Effectiveness of guselkumab in patients with facial and/or genital psoriasis: Interim analysis results at Week 12 from the GULLIVER study.

BACKGROUND: Facial (FP) and genital psoriasis (GP) significantly affect patients' quality of life. Despite the advances in treatments, limited data on efficacy and safety are available on these difficult-to-treat areas. Guselkumab is an interleukin (IL)-23 inhibitor which has been proven effective in treating patients with moderate-to-severe plaque psoriasis. OBJECTIVES: The aim of this interim analysis was to report the efficacy and safety of guselkumab in the treatment of patients with FP and/or GP. MATERIALS AND METHODS: GULLIVER is a 52-week Italian observational study to evaluate the effectiveness and safety of guselkumab in a real-life setting in patients with FP and/or GP. Adult patients with facial and/or genital moderate-to-severe psoriasis (sPGA score ≥ 3) were included. The primary endpoint of this analysis was the percentage of patients achieving a facial or genital sPGA score of 0 (clear) or 1 (almost clear), at Week 12. The change in the score of the facial or genital sPGA components in patients with a score ≥3 for each sPGA component was assessed. PASI score in patients with a baseline PASI above or below 10 was evaluated. RESULTS: Overall, 351 patients were included in the study; 83.3% of FP and 76.5% of GP patients achieved the primary endpoint. Similar response rates were observed for the facial or genital sPGA components in patients with a baseline facial or genital sPGA score ≥3 in each component. Among patients with a baseline PASI score >10, mean PASI score improved from 19.0 (SD 8.3) to 2.2 (SD 4.8). Forty-four AEs were observed in 32 patients; two mild and transient AEs (fatigue and nausea) were considered treatment related. No SAEs were observed. CONCLUSIONS: Guselkumab, showing to be effective and safe in treating FP and GP, may be a valid therapeutic option for patients with psoriasis localized in these difficult-to-treat areas.

Between history and gossip: the state of women relative to syphilis, a traditionally male disease.

Despite the new World Health Organization data remind us how syphilis is a disease which affects both sexes equally, this pathology has always been mainly considered a male disease. While several famous men are known to be affected by syphilis, there are very few women affected by this pathology of which we have historical records. Through the lives of Mary Todd Lincoln, Catherine of Aragon, Karen Blixen and Florence Foster Jenkins, this article would like to grant dignity to all the women who contracted syphilis in the wrong historical era where, for a woman, admitting to contracting it was shameful. Through the important women who lived their lives fighting against this disease and its complications, we would like to pay tribute to all those women who still today, in an era of antibiotics and where syphilis is a treatable pathology, they cannot be cured because they are both geographically and socially disadvantaged.

A short novel about the spread of two important diseases in history: syphilis and SARS.

Throughout the centuries, the undefended nature of man has very often manifested in cases of epidemics, which have determined scenarios of suffering and death. Through "historical" observation lens, it is possible to understand the relationship between the spread of viruses, bacteria and parasites responsible for these epidemics and the displacement of ancient or contemporary travellers. We have analysed two infective diseases, syphilis and SARS, and their role in history and in medicine.