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    Clinical course of psoriasis patients that discontinued biologics during the COVID-19 pandemic
    (Wiley, 2023) Demir, Filiz Topaloğlu; Ekinci, Algün Polat; Aytekin, Sema; Topkarçı, Zeynep; Kayıran, Melek Aslan; Akbulut, Tuğba Özkök; Topal, İlteriş Oğuz
    BackgroundSince psoriasis is a chronic disease, it is not recommended to discontinue the treatment agents used. However, in real life, the treatment of psoriasis patients may be interrupted for various reasons. During the pandemic period, the treatment of many patients was also interrupted. ObjectivesTo evaluate relapse and clinical worsening in psoriasis patients whose biological therapy was interrupted during the pandemic and reveal associated factors. MethodsThe study included patients aged >= 18 years, who were followed up with moderate and severe chronic psoriasis controlled by the last biological agent [Psoriasis Area Severity Index (PASI) 75 response achieved] but had to discontinue their treatment during the pandemic. The patients' demographic and clinical characteristics, clinical course after the discontinuation of these agents, presence of clinical worsening, and relapse were evaluated. Risk factors were analyzed with the logistic regression analysis. ResultsThe study included 169 patients, with a mean age of 47.3 +/- 14.5 (18-87) years. The mean biologics-free time was 18.2 +/- 12.3 (2-56) weeks. Clinical worsening was detected in 41.4% and relapse in 48.5% of the patients. The significant risk factors for clinical worsening and relapse in both univariate and multivariate analyses were alcohol use during the biologics-free period, total time off biologics, and the presence of an additional triggering factor. The use of secukinumab and ustekinumab was found to be a protective factor against clinical worsening in multivariate analyses. ConclusionAs the biologics-free period is prolonged, the likelihood of clinical worsening and relapse increases, therefore, we do not recommend discontinuing biological agents.
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    Maladaptive Daydreaming in Psoriasis Patients
    (Galenos Publ House, 2024) Zorlu, Ozge; Beyazyuz, Elmas; Aytekin, Sema; Albayrak, Hulya
    Aim: Many psychiatric disorders are associated with psoriasis. A 16-item self-report maladaptive daydreaming (MD) scale (MDS-16) is described as a screening tool for MD. We aimed to explore whether MDS-16 scores differed in psoriasis patients compared to healthy individuals, hypothesizing higher scores and higher rates of probable maladaptive daydreamers (MDers) among psoriazis patients. Materials and Methods: We included 184 psoriazis patients and 93 age- and sex-matched people without any cutaneous disorders in this casecontrol, cross-sectional, and questionnaire-based study. Dermatology Quality of Life Instrument in Turkish (TQoL) and MDS-16 were applied. We considered the participants with a total MDS-16 score >50 as probable MDers. Results: Total MDS-16 score was higher in the psoriasis group (p=0.038). However, the difference between the frequencies of probable MDers was not significant (p=0.234). According to the multivariable analysis, psoriasis was not found as an independent risk factor for being probable MDer. In the psoriasis group, total MDS-16 scores were positively correlated with TQoL scores (r (s )=0.259, p=0.001), which were significantly higher in probable MDers (p=0.032). Conclusion: The association between psoriasis and MD may be related to the level of the impact of psoriasis on the quality of life.