The available data on past and present outbreaks of Coronavirus infections (SARS, MERS, COVID-19) suggest that immunosuppressed patients are not at increased risk for severe manifestations and complications of COVID-19 compared to the general population.
Immunosuppressive and immunomodulatory drugs (human interleukin-1 receptor antagonist and anti-interleukin-6) may potentially control the “cytokine storm” associated with a poorer outcome in these patients.
Thus, patients with cutaneous immune-mediated diseases (including psoriasis, atopic dermatitis, and hidradenitis suppurativa) can, in general (and subject to individual consideration with the prescriber), continue their treatment during the COVID-19 outbreak. This would prevent disease flares that can contribute to increasing patient burden, disability, poor quality of life, and healthcare usage.
Withholding immunosuppressive (e.g. methotrexate, cyclosporine) or biologic treatment in patients with active COVID-19 infection is generally recommended. Starting these treatments in the event of active infections is contraindicated.
If patients develop symptoms consistent with COVID-19 infection, it is advisable that such treatments are paused. We recognize that some comorbidities associated with psoriasis, hidradenitis suppurativa and atopic dermatitis (obesity, diabetes, hypertension, cardiovascular disease, chronic lung disease, asthma), and in those aged 60 years and older, worsen the prognosis of COVID-19 infection.
If patients live in areas with a high incidence of COVID-19 infection, or are close contacts of confirmed cases, individual consideration should be given to temporary discontinuation of some therapies considering factors such as age or comorbidities.
Currently we have no data regarding the impact of systemic psoriasis therapies (or therapies for atopic dermatitis and hidradenitis suppurativa) on susceptibility to or severity of COVID-19 infection. Thus, any guidance is based on previous clinical experience and an understanding of the mechanisms of action of our therapies. The TF recommends that all patients with these diseases who have either suspected or confirmed COVID-19 infection are entered into the relevant registries established to address this lack of data.
Repository of references and further readings:
• Managing Cutaneous Immune-Mediated Diseases During the COVID-19 Pandemic
Abstract on recommendations for patients with cutaneous immune-mediated diseases,
Pr. Luis Puig and Dr Tiago Torres, Spain
American Journal of Clinical Dermatology, 10 April 2020
• Should biologics for psoriasis be interrupted in the era of COVID-19?
Concern about immunosuppressive or immunomodulating effects that might render patients on biologic therapies more susceptible to COVID-19 infection -> provide data on infectious complications for biologic therapies from pivotal trials for psoriasis.
Dr Mark Lebwohl, Ryan Rivera-Oyola /US, Dr. Dedee Murrell /Australia - JAAD, 31 March 2020
• Recommendations for systemic therapy in persons with psoriasis during the pandemic phase of SARS-CoV-2
Statement and patient information to be used in practice and/or hospital. The statement is based on currently available evidence and an expert consensus on the basis of data from published literature.
PSOBest / The German Psoriasis-Registry
PsoBest, 18 March 2020, SARS-CoV-2
• Statement on the Coronavirus (COVID-19) Outbreak
Recommendations for psoriasis patients treated with immunosuppressant medications
IPC (International Psoriasis Council)
COVID-19, IPC ALERT; 11 March 2020
• How to proceed in patients with concomitant diseases/comorbidities?
(Link available soon. Papers to be available during week 16 or 17)
GRAPPA (Group for Research and Assessment of Psoriasis and Psoriatic Arthritis),
ECCO (European Crohn’s and Colitis Organisation)
SPIN Presentation
Recent news
- 2019/10/29 Focus on...
- 2019/08/12 Focus on...
Latin American Clinical Practice Guidelines on the Systemic Treatment of Psoriasis
- 2019/06/03 Focus on...
- 2019/05/21 Focus on...
Prof Nelida Aurora Raimondo
News from the web office
- 2016/10/29
- 2016/05/26
- 2016/02/20
Events
- 2019/04/18 Focus on...
