A Comprehensive Investigation of Novel and Traditional Inflammatory and Metabolic Markers as Predictive Indicators in Psoriasis
The absence of specificity of these markers for psoriasis limits their practical application. However, the development of new objective measures by using them in combination with specific data such as PASI will provide significant benefits in terms of disease diagnosis, follow-up, and treatment.
KEY FINDINGS: The absence of specificity of these markers for psoriasis limits their practical application. However, the development of new objective measures by using them in combination with specific data such as PASI will provide significant benefits in terms of disease diagnosis, follow-up, and treatment.
BACKGROUND: Psoriasis is a chronic inflammatory and papulosquamous dermatological disorder. While previous studies have discussed certain inflammatory markers for diagnosing and monitoring psoriasis, there is an absence of comprehensive research encompassing both novel and traditional inflammatory markers, as well as metabolic markers, in relation to psoriasis.
DETAILS: A total of 209 individuals participated, including 54 psoriasis patients and 155 controls. Psoriasis Area Severity Index (PASI) was calculated for the patient group. Potential predictive markers for psoriasis were identified: Uric acid/HDL ratio (UHR), D-dimer/albumin ratio (DAR), fibrinogen/albumin ratio (FAR), erythrocyte sedimentation rate, CRP, WBC, HOMA-IR, and vitamin D levels. Differences between groups and correlations with PASI and each other were analyzed using the Mann–Whitney U test and Spearman correlation coefficient. The results indicate that the patient group exhibited statistically significantly higher levels of UHR, FAR, CRP, WBC, and HOMA-IR. Upon analyzing the correlations between PASI and the identified markers, statistically significant positive correlation with WBC and negative correlation with vitamin D were observed. The correlations of PASI with other markers did not reach statistical significance. It should be underlined that our study was conducted in a predominantly mild-to-moderate patient population.
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Source: Metin, Z., Tur, K., Durmaz, K., et al. (2023). A Comprehensive Investigation of Novel and Traditional Inflammatory and Metabolic Markers as Predictive Indicators in Psoriasis. International Journal of Dermatology. 2023; 62(10): 1272-1280. Published: October, 2023. DOI: 10.1111/ijd.16813.
IL-17 Inhibitors Not Associated With Increased IBD Risk in Hidradenitis Suppurativa
A systematic review and meta-analysis of 24 studies found that inflammatory bowel disease events were rare among patients with hidradenitis suppurativa receiving IL-17 inhibitors. In randomized trials, new-onset IBD occurred in 0.23% of patients receiving IL-17 inhibitors versus 0% with placebo, with no significant difference between groups. The findings are reassuring but support continued monitoring because event numbers were low and reporting was inconsistent.
KEY FINDINGS: IBD events were uncommon among patients with HS receiving IL-17 inhibitors, and randomized trial data did not demonstrate a significant increase in IBD risk compared with placebo. The higher incidence observed in nonrandomized studies may reflect differences in patient populations, follow-up, or other sources of bias and should not be interpreted as evidence of causation. Because event numbers were low and reporting of IBD outcomes was inconsistent, continued monitoring remains important, particularly in patients with existing or suspected IBD. The findings support the use of IL-17 inhibitors in HS while emphasizing the need for further prospective data on gastrointestinal outcomes.
BACKGROUND: Interleukin-17 (IL-17) inhibitors are increasingly used to treat moderate to severe hidradenitis suppurativa (HS), but concern remains about their potential relationship with inflammatory bowel disease (IBD), particularly Crohn disease and ulcerative colitis. Because patients with HS already have an elevated background risk of IBD, it can be difficult to determine whether IBD events occurring during IL-17 inhibitor therapy are treatment-related or reflect the underlying disease. This systematic review and meta-analysis evaluated the incidence of IBD among patients with HS receiving IL-17 inhibitors and compared event rates with placebo in randomized clinical trials.
DETAILS: The investigators searched PubMed, Embase, and the Cochrane CENTRAL database from inception through November 2025. Twenty-four studies met the inclusion criteria, comprising 10 randomized clinical trials, 11 nonrandomized studies, and 3 case reports. Overall, the analysis included 3,015 patients with HS treated with an IL-17 inhibitor. Outcomes included new-onset IBD, worsening of preexisting IBD, IBD subtype, clinical features, and time to IBD onset.
