Dermatology

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Genetic Risks and Severe Cutaneous Reactions to Allopurinol

Jack Cush, MD

A matched cohort study shows that HLA-B*58:01 and HLA-A*34:02 are strongly associated with allopurinol-induced severe cutaneous adverse reactions (SCARs), these alleles were absent in more than one-third of those affected, suggesting these are strong but incomplete indicators of SCAR risk.

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IL-23 Blockade Goes Oral A new player is entering the IL-23 arena — and it’s a tablet! Icotrokinra (ICO), a first-in-class peptide that binds and blocks the interleukin-23 receptor (IL-23R), is showing encouraging efficacy and safety across a range of psoriasis (PSO) and https://t.co/7awBk16ZrQ
Dr. John Cush @RheumNow( View Tweet )
psoriasis,arms,pain

IL-23 Blockade Goes Oral

Aurelie Najm, MD, PhD

A new player is entering the IL-23 arena — and it’s a tablet! Icotrokinra (ICO), a first-in-class peptide that binds and blocks the interleukin-23 receptor (IL-23R), is showing encouraging efficacy and safety across a range of psoriasis (PSO) and psoriatic disease (PsD) studies.

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Secrets and Pearls in Rheumatology https://t.co/SwnlB8UbHO @Janetbirdope pearls in rheumatology. Sero negative inflammatory arthritis ? Or is it? Look at the toes for early signs of PsA. In my clinic ITS inflammatory arthritis to determine etiology . @RheumNow #ACR25

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Nouf Al hemmadi @NoufAhmedAlham2( View Tweet )

Can we catch PsA before it starts? My take on #ABSTRACT0877 for #ACR25 @RheumNow https://t.co/Rw2gJ4XSsz

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Aurelie Najm @AurelieRheumo( View Tweet )

Post-hoc analysis of CARE study comparing effect of Cenerimod 4mg vs. PBO Mos. 4-6: >10% improvement in alopecia w/Cenerimod Mos. 2-6: >10% improvement in mucosal ulcers w/ Cenerimod Early improvement in alopecia & ulcers w/Cenerimod Promising? #ACR25 @RheumNow Abs2440 https://t.co/mAqmIQashr

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sheila @RHEUMarampa( View Tweet )
Cutaneous vasculitis: who is most likely to have systemic disease? 430 pt w skin vasculitis examined in case-control Associated with risk for systemic vasculitis/CTD: - GI sx - ulcerating/necrotic lesions - constitutional sx - hematuria @RheumNow #ACR25 Abst 2525 https://t.co/lRjLKRYxDW

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Brian Jaros, MD @Dr_Brian_MD( View Tweet )
#1725 Functional NOTCH4 variants contribute to vasculopathy & fibrosis in SSc, particularly in African-American patients NOTCH4 hyperactivation disrupts angiogenesis & drives EndoMT; inhibition (including with FDA-approved Nirogacestat) restores vascular repair @RheumNow #ACR25

Mrinalini Dey @DrMiniDey( View Tweet )

#ACR25 Please find my video and take on Abstr#0646. Promising new Bi-specific T-cell engager (BiTE) other than Blinatumomab in #SLE @RheumNow https://t.co/5JrLG41nsD https://t.co/KeY6AkHUNK

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Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
Stress Raises the Risk of Psoriasis New longitudinal research reveals that severe stress caused by changes in family structure like divorce or separation experienced during the first year of life may triple the risk of developing psoriasis later in life. https://t.co/TSXoQKjRPN
Dr. John Cush @RheumNow( View Tweet )
X-sectional study by Dr Toledano et al showed that 20% (46/230) PsA pts had restless leg syndrome (RDS). Pts w/ RDS: - Polyarthritis ⬆️ Swollen jts ⬆️ Fatigue, anxiety, depression ⬆️ Dse activity Poor sleep quality Polyarthritis & Pso: assocd w/ RDS #ACR25 @RheumNow Abs1413 https://t.co/8Ds3TgLjs1

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sheila @RHEUMarampa( View Tweet )
In ICONIC-LEAD, adolescents (12 to <18 years) with moderate-to-severe psoriasis treated with icotrokinra (ICO) achieved Investigator Global Assessment (IGA) 0/1 in 84.1% vs 27.3% (placebo) and PASI 90 in 70.5% vs 13.6% at Week 16. Week 24 responses reached 88.6%. Safety profile https://t.co/L7h8BlnWaO

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Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Icotrokinra, the new kid on the bloc! Targeted oral peptide IL-23R-inhibitor Effective in Ph2 and Ph3 in PSO Adults Data in Adolescents (12-18yo) with PSO ICO 200mg QD 44pts vs. PBO 22pts 16wks All pts received ICO wk16-wk24 Clear/Almost clear skin IGA 0/1 84% vs. 24% PASI 90 https://t.co/77YvXtdLi1

