European Journal of Dermatology最新文献

Psoriasis is a chronic, inflammatory disorder with incidence increasing markedly with age. Frailty, a multidimensional syndrome characterized by diminished physiological resilience, has emerged as a critical concern in aging populations. Despite the clinical relevance of both conditions in aging populations, the potential association between frailty and psoriasis remains poorly understood. To investigate the association between frailty and the risk of psoriasis and evaluate potential causal relationships. Cross-sectional analyses were conducted using data from the National Health and Nutrition Examination Survey (NHANES) 2003-2006 and 2009-2014. Psoriasis was defined based on self-reported physician diagnoses, while frailty was quantified using a validated 49-item frailty index. Multivariable logistic regression, subgroup analyses, and interaction tests were employed to examine associations between psoriasis and frailty. Mendelian randomization (MR) analyses were conducted utilizing genome-wide association study summary statistics. The inverse-variance weighted (IVW) method served as the primary method, supplemented by sensitivity analyses. Frailty was significantly associated with elevated psoriasis risk (OR=1.75; 95% CI: 1.31-2.33; p=0.0003). This association was amplified in adults aged ≥60 years (OR=2.17; 95% CI: 1.26-3.73) and females (OR=2.08; 95% CI: 1.48-2.91). Stratified analyses demonstrated consistency across racial/ethnic, educational, and smoking subgroups. MR analyses supported a causal effect of frailty on psoriasis (IVW-derived OR=1.13; 95% CI: 1.03-1.21; p=0.01), with sensitivity models confirming robustness. Frailty is positively associated with psoriasis risk in observational analyses, and MR analyses further support a causal relationship. These findings highlight frailty as a potential modifiable target for psoriasis prevention in aging populations.

Alopecia areata can be accompanied by atopic dermatitis. Alopecia areata accompanied by atopic dermatitis shows more severe symptoms and responds limitedly to dupilumab monotherapy. Topical immunotherapy often fails due to atopic dermatitis flares. To report the usefulness of dupilumab combined with topical immunotherapy in alopecia areata patients with atopic dermatitis. Eleven cases of alopecia areata with atopic dermatitis, all with Severity of Alopecia Tool (SALT) scores ≥70 and Eczema Area and Severity Index (EASI) scores ≥16, received dupilumab for atopic dermatitis and topical immunotherapy for alopecia areata. A representative treatment began with sensitization using squaric acid dibutyl ester or diphenylcyclopropenone, followed by dupilumab monotherapy to control atopic dermatitis. After topical immunotherapy titration, concurrent dupilumab and topical immunotherapy were administered. SALT scores were evaluated at week 28. All patients completed the combination therapy without atopic dermatitis flares. At week 28, 64% achieved SALT ≤20, including those with alopecia areata duration ≤seven years. Patients with IgE ≥200 IU/mL tended towards higher efficacy. No serious adverse events were reported, including in paediatric or oncology cases. Notably, 75% of patients who had previously failed topical immunotherapy tolerated concentrations up to 100-fold higher. Dupilumab combined with topical immunotherapy demonstrated favourable effects in alopecia areata patients with atopic dermatitis, offering a safer and effective option, especially for paediatric or oncology cases.