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In the past, the main treatment options for severe plaque psoriasis included methotrexate, acitretin, and cyclosporine
.
However, almost all current psoriasis trials ignore pustular psoriasis and its variants
Consensus on managing FDA funds
However, in the past ten years, we have learned a lot about the biology of pustular psoriasis from the study of single-gene diseases
.
In 2009, Aksentijevich of the National Institutes of Health and colleagues described a severe neonatal-onset pustular psoriasis with systemic inflammatory symptoms (interleukin 1 receptor antagonist or DIRA deficiency) (OMIM 612852)
child
Although our understanding of the genetic basis of psoriasis vulgaris and pustular psoriasis is mature, there is still a gap in our understanding of the various clinical manifestations of pustular psoriasis
.
For example, we know that patients with IL36RN pathogenic variants tend to show more severe clinical phenotypes
In this issue of the Journal of Dermatology of the American Medical Association, two multicenter studies described the patient characteristics and course of 14 local and generalized impetigo diseases in the United States
.
The purpose of these studies is to recruit 10 palmoplantar pustulosis (PPP) patients and 5 GPP patients from 20 centers in the previously defined 11-year period
antibiotic
Most ppp patients receiving systemic drug therapy receive treatment with acitretin or methotrexate (or phototherapy), but very few receive biological drug therapy
.
The reason for the lack of biological intervention is not clear, but it may include the degree of the patient’s condition, risk/benefit calculations, insurance factors, or lack of evidence to support biological use in a PPP environment
Small, viable proof-of-concept trials for pustular psoriasis (and other rare diseases) can and should be encouraged by departments that have sufficient resources to support this work
.
Recruiting patients to participate in rare disease trials is a long-standing issue; however, patient networks established through social media and other patient support platforms can be used to identify trial candidates in a grassroots manner
Coronavirus disease
Source: Cowen EW, It Is Time to Focus on Pustular Psoriasis, JAMA Dermatol 2021 Dec 08;
Cowen EW, It Is Time to Focus on Pustular Psoriasis, JAMA Dermatol 2021 Dec 08;Leave a message here
