Dermatologic Surgery

<jats:sec>
            <jats:title>BACKGROUND</jats:title>
            <jats:p>Cryolipolysis is an effective, well-tolerated noninvasive subcutaneous fat reduction treatment.</jats:p>
          </jats:sec>
          <jats:sec>
            <jats:title>OBJECTIVE</jats:title>
            <jats:p>Assess participant satisfaction, effectiveness, and safety of a dual-applicator cryolipolysis system that can deliver simultaneous treatments.</jats:p>
          </jats:sec>
          <jats:sec>
            <jats:title>MATERIALS AND METHODS</jats:title>
            <jats:p>Adult participants received treatment to the abdomen/flanks (midsection). Participants could also receive treatment to upper arms, thighs, and submental area. Primary end point was participant satisfaction with midsection results at 12 weeks after final treatment. Secondary end points included independent photography review, participant satisfaction with additional body areas, and overall satisfaction. Exploratory end points included 3D imaging of midsection volumetric changes and assessments at 4 weeks after initial treatment. Safety was monitored throughout.</jats:p>
          </jats:sec>
          <jats:sec>
            <jats:title>RESULTS</jats:title>
            <jats:p>Of 110 treated participants, 75% were female. Mean age and body mass index were 43 years and 25.1 kg/m<jats:sup>2</jats:sup>, respectively. Of 96 evaluable participants, 83.3% (80/96) were “satisfied/very satisfied” with midsection results. Reviewers correctly identified 88.0% (81/92) of baseline versus 12 weeks after final treatment midsection images. Mean (SD) subcutaneous fat volume loss was 194.8 (492.3) mL at 12 weeks after final treatment (<jats:italic toggle="yes">p</jats:italic> &lt; .001). Visible improvements were noted at 4 weeks after initial treatment by a majority of physician reviewers and participants. Five (4.5%, 5/110) participants reported 7 treatment-emergent adverse device effects.</jats:p>
          </jats:sec>
          <jats:sec>
            <jats:title>CONCLUSION</jats:title>
            <jats:p>The dual-applicator cryolipolysis system demonstrated high participant satisfaction, effectiveness, and safety.</jats:p>
          </jats:sec>

Fat reduction in the inner thigh using a prototype cryolipolysis applicator

Dermatol Surg

Non-invasive fat reduction of the flanks using a new cryolipolysis applicator and overlapping, two-cycle treatments

Lasers Surg Med

Three-dimensional volumetric quantification of fat loss following cryolipolysis

Safety and efficacy of cryolipolysis for non-invasive reduction of submental fat

Cryolipolysis for noninvasive contouring of the periumbilical abdomen with a nonvacuum conformable-surface applicator

Significant improvement in body contour with multiple cycles of CoolSculpting: results of a prospective study

Dermatol Ther

High participant satisfaction achieved using cryolipolysis for fat reduction of the abdomen and flanks

Aesthet Surg J

Patient satisfaction, recommendation rate, and patient comfort with an FDA-cleared cryolipolysis system

Aesthet Surg J Open Forum

Global expert opinion on cryolipolysis treatment recommendations and considerations: a modified Delphi study

Cryolipolysis is an effective, well-tolerated noninvasive subcutaneous fat reduction treatment.
Assess participant satisfaction, effectiveness, and safety of a dual-applicator cryolipolysis system that can deliver simultaneous treatments.
Adult participants received treatment to the abdomen/flanks (midsection). Participants could also receive treatment to upper arms, thighs, and submental area. Primary end point was participant satisfaction with midsection results at 12 weeks after final treatment. Secondary end points included independent photography review, participant satisfaction with additional body areas, and overall satisfaction. Exploratory end points included 3D imaging of midsection volumetric changes and assessments at 4 weeks after initial treatment. Safety was monitored throughout.
Of 110 treated participants, 75% were female. Mean age and body mass index were 43 years and 25.1 kg/m2, respectively. Of 96 evaluable participants, 83.3% (80/96) were "satisfied/very satisfied" with midsection results. Reviewers correctly identified 88.0% (81/92) of baseline versus 12 weeks after final treatment midsection images. Mean (SD) subcutaneous fat volume loss was 194.8 (492.3) mL at 12 weeks after final treatment (p < .001). Visible improvements were noted at 4 weeks after initial treatment by a majority of physician reviewers and participants. Five (4.5%, 5/110) participants reported 7 treatment-emergent adverse device effects.
The dual-applicator cryolipolysis system demonstrated high participant satisfaction, effectiveness, and safety.

