Dermatology

Consensus core domains for SSc-associated Raynaud's and digital ulcer trials.

An international 3-round Delphi with patients and clinicians identified core domains for SSc-associated Raynaud's and digital ulcers. For SSc-RP, nine domains reached consensus covering pathophysiology and life impact; for SSc-DUs, sixteen domains reached consensus including resource use. Several Life Impact domains were common to both vascular manifestations, supporting harmonized outcome measurement across trials. These domain sets are intended to guide development of a final Core Domain Set for future SSc-RP and SSc-DU trials. 1

Skin microbiome dysbiosis linked to psoriasis progression and potential therapeutic targets.

Review of >20 studies documents psoriatic lesions with increased pro-inflammatory taxa and reduced commensals. Dysbiosis is proposed to worsen barrier function and modulate innate and adaptive immunity via microbial metabolites. Authors highlight microbiome-based diagnostics and targeted modulation as promising, but emphasize further mechanistic and multi-omics work. Current findings suggest potential prognostic biomarkers and adjunctive therapeutic targets, not established clinical treatments yet. 2

MDA and PASDAS better discriminate active PsA treatments than DAPSA in RCTs.

Network meta-analysis of 24 RCTs (43 comparisons) compared composite PsA outcome measures for discriminating active treatment from placebo. MDA (OR 5.06) and PASDAS (OR 3.70) showed greater discriminant capacity than DAPSA (OR 3.02), while ACR20 performed well (OR 4.01). Sensitivity analyses confirmed consistent numerical advantages for MDA and PASDAS over DAPSA across trials. For trial design and comparative interpretation, prefer instruments with higher discriminant capacity when feasible. 3