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Across the 10 randomized clinical trials, new-onset IBD occurred in 6 of 2,572 patients receiving IL-17 inhibitors (0.23%) compared with 0 of 1,066 patients receiving placebo through week 16. The pooled risk difference was 0.002 (95% CI, -0.003 to 0.007), indicating no statistically significant difference between treatment and placebo groups.
In the nonrandomized studies, 7 new-onset IBD events were reported among 469 patients, corresponding to a crude incidence of 1.49%. The pooled incidence was 3.90% (95% CI, 2.30%-6.50%). Across randomized trials, long-term extension studies, and nonrandomized studies, 17 new-onset IBD cases and 4 IBD flares were reported.
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Source: Cutrona, M., Jolkovsky, E. L., Romanelli, S., et al. Inflammatory Bowel Disease and Interleukin-17 Inhibitors in Hidradenitis Suppurativa: A Systematic Review and Meta-Analysis. JAMA Dermatology. 2026; Published: September 9, 2026. DOI: 10.1001/jamadermatol.2026.3373.
Psoriasis-Atopic Dermatitis Overlap Phenotype Shows Dual Type 2 and Type 3 Inflammation and Response to JAK1 Inhibition
Clinicians should consider Pso-Ec in adults with persistent lesions showing both psoriasis-like and eczema-like clinical and histopathologic features without a clearly dominant inflammatory pathway. The study found involvement of Th2/Tc2 and Th17/Tc17 pathways and JAK1-STAT2/6 signaling. Previous psoriasis- or atopic dermatitis-directed biologics were often inadequate, while JAK1 inhibitors achieved minimal disease activity in the patients studied. These findings suggest Pso-Ec may be a distinct phenotype for which JAK1 inhibition could be a targeted treatment option. However, the findings are limited by the small sample size and immunologic testing in only a subset of patients.
KEY FINDINGS: Clinicians should consider Pso-Ec when an adult patient has persistent lesions showing simultaneous psoriasiform and eczematous clinical and histopathologic characteristics, particularly when there is no clear dominant inflammatory pathway. In this study, the phenotype was associated with dual Th2/Tc2 and Th17/Tc17 activity and involvement of JAK1-STAT2/6 signaling. Prior Pso- or AD-directed biologics were often inadequate, whereas JAK1 inhibitors achieved minimal disease activity with BSA ≤2 and NRS ≤1 during a median 17-month follow-up. The findings support recognition of Pso-Ec as a distinct phenotype and suggest JAK1 inhibition as a mechanism-based therapeutic approach. The study's interpretation is limited by its small sample size and the fact that immunologic analyses were performed in a representative subset of patients.
BACKGROUND: Psoriasis (Pso) and atopic dermatitis (AD) are generally characterized by different dominant inflammatory pathways. However, some patients present with lesions containing both psoriasiform and eczematous features, creating diagnostic and therapeutic challenges. This prospective study characterized a distinct psoriasis–atopic dermatitis overlapping phenotype, termed Pso-Ec, with particular attention to its clinical, histopathologic, immunologic, and treatment characteristics.
DETAILS: The two-center prospective study enrolled 30 patients with Pso-Ec between January 2021 and December 2025. Reference cohorts consisted of 150 patients with typical Pso and 150 with AD. The Pso-Ec group included patients aged 13-72 years, with a mean age of 49.7 ± 17.7 years and a male-to-female ratio of 19:11. None had a previous history of Pso or AD. Notably, 63.3% had associated atopic diseases, compared with 2.7% of patients with typical Pso and 47.3% of those with AD (P < .001). Pso-Ec lesions were characterized clinically by ill-defined erythematous plaques, thin scales, excoriation, and prominent pruritus. Histopathologic examination demonstrated concurrent psoriatic and eczematous features within the same lesions. Immunologic assessment of lesional skin and peripheral blood identified simultaneous type 2 and type 3 inflammatory activity, represented by Th2/Tc2 and Th17/Tc17 populations. JAK1-STAT2/6 signaling was also implicated in the inflammatory profile.