Participant Satisfaction, Effectiveness, and Safety With a Novel Dual-Applicator Cryolipolysis System: A Prospective, Multicountry Study.

Participant Satisfaction, Effectiveness, and Safety With a Novel Dual-Applicator Cryolipolysis System: A Prospective, Multicountry Study

Journal of Investigative Dermatology

publisher

articletitle

journaltitle

articlelink

content_type

copyright

Instituto de Salud Carlos III

National Psoriasis Foundation

HudFonden

National Heart, Lung, and Blood Institute

Early Detection and Progression of Subclinical Atherosclerosis in Psoriasis (EDSAP): protocol for an observational, single-centre, prospective cohort study

BMJ Open

Monocyte-to-high-density lipoprotein ratio is associated with systemic inflammation, insulin resistance, and coronary subclinical atherosclerosis in psoriasis: results from 2 observational cohorts

J Invest Dermatol

Systemic inflammation and cardiovascular comorbidity in psoriasis patients: causes and consequences

Front Immunol

Achievement of dual low-density lipoprotein cholesterol and high-sensitivity C-reactive protein targets more frequent with the addition of ezetimibe to simvastatin and associated with better outcomes in IMPROVE-IT

Circulation

Sex and race differences in the relationship between obesity and C-reactive protein

Ethn Dis

High-density lipoprotein and inflammation in cardiovascular disease

Transl Res

Association of inflammatory cytokines with non-alcoholic fatty liver disease

Association of biologic therapy with coronary inflammation in patients with psoriasis as assessed by perivascular fat attenuation index

JAMA Cardiol

C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis

Lancet

Race, gender, and socioeconomic variations in C-reactive protein using the health and retirement study

J Gerontol B Psychol Sci Soc Sci

Chronic inflammation in the etiology of disease across the life span

Nat Med

Risk of myocardial infarction in patients with psoriasis

JAMA

Association of apremilast with vascular inflammation and cardiometabolic function in patients with psoriasis: the VIP-A Phase 4, open-label, nonrandomized clinical trial

JAMA Dermatol

Underperformance of clinical risk scores in identifying imaging-based high cardiovascular risk in psoriasis: results from two observational cohorts

Eur J Prev Cardiol

Subclinical liver disease is associated with subclinical atherosclerosis in psoriasis: results from two observational studies

Psoriasis as a human model of disease to study inflammatory atherogenesis

Am J Physiol Heart Circ Physiol

Inflammation, metaflammation and immunometabolic disorders

Nature

Race and gender differences in C-reactive protein levels

J Am Coll Cardiol

Gender and C-reactive protein: data from the Multiethnic Study of Atherosclerosis (MESA) cohort

Am Heart J

Prevalence of metabolic syndrome in patients with psoriasis: a population-based study in the United Kingdom

Coronary plaque characterization in psoriasis reveals high-risk features that improve after treatment in a prospective observational study

Atherosclerosis

Abdominal visceral adiposity is associated with coronary artery plaque lipid-rich necrotic core partly mediated by bone marrow uptake of 18F-FDG positron emission tomography/computed tomography in psoriasis

Geoepidemiology, gender and autoimmune disease

Autoimmun Rev

Association of the complement system with subclinical atherosclerosis in psoriasis: findings from an observational cohort study

Gender differences in autoimmune disease

Front Neuroendocrinol

Low-dose colchicine for secondary prevention of cardiovascular disease

Objective measures of psoriasis severity predict mortality: a prospective population-based cohort study [published correction appears in J Invest Dermatol 2018;138:998]

Risk of incident liver disease in patients with psoriasis, psoriatic arthritis, and rheumatoid arthritis: a population-based study

The relationship between body mass index, waist circumference and psoriatic arthritis in the Turkish population

Postepy Dermatol Alergol

High levels of CRP in morbid obesity: the central role of adipose tissue and lessons for clinical practice before and after bariatric surgery

Surg Obes Relat Dis

Eur Heart J

Residual inflammatory risk: addressing the obverse side of the atherosclerosis prevention coin

How common is residual inflammatory risk?

