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  1. Rezazadeh F, Moshaverinia M, Handjani F, Khoshkholgh F, Saki N, Heiran A
    Malays J Med Sci, 2020 Mar;27(2):57-63.
    PMID: 32788842 DOI: 10.21315/mjms2020.27.2.7
    Background: Pemphigus vulgaris (PV) is a chronic autoimmune disease. Dyslipidemia, increased risk of atherosclerosis and higher cardiovascular morbidity, and mortality have been reported in several autoimmune conditions. It has been hypothesised that there might be an association between dyslipidemia and PV. Therefore, the objective of this study was to compare the serum lipid profile of patients with PV with healthy controls.

    Methods: This case-control study was carried out on 113 patients with PV and 100 healthy controls. Total cholesterol, high-density lipoprotein (HDL) and triglycerides (TG) levels were measured and low-density lipoprotein (LDL), non-HDL cholesterol (non-HDL-C) and atherogenic index of plasma (AIP) were calculated. Chi-squared test and independent Student t-test (or their alternatives) were used for group comparison.

    Results: The mean age and BMI of patients and controls were 47.7 ± 14.5 and 28 ± 6.2 and, 44.5 ± 18.5 and 25.5 ± 5.1, respectively. Total cholesterol, LDL, HDL, non-HDL-C and TG were statistically different between the two groups (P values < 0.001; < 0.001; < 0.001; < 0.001 and 0.021, respectively). However, AIP was not significantly different (P-value = 0.752).

    Conclusion: The serum lipid profile was significantly higher in PV patients compared to healthy controls. Therefore, PV patients may be more prone to develop atherosclerosis and this finding can be important in the overall management of these patients.

  2. van Huizen AM, Menting SP, Gyulai R, Iversen L, van der Kraaij GE, Middelkamp-Hup MA, et al.
    JAMA Dermatol, 2022 May 01;158(5):561-572.
    PMID: 35353175 DOI: 10.1001/jamadermatol.2022.0434
    IMPORTANCE: A clear dosing regimen for methotrexate in psoriasis is lacking, and this might lead to a suboptimal treatment. Because methotrexate is affordable and globally available, a uniform dosing regimen could potentially optimize the treatment of patients with psoriasis worldwide.

    OBJECTIVE: To reach international consensus among psoriasis experts on a uniform dosing regimen for treatment with methotrexate in adult and pediatric patients with psoriasis and identify potential future research topics.

    DESIGN, SETTING, AND PARTICIPANTS: Between September 2020 and March 2021, a survey study with a modified eDelphi procedure that was developed and distributed by the Amsterdam University Medical Center and completed by 180 participants worldwide (55 [30.6%] resided in non-Western countries) was conducted in 3 rounds. The proposals on which no consensus was reached were discussed in a conference meeting (June 2021). Participants voted on 21 proposals with a 9-point scale (1-3 disagree, 4-6 neither agree nor disagree, 7-9 agree) and were recruited through the Skin Inflammation and Psoriasis International Network and European Academy of Dermatology and Venereology in June 2020. Apart from being a dermatologist/dermatology resident, there were no specific criteria for participation in the survey. The participants worked mainly at a university hospital (97 [53.9%]) and were experienced in treating patients with psoriasis with methotrexate (163 [91.6%] had more than 10 years of experience).

    MAIN OUTCOMES AND MEASURES: In a survey with eDelphi procedure, we tried to reach consensus on 21 proposals. Consensus was defined as less than 15% voting disagree (1-3). For the consensus meeting, consensus was defined as less than 30% voting disagree.

    RESULTS: Of 251 participants, 180 (71.7%) completed all 3 survey rounds, and 58 participants (23.1%) joined the conference meeting. Consensus was achieved on 11 proposals in round 1, 3 proposals in round 2, and 2 proposals in round 3. In the consensus meeting, consensus was achieved on 4 proposals. More research is needed, especially for the proposals on folic acid and the dosing of methotrexate for treating subpopulations such as children and vulnerable patients.

    CONCLUSIONS AND RELEVANCE: In this eDelphi consensus study, consensus was reached on 20 of 21 proposals involving methotrexate dosing in patients with psoriasis. This consensus may potentially be used to harmonize the treatment with methotrexate in patients with psoriasis.

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