A patient doing well on an IL-17 inhibitor is diagnosed with cancer, and the oncologist wants the biologic stopped. It is a call most dermatologists have made without much to stand on: patients with cancer are excluded from psoriasis trials, so the entire evidence base is observational. A new IPC paper in JAAD Reviews takes a position anyway. Per the summary of product characteristics, active malignancy is not a contraindication to any biologic. IL-17 and IL-23p19 inhibitors are first-line, TNF inhibitors and deucravacitinib warrant caution, and cyclosporine is the one to avoid outright. The authors also warn that psoriasis severity is routinely underestimated once a patient is in oncology care: if they meet IPC’s criteria, they are a candidate for systemic therapy regardless of what else is on their problem list. “Too often, systemic psoriasis therapy is discontinued or never initiated in patients with cancer, even when the evidence supports safe and effective options,” says Paolo Gisondi, MD, IPC Councilor and lead author. The post includes the therapeutic options figure, designed as a reference for both specialties to work from, and a slide set for teaching and presentations.
In this article, IPC Board Member Lluís Puig, MD, PhD, gives his expert commentary on two randomized trials showing that ixekizumab plus tirzepatide outperforms ixekizumab alone for skin clearance, joint control, and weight loss in psoriasis and PsA.
IPC is accepting applications for the 2027 International Fellowship Program, a 12-month opportunity for early-career dermatologists and researchers focused on psoriasis. Fellows are matched with IPC Board Members or Councilors for hands-on clinical or research experience, along with virtual mentoring, skills-development classes, and ongoing connections to IPC’s global network throughout the fellowship year. Applications are open until September 30, 2026.
Recognizing GPP in clinical practice can be a challenge, even for experienced dermatologists. IPC’s new five-part training series walks clinicians through the practical skills needed to diagnose and assess GPP with confidence: distinguishing it from plaque psoriasis and other mimicking conditions, and scoring its severity using tools such as the GPPGA and GPPASI. Each module pairs an expert-led video with a case-based exercise, and the series is built to be completed in sequence at your own pace. All five modules are free and open to everyone; watch the videos on your own or work through the assessments as you go. Score 80% or higher on each of the five assessments to earn a Certificate of Completion.
IPC has released a set of summary slides distilling the key findings from its recent publication on psoriasis and metabolic health, published in the Journal of the American Academy of Dermatology (JAAD). The paper outlines five priorities for improving cardiometabolic risk screening and care in patients with psoriasis. Designed for sharing, the slides give clinicians and colleagues an easy way to disseminate the findings.
In this Take Ten with IPC video, IPC Junior Councilor Dr. María Julia Cura discusses paradoxical psoriasis, including its definition and pathogenesis, and reviews clinical case examples, key clinical features, histopathology, predictors of disease severity, and potential treatment options.
Commentary: Preclinical and Clinical Evidence for Suppression of Alcohol Intake by Apremilast
Johann Gudjonsson, MD, PhD
University of Michigan, Department of Dermatology
Ann Arbor, Michigan, United States
IPC Board Member
PUBLICATION
Preclinical and Clinical Evidence for Suppression of Alcohol Intake by Apremilast. Grigsby KB, Mangieri RA, Roberts AJ, et al. J Clin Invest. 2023 Mar 15;133(6):e159103. doi: 10.1172/JCI159103. PMID: 36656645; PMCID: PMC10014105.
Why this article was chosen
Commentary
A recently published article in the Journal of Clinical Investigation demonstrated that apremilast, a commonly used drug to treat psoriasis, is associated with reduced excessive alcohol drinking in models of stress-facilitated drinking and alcohol dependence.1 These findings may have major implications regarding the treatment of psoriasis, where there is a clear link between disease and alcohol use,2,3 and where apremilast is frequently used for treatment.4
Genetic variants in the PDE4B gene locus have been implicated with both alcohol and nicotine dependence in a genome-wide association study,5 and another PDE4 inhibitor, rolipram, has been shown to dose-dependently reduce self-administration of alcohol in a mouse model of alcohol consumption.6 PDE4 is expressed in the central nervous system, in the nucleus accumbens, a brain region associated with motivation and emotional processes.7 In the study highlighted here, the authors set out to determine if apremilast, a PD4 inhibitor, affects alcohol consumption in both mouse models of alcohol drinking and a double-blind, placebo-controlled proof-of-concept study in a moderate-size cohort composed of 24 women and 27 men, with a history of heavy drinking for an average ten years prior to the study. The findings demonstrated that apremilast reduced the number of drinks per day relative to the placebo and the probability of a heavy drinking day.1 The group further showed that apremilast alters the intrinsic excitability of nucleus accumbens-derived neurons expressing dopamine receptor D1, providing a mechanistic basis for its effect on alcohol consumption.1
Alcohol use disorder is frequent in patients with psoriasis and found in up to 8.6% of patients with psoriasis,2 and up to 23.8% of been reported to be high-risk drinkers.3 Furthermore, alcohol consumption has been shown to correlate with psoriasis severity.2 This also could relate to weight loss mechanisms in psoriasis, which principally relates to decreased abdominal subcutaneous fat, independent of its effect on psoriatic disease activity.8 Thus, the implications of this study on psoriasis management could be substantial and may help guide treatment in psoriasis patients with concomitant addiction problems. However, this will need to be confirmed and validated in future studies.
References
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Recent Posts
When Cancer and Psoriasis Coexist: New IPC Guidance Puts Clarity Where It Is Needed Most
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When Cancer and Psoriasis Coexist: New IPC Guidance Puts Clarity Where It Is Needed Most
Can a psoriasis patient with cancer still receive biologic therapy? IPC’s newest manuscript gives dermatologists and oncologists a shared, evidence-based answer, including which therapies to favor, which to avoid, and why the two specialties need to decide together.
Reframing Obesity in Psoriatic Disease: From Pharmacokinetic Barrier to Therapeutic Target
In this article, IPC Board Member Lluís Puig, MD, PhD, gives his expert commentary on two randomized trials showing that ixekizumab plus tirzepatide outperforms ixekizumab alone for skin clearance, joint control, and weight loss in psoriasis and PsA.
Psoriasis and Metabolic Health: What IPC’s Latest Publication Means for Clinical Practice
A new IPC paper in JAAD presents five priorities for improving metabolic screening, advancing GLP-1 research in the context of psoriasis, and defining the dermatologist’s role in managing cardiometabolic risk in psoriasis patients.
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