Circ Res

Anticytokine agents: targeting interleukin signaling pathways for the treatment of atherothrombosis

Targeting residual inflammatory risk: the next frontier for atherosclerosis treatment and prevention

Vascul Pharmacol

Inflammation and cholesterol as predictors of cardiovascular events among patients receiving statin therapy: a collaborative analysis of three randomised trials

C-reactive protein levels and outcomes after statin therapy

N Engl J Med

Low-dose methotrexate for the prevention of atherosclerotic events

Antiinflammatory therapy with canakinumab for atherosclerotic disease

Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events

Visceral adiposity in psoriasis is associated with vascular inflammation by 18F-Fluorodeoxyglucose positron-emission tomography/computed tomography beyond cardiometabolic disease risk factors in an observational cohort study

JACC Cardiovasc Imaging

Psoriasis-related visceral adiposity and arterial inflammation: a new adiposity disease entity?

C-reactive protein, inflammation and coronary heart disease

Egypt Heart J

SCIL-STROKE (subcutaneous interleukin-1 receptor antagonist in ischemic stroke): a randomized controlled Phase 2 trial

Stroke

Skin inflammation, systemic inflammation, and cardiovascular disease in psoriasis

The psoriasis area and severity index is an independent risk factor for cardiovascular events: a prospective register study

J Eur Acad Dermatol Venereol

Efficacy and safety of low-dose colchicine after myocardial infarction

Metabolic syndrome and its factors are associated with noncalcified coronary burden in psoriasis: an observational cohort study

J Am Acad Dermatol

The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies

J Clin Epidemiol

Global prevalence of obesity in patients with psoriasis: an analysis in the past two decades

Association of obesity and psoriasis: a ten years systematic review

J Adv Res Med Health Sci

High-sensitivity C-reactive protein is a strong predictor of non-alcoholic fatty liver disease

Hepatogastroenterology

C-reactive protein levels in relation to various features of non-alcoholic fatty liver disease among obese patients

J Hepatol

Psoriasis is associated with a higher cardiovascular disease burden, with systemic inflammation being the root cause of this association. The concept of residual inflammation (RI) was defined in patients with features of high-risk atherosclerosis who had increased inflammatory markers in blood, as characterized by high-sensitivity CRP, despite receiving optimal medical therapy. This study aims to assess RI in patients with psoriasis undergoing biologic therapy, specifically defined as high-sensitivity CRP ≥ 2 mg/l despite achieving a PASI ≤ 2. A prospective observational study was conducted across 3 international cohorts (Spain, United States, and Sweden) comprising 209 patients with psoriasis who achieved a PASI ≤ 2 after stable biologic therapy. RI was observed in 36.3% of patients and was significantly associated with higher body mass index, metabolic dysfunction-associated steatotic liver disease, increased baseline systemic inflammation, and visceral adipose tissue. Female sex was identified as a predictor of RI in the 3 cohorts. The study concludes that RI persists despite optimal skin response and is strongly linked with obesity and fatty liver disease. These conditions are highlighted as critical drivers and treatment targets of inflammation in psoriasis.

Residual Inflammation in Patients with Psoriasis Treated with Biologic Therapy: Findings from 3 Prospective Observational Cohorts.

Residual Inflammation in Patients with Psoriasis Treated with Biologic Therapy: Findings from 3 Prospective Observational Cohorts

