Clinical Utility of Guselkumab in the Treatment of Moderate-to-Severe Plaque Psoriasis.

Psoriasis is a chronic immune-mediated disease involving complex interaction of T cells and keratinocytes. The comprehensive pathogenesis of psoriasis is not fully understood but the IL-23/Th17 axis is a central pathway in driving disease development. Guselkumab is the first treatment of moderate-to-severe psoriasis that specifically targets the p19 subunit of IL-23. The benefit of guselkumab has been established by a number of clinical trials including demonstration of greater long-term efficacy in recent comparator trials. This review addresses the results of head-to-head trials (ECLIPSE, IXORA-R, and POLARIS) that compared guselkumab to secukinumab, ixekizumab, and fumaric acid esters. The previously demonstrated long-term efficacy of guselkumab has been corroborated by many recently published studies. The effective and safe profile, convenient dosing, and improved quality of life in patients make gulselkumab a viable first-line treatment option for moderate-to-severe psoriasis.

Evaluation of Accountability Measurement Tool in Patients with Psoriasis: A Validation Study.

INTRODUCTION: The role of accountability in promoting patient adherence to medication is not well characterized. An accountability measurement tool (AMT) has been developed to quantify accountability but has not been investigated for use with patients with skin disease. We aim to test the reliability and validity of the AMT for patients with psoriasis. METHODS: A 12-item AMT was used for patients with psoriasis. English-speaking adults with psoriasis who were expected to continue their medication were asked to complete the questionnaire. Reliability was measured using Cronbach's alpha. Validity was measured using Pearson's correlation coefficient and t-tests between the AMT and other validated scales measuring fear of negative evaluation and self-regulation. RESULTS: A total of 30 patients were recruited for this study. The AMT demonstrated excellent internal consistency (Cronbach's [Formula: see text] = 0.86). Total accountability positively correlated with fear of negative evaluation (r = 0.59), autonomous motivation (r = 0.46), introjected regulation (r = 0.60), and external regulation (r = 0.57), demonstrating good convergent validity. Divergent validity was supported by nonsignificant associations between psoriasis accountability and age, gender, race, education level, years with physician, and amotivation. CONCLUSIONS: The AMT has been further validated for measuring accountability in patients with psoriasis.

Contact dermatitis: one for the books.

Allergic contact dermatitis (ACD) is a frequent problem, often caused from repeated exposure to an object or substance related to the patient's routine activities. We present a case of a well-demarcated, erythematous, scaly plaque on a finger caused from reading with an e-book device. Although metal from mobile devices can cause ACD, mobile device cases may cause irritation or contain additives that can also cause contact dermatitis. Similar presentations of contact dermatitis may become more common as technology use increases.

Accountability in patient adherence.

BACKGROUND: The accountability inherent in the social interaction between a patient and healthcare provider affects patients' motivation to adhere to treatment. To characterize the role of accountability as a tool to improve self-efficacy and self-management and thereby promote patients' adherence to treatment, a measure of accountability is needed. AIMS: To develop and test the validity, reliability, and sensitivity of a new outcome measure designed to assess accountability. METHODS: The accountability measurement tool was developed from the literature, expert consultation, and focus groups. A focus group and three pilot studies were performed both in clinic and through an online crowdsourcing platform. Principal Component Analysis evaluated constructs, and Cronbach's alpha measured internal consistency. Validity was established using convergent and divergent correlations to other validated scales. RESULTS: A total of 292 participants took part in this study. The 12-item accountability scale demonstrated very good internal consistency (Cronbach's α=0.92). Components of the accountability measurement tool correlated with predicted validated measures, including the Treatment Self-Regulation Questionnaire. Divergent validity was established with no significant difference noted between age, sex, race, and education level. CONCLUSION: Future use of this questionnaire will allow for the assessment of the interaction between accountability and adherence to treatment and lead to the development of new interventions to promote better adherence.