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The role of systemic therapies for psoriasis in the development of cardiovascular events is addressed by Mai Thi Hoai Son et al.2 in a systematic review involving 1,795,823 patients (Figure 2). Although long-term, high-quality studies specifically designed for this topic are needed to clarify the safety of antipsoriatic drugs, this systematic review concludes that methotrexate and anti-TNF agents consistently demonstrate cardiovascular protective effects, with reductions in myocardial infarction, stroke, and cardiovascular mortality. IL-17 inhibitors showed neutral to potentially beneficial cardiovascular profiles, whereas cyclosporine, retinoids, and fumaric acid esters were associated with elevated cardiovascular risks. Evidence regarding IL-12/23 and IL-23 inhibitors remains inconclusive. These findings should be interpreted with caution in light of the clear methodological limitations of the available studies; nevertheless, the matter is of great clinical interest, given the elevated risk of cardiovascular events in patients with psoriasis. The role of punch grafting in chronic leg ulcers is addressed by Malou van Zanten et al.,3 who retrospectively reviewed 74 patients with chronic lower leg ulcers treated at a single institution (Figure 3). The authors assessed the impact of this relatively simple procedure on pain and found a significant decrease in pain severity and opioid use; notably, 30% of patients no longer required any analgesic therapy. Punch grafting was shown to be a minimally invasive procedure, with a low rate of complications, mainly limited to minor infections and donor-site-related adverse events.
Published in: Journal of the European Academy of Dermatology and Venereology
Volume 40, Issue 4, pp. 550-551
DOI: 10.1111/jdv.70326