JAMA Dermatology

<jats:sec id="ab-doi240070-4"><jats:title>Importance</jats:title><jats:p>Therapies for individual keratinocyte carcinomas (KCs) do not prevent the onset of new KCs in a field of sun damage, and therefore the KC burden remains unchanged.</jats:p></jats:sec><jats:sec id="ab-doi240070-5"><jats:title>Objective</jats:title><jats:p>To investigate the association of immune checkpoint inhibitors (ICIs) with changes in field cancerization evaluated by the number of actinic keratoses (AKs) and KCs at baseline compared with 12 months after starting ICI therapy.</jats:p></jats:sec><jats:sec id="ab-doi240070-6"><jats:title>Design, Setting, and Participants</jats:title><jats:p>This prospective cohort study was performed at the outpatient oncology clinic of a single tertiary public hospital in Brisbane, Australia, from April 1, 2022, to November 30, 2023. Consecutive immunocompetent adults starting therapy with an inhibitor for programmed cell death 1 (PD-1) or programmed cell death ligand 1 (PDL-1) for any active cancer, with a planned treatment duration of at least 6 months, and who exhibited clinical AKs on their forearms were eligible. Those with immunosuppression, concurrent chemotherapy or radiotherapy, or recent topical fluorouracil use were excluded.</jats:p></jats:sec><jats:sec id="ab-doi240070-7"><jats:title>Exposures</jats:title><jats:p>Intravenous ICI therapy, either PD-1 or PDL-1 inhibitors with or without a cytotoxic T-lymphocyte–associated protein 4 inhibitor, with therapy duration determined by the treating oncologist.</jats:p></jats:sec><jats:sec id="ab-doi240070-8"><jats:title>Main Outcomes and Measures</jats:title><jats:p>Clinical AKs were counted and photographed before and 3, 6, and 12 months after starting ICI therapy. KC numbers were evaluated based on histopathology reports of all skin lesions excised 12 months before and after starting ICI therapy. Participants’ medical history, primary cancer tumor response using Response Evaluation Criteria in Solid Tumors, and adverse events were recorded.</jats:p></jats:sec><jats:sec id="ab-doi240070-9"><jats:title>Results</jats:title><jats:p>A total of 23 participants were recruited, of whom 17 (73.9%) were male, with a mean (SD) age of 69.7 (9.6) years. No participants withdrew; however, 4 died during the study due to disease progression. The mean (SD) AK number significantly decreased from 47.2 (33.8) at baseline to 14.3 (12.0) at 12 months (<jats:italic>P</jats:italic> &amp;amp;lt; .001). Younger patients (8 of 12 [66.7%] vs 4 of 12 [33.3%]; <jats:italic>P</jats:italic> = .007) and those with a history of blistering sunburn (12 of 12 [100%] vs 0; <jats:italic>P</jats:italic> = .005) were more likely to reduce their AK numbers by 65% or greater. KC total numbers decreased from 42 in the 12 months before starting ICI therapy to 17 in the 12 months after. The number of cutaneous squamous cell carcinomas decreased from 16 to 5 in the same period.</jats:p></jats:sec><jats:sec id="ab-doi240070-10"><jats:title>Conclusions and Relevance</jats:title><jats:p>This pilot cohort study found that ICIs used for any cancer were associated with a significant reduction of AKs, suggesting potential as an immunopreventive strategy for high-risk individuals. Given the known effects of other chemopreventive agents on KCs, further investigation into ICIs managing field cancerization is required, especially considering toxicity and cost.</jats:p></jats:sec>

The incidence and multiplicity rates of keratinocyte cancers in Australia.

Med J Aust

The kinetics of skin cancer: progression of actinic keratosis to squamous cell carcinoma.

The risk of progression to invasive disease.

From keratinocyte to cancer: the pathogenesis and modeling of cutaneous squamous cell carcinoma.

J Clin Invest

Field cancerization: definition, epidemiology, risk factors, and outcomes.

European consensus-based interdisciplinary guideline for diagnosis, treatment and prevention of actinic keratoses, epithelial UV-induced dysplasia and field cancerization on behalf of European Association of Dermato-Oncology, European Dermatology Forum, European Academy of Dermatology and Venereology and Union of Medical Specialists (Union Européenne des Médecins Spécialistes).

Epidermal mutation accumulation in photodamaged skin is associated with skin cancer burden and can be targeted through ablative therapy.

Sci Adv

Comparative genomics provides etiologic and biological insight into melanoma subtypes.

Cancer Discov

Actinic keratosis with atypical basal cells (AK I) is the most common lesion associated with invasive squamous cell carcinoma of the skin.

Immune checkpoint inhibitors in cancer therapy.

Curr Oncol

Neoadjuvant cemiplimab for stage II to IV cutaneous squamous-cell carcinoma.

Neoadjuvant cemiplimab and surgery for stage II-IV cutaneous squamous-cell carcinoma: follow-up and survival outcomes of a single-arm, multicentre, phase 2 study.

Lancet Oncol

PD-1 blockade with cemiplimab in advanced cutaneous squamous-cell carcinoma.

Cemiplimab in locally advanced cutaneous squamous cell carcinoma: results from an open-label, phase 2, single-arm trial.

Phase 2 study of cemiplimab in patients with metastatic cutaneous squamous cell carcinoma: primary analysis of fixed-dosing, long-term outcome of weight-based dosing.

J Immunother Cancer

Immune checkpoint inhibitor therapy for advanced cutaneous squamous cell carcinoma in Australia: a retrospective real world cohort study.

Pembrolizumab monotherapy for recurrent or metastatic cutaneous squamous cell carcinoma: a single-arm phase II trial (KEYNOTE-629).

