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Background@#Nickel is a leading cause of allergic contact dermatitis. Patients with nickel allergy may suffer from persistent dermatitis not only through contact with nickel-plated items but also through ingestion of nickel-containing food. @*Objective@#This study aimed to evaluate the current nickel content in Korean food products and provide more up-to-date Korean nickel-restricted diets that would increase patient compliance. @*Methods@#The most frequently consumed food items were selected with replicates. Food samples were prepared according to the practices of normal consumers. The solid specimens were finely ground, and the liquid specimens were homogenized using a sterilized mixer. Tea bags were brewed in 100 mL of distilled water at 100 °C for 5 minutes. Solid (0.5 g) and liquid (2 g) specimens were subjected to microwave-assisted nitric acid digestion using inductively coupled plasma-mass spectrometry. @*Results@#In total, 147 samples were collected from different food categories, including plant-based products, animal-based products, packaged foods, and drinks. Cocoa powder had the highest concentration of nickel (1.56 mg/kg), which is consistent with the results of previous studies. Soy products such as fermented soybean paste (Doenjang) (1.16 mg/kg), fermented soybean with red chili paste (Ssamjang) (0.67 mg/kg), and tofu (0.37 mg/kg) had elevated concentration of nickel. Moreover, nut-derived products such as chocolate (1.10 mg/kg), ground coffee (0.86 mg/kg), almond (0.84 mg/kg), and peanuts (0.64 mg/kg) contained elevated nickel concentration. @*Conclusion@#The nickel content in food constantly changes depending on the food processing procedures and place of origin. Therefore, revising the nickel-restricted diet is necessary to enhance patients’ understanding of it and help reduce dietary nickel intake.
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Background@#Interleukin (IL)-17 and IL-23 inhibitors have helped achieve clear skin in many patients with psoriasis. However, real-world data to compare short- and long-term efficacy of these biologics in Korean patients are lacking. @*Objective@#To compare short- and long-term efficacy of IL-17A and IL-23 inhibitors in patients with moderateto-severe psoriasis. @*Methods@#We retrospectively evaluated efficacy of IL-17A and IL-23 inhibitors among patients treated at Ajou University Hospital from 2017 to 2022. The specific agents studied were as follows: secukinumab, 32 patients; ixekizumab, four patients; guselkumab, 13 patients; and risankizumab, 31 patients. Patients who were followed up for less than a year or changed biologics were excluded. @*Results@#The rates of psoriasis area and severity index (PASI) 90 achievement of secukinumab were 62.5%, 86.7%, 89.3%, 80.8%, and 70.8% at weeks 16, 40, 88, 112, and 136, respectively. For ixekizumab, the PASI90 achievement rates were 75%, 100%, 75%, and 100% at weeks 16, 40, 64, and 88, respectively. The PASI90 achievement rates of guselkumab were 53.8%, 76.9%, 72.7%, and 77.8% at weeks 20, 44, 68, and 92, respectively. For risankizumab, PASI90 achievement rates were 69.7%, 90.0%, 93.7%, and 100% at weeks 28, 52, 76, and 100, respectively. Before 52 weeks, PASI90 achievement was significantly lower with guselkumab than with secukinumab (hazardratio=0.22). After 52 weeks, PASI90 achievement was significantly higher with risankizumab than with secukinumab (hazard ratio=2.00). @*Conclusion@#PASI90 was achieved faster with IL-17A inhibitors than with IL-23 inhibitors. However, IL-23 inhibitors afforded the maintenance of a higher PASI score after 52 weeks.
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Background@#Psoriasis is a multifactorial, chronic immunological disease, in which a specific allele HLA-Cw6 is associated with various clinical manifestations. However, information regarding this genetic factor in Korean patients with psoriasis remains limited. @*Objective@#We aimed to explore the differences in clinical patterns and treatment responsiveness, depending on the expression of HLA-Cw6, in Korean patients with psoriasis. @*Methods@#We divided patients into two groups, namely HLA-Cw6-positive and HLACw6-negative, based on the HLA-Cw6 allelic analysis using the single specific primerpolymerase chain reaction method. All clinical information regarding these patients was collected in a retrospective manner. Next, we evaluated the levels of serum Th17-related cytokines in 34 patients diagnosed with psoriasis using a multiplex immunoassay. Finally, we performed immunohistochemical staining of interleukin (IL)-22 and IL-31, as these cytokines showed the maximum differential expression between the HLA-Cw6 positive and negative groups. @*Results@#HLA-Cw6 positive and negative groups comprised of 13 and 21 patients, respectively. HLA-Cw6-positive group had more chance of having metabolic comorbidities (76.9% for HLA-Cw6-positive group; 28.6% for HLA-Cw6-negative group; p=0.002). Also, HLA-Cw6-positive group showed significantly higher treatment response (38.5% in positive group showed Psoriasis Area and Severity Index 90% improvement compared to 4.8% in the negative group; p=0.012). However, all Th17-related cytokines were not significantly different across the two groups. Furthermore, IL-22 and IL-31 immunohistochemical staining did not correlate with the serum cytokines levels. @*Conclusion@#HLA-Cw6 types can be associated with disease severity, comorbidities, and treatment responsiveness in Korean patients with psoriasis.
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Background@#Psoriasis is a chronic relapsing inflammatory disease, with several cytokines related to its pathophysiology and clinical manifestations, such as disease activity, severity, and clinical subtype. However, there is limited information regarding Korean psoriasis patients.Objective We investigated the association between serum inflammatory cytokines and clinical characteristics of psoriasis, including treatment modalities. @*Methods@#We evaluated the serum Th17-related cytokine levels of 70 patients diagnosed with psoriasis using a multiplex immunoassay. All clinical information of patients was collected by reviewing electronic medical records and photo documentation in a retrospective manner. @*Results@#The serum IL-23 level was significantly higher in the young age group (＜40 years), and the IL-6, TNFβ, and IL-28A levels were significantly higher in the early onset group (＜40 years). In addition, patients with moderate-to-severe psoriasis (PASI≥10 and body surface area ≥10%) exhibited significantly lower serum IL-28A levels. We observed high serum TNF-α and CCL20 levels in patients with metabolic comorbidities and those with psoriatic arthritis, respectively, and biologics use and systemic treatment modality were also significantly associated with the serum levels of some cytokines. @*Conclusion@#Disease severity, comorbidities, presence of psoriatic arthritis, and treatment responsiveness might affect the inflammatory cytokine levels in psoriasis patients. Therefore, the serum cytokine levels can be used to predict the severity or treatment responsiveness of psoriasis patients.