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Treatment histories indicated that conventional pathway-directed biologic therapy was frequently inadequate in this phenotype. Among the Pso-Ec patients, 18 had previously received Pso-targeted biologics and 15 had received AD-targeted biologics, with responses described as often inadequate. In contrast, treatment with JAK1 inhibitors was associated with achievement of minimal disease activity, defined as body surface area (BSA) ≤2 and numerical rating scale (NRS) ≤1. This response was maintained during a median follow-up of 17 months. During follow-up, none of the patients progressed to a classic Pso or AD phenotype.
The investigators concluded that Pso-Ec represents a distinct, predominantly adult-onset inflammatory phenotype rather than simply a transitional presentation between psoriasis and atopic dermatitis. Its defining immunologic characteristic is the concurrent presence of type 2 and type 3 inflammation, which may explain the limited effectiveness of therapies directed primarily against either pathway. JAK1 inhibition emerged as an effective treatment option in this cohort.
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Source: Chen, M., Shen, C., Chen, C. B., et al. A Distinct Psoriasis–Atopic Dermatitis Overlapping Phenotype in Adults With Dual Type 2 and Type 3 Immune Features and Favorable Response to Janus Kinase 1 Inhibition. Journal of the American Academy of Dermatology. 2026; Published: September 22, 2026. DOI: 10.1016/j.jaad.2026.05.042.
FDA Approves Engineered Viral Immunotherapy for Treatment-Resistant Advanced Melanoma
FDA approved Tudriqev, an engineered HSV-1-based viral immunotherapy, for adults with treatment-resistant advanced melanoma. The therapy produced tumor responses in 24.2% of patients with a median response duration of 14.1 months. Ongoing Phase III evaluation will further assess long-term efficacy and safety.
KEY FINDINGS: FDA approval of Tudriqev introduces an engineered viral immunotherapy option for adults with treatment-resistant advanced melanoma. By combining direct tumor destruction with immune activation, this therapeutic approach expands the available immunotherapy landscape for patients with limited options after progression on standard treatments. Continued evaluation through confirmatory studies will determine its long-term clinical role in melanoma management.
BACKGROUND: Patients with advanced melanoma whose disease progresses despite available systemic therapies have limited treatment options and significant unmet clinical needs. The U.S. Food and Drug Administration (FDA) approved a new engineered viral immunotherapy designed to provide a treatment option for adults with advanced melanoma that is resistant to prior therapies.
DETAILS: The FDA approved Tudriqev (vusolimogene oderparepvec, formerly RP1), an engineered oncolytic viral immunotherapy developed by Replimune, for adults with unresectable or metastatic melanoma that has progressed following treatment with an anti–PD-1 therapy and, when appropriate, targeted therapy for BRAF-mutated disease. Tudriqev is an engineered herpes simplex virus type 1 (HSV-1)-based therapy administered through intratumoral injection. The treatment is designed to selectively replicate within tumor cells, promote tumor cell destruction, and stimulate an immune response against cancer cells. The FDA approval was based on clinical evidence demonstrating tumor responses in patients with advanced melanoma who had limited therapeutic alternatives. The therapy represents an additional immunotherapeutic approach that uses direct tumor targeting combined with immune system activation. In clinical evaluation, Tudriqev demonstrated tumor reduction or elimination in 24.2% of treated patients, with a median duration of response of 14.1 months. The FDA approval provides a new treatment option for patients with advanced melanoma whose disease has become resistant to prior immunotherapy approaches. A confirmatory Phase III study is ongoing to further evaluate the therapy’s clinical benefit and long-term outcomes.
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Nationwide Recall of Cetirizine Hydrochloride Tablets USP 5 mg Due to Potential Ranitidine Cross-Contamination
Four nationwide-distributed lots of Cetirizine Hydrochloride Tablets USP 5 mg are being voluntarily recalled because of potential ranitidine cross-contamination. Patients with ranitidine hypersensitivity may be at risk for severe allergic reactions or anaphylaxis. No recall-related adverse events had been reported.