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Aurelie Najm @AurelieRheumo( View Tweet )
The severity of skin psoriasis increases the risk of psoriatic arthritis. Scher J @RheumNow #ACR25 https://t.co/EI0ACWACHy

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Antoni Chan MD (Prof) @synovialjoints( View Tweet )
A closer look in skin toxicity of GCs in RMDs GC Toxicity Index, LONG TOX prospective cohort Frequent: -Easy bruising 35% -Atrophy 22% -Hirsutism 17% -Acneiform rash 15% -Erosion/Tear 12% GC-related Neuropsychiatric toxicity highly associated with/ skin, something to look out https://t.co/NfxG8JkxSP

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Aurelie Najm @AurelieRheumo( View Tweet )
#ACR25 Abstr#802 In #SLE pts with CLASI-A ≥8, pooled post-hoc analysis of Phase 2 RCT showed enpatoran, oral small molecule toll-like receptor 7/8-i impoved cutaneous response vs PBO as early as WK4. First-in-class promising therapy & warrant investigation in Phase 3 @RheumNow https://t.co/rn6NXdiGjD

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Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
Effect of BioDMARDs on Diabetes risk in 6400+ Psoriasis pts IL-23i and IL-17Ai associated w/ -lower risks of diabetes -Diabetic nephropathy -Stage 3–5 CKD and reduced risk compared to TNFi treated and bionaive pts Adjustment on several variables, but not disease severity https://t.co/TDIHXJOC2T

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Aurelie Najm @AurelieRheumo( View Tweet )
Redefining When to Biopsy the Kidney in Patients with SLE # Petri et al. ACR 2025 - Lupus nephritis may be seen in lower proteinuria too (69%) Happy to share similar results from our study-Padiyar S, As C, Gowri M, Mathew J. Lupus. 2024;33(13):1511-1517. @RheumNow

Dr Shivraj Padiyar @DrPadiyar( View Tweet )

#Cancers esp #hematologic & #lung are ⬆️in Pts w #inflammatory #rheum #diseases Odds ratios of hem malignancies are wide & risk stratification is imp Are we doing a good job? 🤔skin cancer screening ??- not as per general standards Abst#0172 #ACR25 @RheumNow @ACRheum https://t.co/Uve9knXD3o

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Janet Pope @Janetbirdope( View Tweet )
Icotrokinra, a first-in-class targeted oral peptide IL-23R inhibitor, cleared scalp (66%), genital (77%), and overall skin (57%) PsO vs placebo at Week 16. Basket trial design enabled targeted evaluation. Safety profile favorable. Abstract 0555 @RheumNow #ACR25

Antoni Chan MD (Prof) @synovialjoints( View Tweet )

Not all inflammatory nasal lesions are vasculitis! Dr. Zacharek presents from the ENT perspective @RheumNow #ACR25 https://t.co/TJ4d56oBaJ

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Brian Jaros, MD @Dr_Brian_MD( View Tweet )
Topical therapies in cutaneous lupus - find the right level Victoria Werth #ACR25 SLE guideline session @RheumNow https://t.co/o3gBuFkr4n

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David Liew @drdavidliew( View Tweet )
HIGH YIELD🚨Summary of Organ Specific Recommendations-ACR guidelines for Management of SLE by Dr Lisa Sammaritano. @RheumNow #ACR2025 https://t.co/ysSTKOz1ym

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Gabriela Martinez Zayas, MD @MartinezZayasMd( View Tweet )
High-resolution ultrasound detected subclinical enthesitis in 44% of psoriasis patients without arthritis and 12% had PD positivity. Supports a preclinical PsA phase and use of MSUS to detect entheseal inflammation in both symptomatic and asymptomatic PsO patients for timely

Antoni Chan MD (Prof) @synovialjoints( View Tweet )

Basic Sci Year in Review: Dr. Anne Davidson discusses the potential pathologic link bet tryptophan, indole, I3S & IL-17 pathways. I3S induces epidermal thickening in mice and correlated with dse activity in patients with #psoriasis #ACR25 @RheumNow https://t.co/WNNbBBESQ3

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sheila @RHEUMarampa( View Tweet )

Recent Blogs

A Domain-Based Approach to the GRAPPA Psoriatic Arthritis Treatment Recommendations

Laura Coates
heel enthesitis spur calcaneal

With their publication in June 2022 (1), the 3rd iteration of the Group for Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) Treatment recommendations for Psoriatic Arthritis (PsA) may have set a record or sorts.

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Pain in Psoriatic Arthritis

Philip Mease, MD
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Pain is typically ranked by both patients and physicians as the most important symptom of psoriatic arthritis (PsA) to assess and treat. Although the predominant concept of the etiology of pain in PsA is that of inflammation in peripheral joints, entheses, and bone signaling through peripheral nociceptive fibers, perceived as pain in the central nervous system, it is actually more complex than that. The ability of a treatment to ameliorate pain is one of the principle measures of its effectiveness. Thus pain improvement or worsening are key determinants of shared decision making about treatment in PsA.  Read Post
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