J Clin Oncol

New Response Evaluation Criteria in Solid Tumours: revised RECIST guideline (version 1.1).

Eur J Cancer

Chemoprevention of cutaneous squamous cell carcinoma and its precursors in solid organ transplant recipients using topical sirolimus: a randomized, double-blind, placebo-controlled pilot trial.

Risk of invasive cutaneous squamous cell carcinoma after different treatments for actinic keratosis: a secondary analysis of a randomized clinical trial.

Randomized trial of four treatment approaches for actinic keratosis.

Randomized controlled trial of acitretin versus placebo in patients at high-risk for basal cell or squamous cell carcinoma of the skin (North Central Cancer Treatment Group Study 969251).

Cancer

A phase 3 randomized trial of nicotinamide for skin-cancer chemoprevention.

Evaluation of the use of capecitabine for the treatment and prevention of actinic keratoses, squamous cell carcinoma, and basal cell carcinoma: a systematic review.

Multinational analysis of estimated health care costs related to extended-interval fixed dosing of checkpoint inhibitors.

JAMA Netw Open

Patterns and timing of sunlight exposure and risk of basal cell and squamous cell carcinomas of the skin—a case-control study.

BMC Cancer

JCO Precis Oncol

Immune-checkpoint inhibitors: long-term implications of toxicity.

Nat Rev Clin Oncol

Dermatologic reactions to immune checkpoint inhibitors: skin toxicities and immunotherapy.

Am J Clin Dermatol

Cutaneous manifestations associated with immune checkpoint inhibitors.

Artificial white light vs daylight photodynamic therapy for actinic keratoses: a randomized clinical trial.

Therapies for individual keratinocyte carcinomas (KCs) do not prevent the onset of new KCs in a field of sun damage, and therefore the KC burden remains unchanged.
To investigate the association of immune checkpoint inhibitors (ICIs) with changes in field cancerization evaluated by the number of actinic keratoses (AKs) and KCs at baseline compared with 12 months after starting ICI therapy.
This prospective cohort study was performed at the outpatient oncology clinic of a single tertiary public hospital in Brisbane, Australia, from April 1, 2022, to November 30, 2023. Consecutive immunocompetent adults starting therapy with an inhibitor for programmed cell death 1 (PD-1) or programmed cell death ligand 1 (PDL-1) for any active cancer, with a planned treatment duration of at least 6 months, and who exhibited clinical AKs on their forearms were eligible. Those with immunosuppression, concurrent chemotherapy or radiotherapy, or recent topical fluorouracil use were excluded.
Intravenous ICI therapy, either PD-1 or PDL-1 inhibitors with or without a cytotoxic T-lymphocyte-associated protein 4 inhibitor, with therapy duration determined by the treating oncologist.
Clinical AKs were counted and photographed before and 3, 6, and 12 months after starting ICI therapy. KC numbers were evaluated based on histopathology reports of all skin lesions excised 12 months before and after starting ICI therapy. Participants' medical history, primary cancer tumor response using Response Evaluation Criteria in Solid Tumors, and adverse events were recorded.
A total of 23 participants were recruited, of whom 17 (73.9%) were male, with a mean (SD) age of 69.7 (9.6) years. No participants withdrew; however, 4 died during the study due to disease progression. The mean (SD) AK number significantly decreased from 47.2 (33.8) at baseline to 14.3 (12.0) at 12 months (P < .001). Younger patients (8 of 12 [66.7%] vs 4 of 12 [33.3%]; P = .007) and those with a history of blistering sunburn (12 of 12 [100%] vs 0; P = .005) were more likely to reduce their AK numbers by 65% or greater. KC total numbers decreased from 42 in the 12 months before starting ICI therapy to 17 in the 12 months after. The number of cutaneous squamous cell carcinomas decreased from 16 to 5 in the same period.
This pilot cohort study found that ICIs used for any cancer were associated with a significant reduction of AKs, suggesting potential as an immunopreventive strategy for high-risk individuals. Given the known effects of other chemopreventive agents on KCs, further investigation into ICIs managing field cancerization is required, especially considering toxicity and cost.

Immune Checkpoint Inhibitors in Field Cancerization and Keratinocyte Cancer Prevention.