- 2018/02/21
News from medical groups
- 2018/04/18
- 2017/06/21
News from patients associations
- 2017/02/08
- 2016/05/26
Recent publications on Psoriasis and Atopic Dermatitis
on Psoriasis
Total glucosides of paeony: A review of its phytochemistry, role in autoimmune diseases, and mechanisms of action.
J Ethnopharmacol.
2020 Aug 10, 258:112913.
Paeoniae Radix Alba (PRA, called baishao in China), the root of Paeonia lactiflora Pall., has shown a rich medicinal value for more than 2000 years. PRA is used in local medicine and traditional medicine for autoimmune diseases associated with inflammation. At present, total glucosides of paeony (TGP), the main active ingredient of PRA, has been developed into a preparation for the treatment of autoimmune diseases, as TGP exhibits the effect of regulating immunity, anti-inflammatory, and (...)
see on pubmed
Immobilization of papain enzyme on a hybrid support containing zinc oxide nanoparticles and chitosan for clinical applications.
Carbohydr Polym.
2020 Sep 01, 243:116498.
A new hybrid bionanomaterial composed of zinc oxide nanoparticles (ZnO NPs) and chitosan was constructed after enzymatic immobilization of papain for biomedical applications. In this work, we report the preparation and characterization steps of this bionanomaterial and its biocompatibility in vitro. The properties of the immobilized papain system were investigated by transmission electron microscopy, zeta potential, DLS, UV-vis absorption spectroscopy, FTIR spectroscopy, and X-ray (...)
see on pubmed
Tackling the various classes of nano-therapeutics employed in topical therapy of psoriasis.
Drug Deliv.
2020 Dec , 27, (1):662-680.
Psoriasis is a dermatological chronic skin condition with underlying autoimmune etiology. It deeply affects patients' quality of life. Therefore, it was an interesting target for researchers throughout the past years. Conventionally, the treatment options include anti-inflammatory agents, immune suppressants, biologic treatment, and phototherapy. Nanotechnology offers promising characteristics that allow for tailoring a drug carrier to achieve dermal targeting, improved efficacy and (...)
see on pubmed
on Atopic Dermatitis
The clinical impact of cross-reactions between allergens on allergic skin diseases.
Curr Opin Allergy Clin Immunol.
2020 Aug , 20, (4):374-380.
The route of allergen sensing via the skin appears to influence the immune system towards mounting a type 2 response, especially in genetically predisposed individuals. Allergens recognized this way may derive from microbial, animal, food, or other plant sources and trigger atopic dermatitis. Allergens can be grouped into families depending on their structure and function, harboring significant structural and sequence similarities. Cross-reactivity between allergens is believed to arise as (...)
see on pubmed
Spectral diagnosis of health hazardous toxins in face foundation powders using laser induced breakdown spectroscopy and inductively coupled plasma-optical emission spectroscopy (ICP-OES).
Talanta.
2020 Sep 01, 217:121007.
In this work, we applied laser-induced breakdown spectroscopy (LIBS) to estimate the amount of toxic heavy metals (Pb, Cr, Ni) in five different brands of face foundation powders available in the local market using standard calibration curve (CC)-LIBS approach. These samples contain toxic elements like lead, chromium, nickel which are highly carcinogens to cause eczematous and atopic dermatitis. The strongest atomic transition lines of lead (405.7 line), chromium (425.4 nm line), and nickel (...)
see on pubmed
Update on canine filaggrin: a review.
Combarros D et al.
Update on canine filaggrin: a review.
Vet Q.
2020 Dec , 40, (1):162-168.
Human filaggrin (FLG) plays a key role in epidermal barrier function, and loss-of-function mutations of its gene are primarily responsible for the development of human atopic dermatitis (AD). FLG expression is also reduced in the epidermis of atopic patients, due to the transcriptional effect of Th2 type cytokines. Canine atopic dermatitis (CAD) is a prevalent skin disease that shares many clinical and pathogenic features with its human homologue. The aim of this review is discuss current (...)
see on pubmed
