The edition · Dermatology
On IL-17 inhibitors, candidiasis was three to five times more common than on other psoriasis systemics
Seventeen years of the British biologics register put numbers on tuberculosis, meningitis and fungal infection across psoriasis treatments. Plus a paediatric consensus on low-dose oral minoxidil, an IL-36 receptor antibody for pustular flares, risk-tiered skin checks after transplant, and an FDA abrocitinib supplement.
The edition in brief
In the British Association of Dermatologists Biologic and Immunomodulators Register, 18,635 adults with psoriasis contributed 118,018 person-years on systemic treatment between 2007 and 2024. Tuberculosis (0.19 per 1,000 person-years) and meningitis (0.25) were rare, and most cases occurred on TNF inhibitors, especially adalimumab. Fungal infection was commoner (7.53 per 1,000 person-years), and IL-17 inhibitors carried a higher risk of candidiasis than every other group, with rate ratios from 2.67 against apremilast to 4.65 against ustekinumab-class drugs. An international Delphi panel of 49 experts reached consensus on low-dose oral minoxidil for children aged 4 to under 12 with non-scarring hair disorders, with fixed weight-band doses and review every three to six months. A phase 2 trial in China of 33 patients with acute generalised pustular psoriasis found a single intravenous dose of recibokibart, an IL-36 receptor antibody, cleared pustulation by day 8 in 86.4% against 9.1% on placebo. A Swedish transplant cohort found a three-tier risk model separated time to invasive skin cancer, with high-risk recipients at almost 12 times the hazard. The FDA recorded a supplement to Pfizer's abrocitinib application on 2 September, without stated changes. The pearl covers a TB screen before biologics in India.
Low-dose oral minoxidil for children: an international consensus on who, how much and how to monitor
For children aged 4 to under 12 with non-scarring hair loss, low-dose oral minoxidil now has an agreed dosing and review framework.
A single IL-36 receptor antibody infusion cleared pustules within a week in pustular psoriasis flares
IL-36 receptor blockade can clear a pustular psoriasis flare within a week; recibokibart itself remains investigational.
A three-tier risk model separated transplant recipients by their chance of skin cancer
Stratify transplant recipients by skin cancer risk and set follow-up intervals to match.
FDA records a supplement to the abrocitinib application
This is an FDA supplement without stated changes; abrocitinib monitoring is unchanged.
Screen for latent tuberculosis before every biologic or JAK inhibitor, and again if exposed
Screen for latent tuberculosis before any biologic or JAK inhibitor, and re-screen after exposure.
IL-17 inhibitors raised candidiasis risk; TNF inhibitors carried most of the tuberculosis
Warn about candidiasis on IL-17 inhibitors, and consider an IL-23 inhibitor for patients prone to it.
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