Immune Checkpoint Inhibitors in Field Cancerization and Keratinocyte Cancer Prevention

Journal of the European Academy of Dermatology and Venereology

<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Although stress is considered to be a negative factor for psoriasis, no convincing scientific evidence of this association exists, largely because of difficulties in measuring stress. Stress resilience is the ability to cope with and adapt to stressful events. Stress resilience can be measured in a standardized way and used as a marker for chronic stress.</jats:p></jats:sec><jats:sec><jats:title>Objectives</jats:title><jats:p>The objective of this study is to investigate whether low stress resilience in adolescence increases the risk for onset of psoriasis and psoriatic arthritis later in life.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>A cohort of Swedish men (mean age 18.3 years), enrolled in compulsory military service between 1968 and 2005, was created using data from the Swedish Military Service Conscription Register (<jats:italic>n</jats:italic> = 1,669,422). Stress resilience at conscription was estimated using standardized semi‐structured interviews, and was divided into three categories: low, medium and high. The men were followed from conscription until new‐onset psoriasis or psoriatic arthritis, death or emigration or at the latest until 31 December 2019. Cox regression models adjusted for confounders at conscription were used to obtain hazard ratios (HRs) with 95% confidence intervals (CIs) for incident psoriasis and psoriatic arthritis.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Men in the lowest stress resilience category had an increased risk of psoriasis and psoriatic arthritis (HR 1.31 (95% CI 1.26–1.36) and 1.23 (95% CI 1.15–1.32), respectively), compared with those in the highest stress resilience category. When including only hospitalized patients the HRs for psoriasis and psoriatic arthritis in the lowest stress resilience group were 1.79 (1.63–1.98) and 1.53 (1.32–1.77), respectively.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>This large, prospective register study suggests that low stress resilience in adolescence is associated with an increased risk of incident psoriasis among men. The results indicate that patients with psoriasis have an inherent psychological vulnerability, and highlight the importance of addressing psychological well‐being in the management of psoriasis.</jats:p></jats:sec>

publication_history

received

accepted

published

Forskningsrådet om Hälsa, Arbetsliv och Välfärd

Göteborgs Läkaresällskap

Although stress is considered to be a negative factor for psoriasis, no convincing scientific evidence of this association exists, largely because of difficulties in measuring stress. Stress resilience is the ability to cope with and adapt to stressful events. Stress resilience can be measured in a standardized way and used as a marker for chronic stress.
The objective of this study is to investigate whether low stress resilience in adolescence increases the risk for onset of psoriasis and psoriatic arthritis later in life.
A cohort of Swedish men (mean age 18.3 years), enrolled in compulsory military service between 1968 and 2005, was created using data from the Swedish Military Service Conscription Register (n = 1,669,422). Stress resilience at conscription was estimated using standardized semi-structured interviews, and was divided into three categories: low, medium and high. The men were followed from conscription until new-onset psoriasis or psoriatic arthritis, death or emigration or at the latest until 31 December 2019. Cox regression models adjusted for confounders at conscription were used to obtain hazard ratios (HRs) with 95% confidence intervals (CIs) for incident psoriasis and psoriatic arthritis.
Men in the lowest stress resilience category had an increased risk of psoriasis and psoriatic arthritis (HR 1.31 (95% CI 1.26-1.36) and 1.23 (95% CI 1.15-1.32), respectively), compared with those in the highest stress resilience category. When including only hospitalized patients the HRs for psoriasis and psoriatic arthritis in the lowest stress resilience group were 1.79 (1.63-1.98) and 1.53 (1.32-1.77), respectively.
This large, prospective register study suggests that low stress resilience in adolescence is associated with an increased risk of incident psoriasis among men. The results indicate that patients with psoriasis have an inherent psychological vulnerability, and highlight the importance of addressing psychological well-being in the management of psoriasis.

Influence of stress resilience in adolescence on long-term risk of psoriasis and psoriatic arthritis among men: A prospective register-based cohort study in Sweden.

Influence of stress resilience in adolescence on long‐term risk of psoriasis and psoriatic arthritis among men: A prospective register‐based cohort study in Sweden