KEY FINDINGS: Unique Pharmaceutical Laboratories has initiated a voluntary nationwide recall of four lots of Cetirizine Hydrochloride Tablets USP 5 mg because of potential cross-contamination with ranitidine. The affected product was distributed nationwide in 100-count HDPE bottles under the Rising Pharma Holdings Inc. brand. Patients with hypersensitivity to ranitidine ingredients may be at risk for serious reactions, including severe hypersensitivity and life-threatening anaphylaxis. No adverse events related to the recalled product had been reported at the time of the announcement.
The recall was initiated after a pharmacy technician identified a discrepancy while counting tablets during dispensing. A product complaint described red dots and discoloration on some cetirizine tablets. The recalled lots are GY825029, GY825030, GY825031, and GY825032, each with an expiration date of 10/2028 and NDC 16571-401-10.
The manufacturer and distributor are arranging the return of the affected products. Clinicians should consider the recall when evaluating patients who may have received the affected medication and should assess and manage any suspected adverse reactions appropriately.
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Source: Unique Pharmaceutical Laboratories (A Div. of J. B. Chemicals & Pharmaceuticals Ltd.) Issues Voluntary Nationwide Recall of Cetirizine Hydrochloride Tablets USP 5 mg Due to Potential Cross Contamination with Ranitidine. FDA. Published: July 20, 2026.
Fish Oil Supplementation Maintains Efficacy While Improving Tolerability of Low-Dose Isotretinoin in Moderate-to-Severe Acne Vulgaris
In adults with moderate-to-severe acne, 1 g/day fish oil combined with 10 mg/day isotretinoin was noninferior to isotretinoin alone for acne reduction (mean difference -6.0; 95% CI, -16.5 to 4.5) while better preserving skin hydration and limiting triglyceride elevation, suggesting improved treatment tolerability without loss of efficacy.
KEY FINDINGS: In this randomized controlled non-inferiority trial, adding 1 g/day fish oil to 10 mg/day isotretinoin for 3 months produced acne improvement comparable to isotretinoin alone while offering potential safety advantages. Fish oil supplementation preserved skin hydration, as reflected by smaller reductions in corneometer values, and attenuated increases in serum triglycerides during therapy. These findings suggest that fish oil may be a useful adjunct to low-dose isotretinoin by improving treatment tolerability without reducing clinical effectiveness, although longer-term studies are needed to confirm sustained benefits.
BACKGROUND: Oral isotretinoin is an established treatment for moderate-to-severe acne vulgaris, but its use is frequently limited by mucocutaneous adverse effects and metabolic abnormalities, particularly hypertriglyceridemia. Fish oil possesses anti-inflammatory and lipid-lowering properties that may help mitigate these treatment-related toxicities. This study evaluated whether adding fish oil to low-dose isotretinoin preserves therapeutic efficacy while improving safety.
DETAILS: This randomized, double-masked, controlled, non-inferiority trial enrolled 80 participants aged 18-25 years with moderate-to-severe acne (Investigator's Global Assessment [IGA] score >=3). Participants received either 10 mg isotretinoin plus 1 g fish oil daily (n = 40) or 10 mg isotretinoin plus placebo daily (n = 40) for 3 months. Outcomes included changes in acne lesion counts, IGA scores, skin biophysical parameters, mucocutaneous adverse effects, serum triglyceride (TG) concentrations, and liver transaminase levels. Combination therapy with fish oil was noninferior to isotretinoin monotherapy in reducing total acne lesion counts. The between-group mean difference in total acne count reduction was -6.0 (95% CI, -16.5 to 4.5), meeting the predefined non-inferiority criteria. In addition to maintaining comparable clinical efficacy, patients receiving fish oil experienced smaller reductions in corneometer values, indicating better preservation of skin hydration, and smaller increases in serum triglyceride levels compared with placebo. The study therefore demonstrated that fish oil supplementation improved selected safety outcomes without compromising acne treatment efficacy.
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Source: Sungkhasunya, P., Asawanonda, P., Kumtornrut, C.. et al. Efficacy and Safety of Fish Oil Supplementation Combined With Low-Dose Isotretinoin for Moderate-to-Severe Acne Vulgaris: A Randomized Controlled Non-Inferiority Trial. Journal of the American Academy of Dermatology. 2026; 95(2): 416-422. Published: June 22, 2026. DOI: 10.1016/j.jaad.2026.03.001
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