in routine clinical practice. METHODS: Retrospective, observational, multicentre study including adult patients with moderate-to-severe plaque psoriasis treated with tildrakizumab under real-life conditions. Patient data were extracted from anonymized electronic medical records. Statistical analysis was performed using SPSS22. RESULTS: A total of 190 patients were included. About 53.9% were men with a mean age of 51.45 (SD 3.9) and a mean BMI of 29.13 (SD 6.21). About 79.8% (132 out of 190) of patients had previously received biological therapy (BT) and 17.3% (33 out of 191) had psoriatic arthritis. Baseline PASI was 10.7 (SD 6.53). Up to 109 patients reached Week 24 and at this point mean baseline PASI decreased to 1.7 (SD 4.8), representing an 88.79% mean PASI reduction. At 6 months, 87.1% and 40.3% of the treated patients achieved PASI ≤3 and ≤1, respectively. At Week 24 mean BSA decreased from 13.2 (SD 10.07) to 1.6 (SD 4.40) and mean DLQI went from 12.5 (SD 7.12) to 1.2 (SD 3.27). Multivariate analysis showed no differences when effectiveness was correlated with gender, obesity, psoriatic arthritis or prior exposure to BT. The rate of adverse events (AE) was 5.9% (11 out of 190), where infections were the most frequent AE (4 out of 11). One patient suffered a haemorrhagic ictus and one patient died due to causes unrelated to the study. CONCLUSION: Tildrakizumab was effective and safe in a large cohort of patients with moderate-to-severe plaque psoriasis treated in a routine clinical setting.

Treatment of hidradenitis suppurativa with intralesional photodynamic therapy with 5-aminolevulinic acid and 630nm laser beam.

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic relapsing inflammatory skin disease with multiple treatment options that have been used with mixed results. OBJECTIVES: To evaluate the effectiveness, safety and tolerability of intralesional photodynamic therapy (I-PDT) in the management of HS. Also, to assess the effect of this technique on the different areas treated. METHODS: Case series of 38 HS patients treated with I-PDT between 2011-2015 following a standardized protocol to assess response at the treated areas RESULTS: 29 patients achieved a complete response, while persistence was noted on 8 cases and only 1 suffered a recurrence. Difference between basal (median 28.5) and final (0) Hidradenitis Severity Score showed a significant reduction of 24.5 points (p<0.001, 95% OR 19.5-31). Basal (median 10) and final (1) Dermatology Life Quality Index scores reached a reduction of 10 points (p<0.001, 95%OR 8-12). Complete response was achieved in 68.2% of armpits, 88.5% of groins, 88.9% of buttocks and 100% of other locations. 18 out of 38 patients needed only a session to achieve a complete response, while maintaining a good tolerability. CONCLUSION: We believe that I-PDT might be an alternative treatment option for localized HS lesions, achieving a high rate of remission with an adequate maintenance of response i and few complications.

Impétigo herpetiforme durante la gestación con empeoramiento posparto / Impetigo herpetiform during pregnancy with postpartum worsening

El impétigo herpetiforme es una rara enfermedad asociada al embarazo, ocurre habitualmente en el tercer trimestre, con una elevada morbimortalidad maternofetal cuando no se establece el tratamiento adecuado y un control obstétrico estricto. En la mayoría de los casos desaparece en el periodo posnatal y recurre en las siguientes gestaciones de manera más precoz y agresiva. Se presenta el caso de una gestante diagnosticada en la semana 28 de impétigo herpetiforme con evolución en brotes a pesar del tratamiento corticoideo y con empeoramiento del cuadro en el puerperio, precisando la administración de corticoides, ciclosporina y adalimumab (AU)

Impetigo herpetiformis is a rare disease associated with pregnancy, mainly during the third trimester. Without adequate treatment or close maternal-obstetric monitoring, thisdisease carries high mortality. In most cases, the disease resolves in the postnatal period but is associated with an earlier and more aggressive recurrence in subsequent pregnancies. We describe the case of a woman diagnosed with impetigo herpetiformis at week 28 week of pregnancy. Despite corticosteroid therapy, she continued to have recurrences, with worsening in the postpartum period, requiring treatment with corticosteroids, cyclosporine, and adalimumab (AU)