<jats:sec id="ab-doi240020-4"><jats:title>Importance</jats:title><jats:p><jats:italic>BRCA1</jats:italic>-associated protein (BAP1) tumor predisposition syndrome (TPDS) is a cancer genodermatosis associated with high risk of uveal and cutaneous melanoma, basal cell carcinoma, and multiple internal malignant neoplasms, including mesothelioma and renal cell carcinoma. Early detection of the syndrome is important for cancer surveillance and genetic counseling of family members who are at risk.</jats:p></jats:sec><jats:sec id="ab-doi240020-5"><jats:title>Objective</jats:title><jats:p>To determine the prevalence of nail abnormalities in individuals with pathogenic germline variants in <jats:italic>BAP1</jats:italic>.</jats:p></jats:sec><jats:sec id="ab-doi240020-6"><jats:title>Design, Setting, and Participants</jats:title><jats:p>In this prospective cohort study, individuals who were known carriers of pathogenic <jats:italic>BAP1</jats:italic> germline variants were consecutively enrolled between October 10, 2023, and March 15, 2024. Dermatologic evaluation for nail abnormalities was performed, including a history of nail abnormalities and associated symptoms, physical examination, medical photography, and nail biopsy for histopathology. This was a single-center study conducted at the National Institutes of Health Clinical Center.</jats:p></jats:sec><jats:sec id="ab-doi240020-7"><jats:title>Main Outcomes and Measures</jats:title><jats:p>Primary outcomes were the prevalence and spectrum of nail changes and histopathologic characterization.</jats:p></jats:sec><jats:sec id="ab-doi240020-8"><jats:title>Results</jats:title><jats:p>Among 47 participants (30 female [63.8%]; mean [SD] age, 46.4 [15.1] years) ranging in age from 13 to 72 years from 35 families, nail abnormalities were detected in 41 patients (87.2%) and included leukonychia, splinter hemorrhage, onychoschizia, and distal nail hyperkeratosis. Clinical findings consistent with onychopapilloma were detected in 39 patients (83.0%), including 35 of 40 individuals aged 30 years or older (87.5%). Nail bed biopsy was performed in 5 patients and was consistent with onychopapilloma. Polydactylous involvement with onychopapillomas was detected in nearly all patients who had nail involvement (38 of 39 patients [97.4%]).</jats:p></jats:sec><jats:sec id="ab-doi240020-9"><jats:title>Conclusions and Relevance</jats:title><jats:p>This study found that BAP1 TPDS was associated with a high rate of nail abnormalities consistent with onychopapillomas in adult carriers of the disease. Findings suggest that this novel cutaneous sign may facilitate detection of the syndrome in family members who are at risk and patients with cancers associated with BAP1 given that multiple onychopapillomas are uncommon in the general population and may be a distinct clue to the presence of a pathogenic germline variant in the <jats:italic>BAP1</jats:italic> gene.</jats:p></jats:sec>

BRCA1-associated protein-1 is a tumor suppressor that requires deubiquitinating activity and nuclear localization.

Cancer Res

Comprehensive study of the clinical phenotype of germline BAP1 variant-carrying families worldwide.

J Natl Cancer Inst

Medical and surgical care of patients with mesothelioma and their relatives carrying germline BAP1 mutations.

J Thorac Oncol

Germline mutations in BAP1 predispose to melanocytic tumors.

Nat Genet

What’s new in dermatopathology 2023: WHO 5th edition updates.

J Pathol Transl Med

BRCA1-associated protein (BAP1)-inactivated melanocytic tumors.

J Cutan Pathol

Clinical and dermoscopic features of cutaneous BAP1-inactivated melanocytic tumors: results of a multicenter case-control study by the International Dermoscopy Society.

BAP1 cancer syndrome: malignant mesothelioma, uveal and cutaneous melanoma, and MBAITs.

J Transl Med

Localized multinucleate distal subungual keratosis.

Br J Dermatol

Longitudinal erythronychia with distal subungual keratosis: onychopapilloma of the nail bed and Bowen’s disease.

Longitudinal erythronychia: suggestions for evaluation and management.

Multiple Onychopapillomas and BAP1 Tumor Predisposition Syndrome

Prospective Cohort Study in Dermatology Research

Participant Satisfaction, Effectiveness, and Safety With a Novel Dual-Applicator Cryolipolysis System: A Prospective, Multicountry Study

Residual Inflammation in Patients with Psoriasis Treated with Biologic Therapy: Findings from 3 Prospective Observational Cohorts

Immune Checkpoint Inhibitors in Field Cancerization and Keratinocyte Cancer Prevention

Influence of stress resilience in adolescence on long‐term risk of psoriasis and psoriatic arthritis among men: A prospective register‐based cohort study in Sweden

Multiple Onychopapillomas and BAP1 Tumor Predisposition Syndrome

Experiences from daily practice of upadacitinib treatment on atopic dermatitis with a focus on hand eczema: Results from the <scp>BioDay</scp> registry

Papers