Hormone therapy (HT) is commonly used for contraception and menopausal symptom relief, but its relationship with psoriasis risk has been uncertain. Using Taiwan’s National Health Insurance Database (2001–2021), researchers conducted a large nationwide cohort study and target trial emulation including women over 20 years without prior psoriasis, ovarian cancer, or breast cancer. Participants were grouped as reproductive-age (≤50 years) or postmenopausal (>50 years) and classified as HT users or nonusers. The primary outcome was new-onset psoriasis over 5 years, analyzed with inverse probability of treatment weighting and Cox models under both intention-to-treat and per-protocol frameworks.

In postmenopausal women (about 1.48 million HT users vs 1.31 million nonusers), HT was associated with a higher psoriasis risk, with an adjusted hazard ratio (HR) of 1.48 in the intention-to-treat (ITT) analysis and 5.93 in the per-protocol analysis. The association was even stronger in reproductive-age women (about 3.85 million HT users vs 1.59 million nonusers), with an ITT HR of 1.93 and a per-protocol HR of 7.85. Overall, the study suggests that HT is linked to a significantly increased risk of developing psoriasis in both age groups, particularly in younger women. These results reinforce the role of hormonal factors in psoriasis pathogenesis and underscore the need for clinicians to monitor HT-treated women for early signs of psoriasis.

Reference: Yang HW, Chen YH, To SY, et al. Hormone therapy and increased risk of psoriasis in reproductive-age and postmenopausal women: a nationwide cohort study and target trial emulation. Br J Dermatol. 2025 Jul 17;193(2):259-266. doi: 10.1093/bjd/ljaf179. PMID: 40343984.

Photodynamic therapy (PDT) is emerging as a targeted, noninvasive option for psoriasis that can complement or, in select cases, offer an alternative to topical agents, phototherapy, systemic drugs, and biologics. PDT uses 3 components—photosensitizers (PS), specific light wavelengths, and molecular oxygen—to generate reactive oxygen species (ROS) that induce apoptosis and necrosis in photoactivated cells. In psoriasis, PDT can suppress keratinocyte proliferation and modulate key inflammatory pathways (e.g., NF-κB, MAPK, JAK/STAT) while limiting systemic exposure. Early agents such as 5-aminolevulinic acid (ALA) laid the groundwork. Newer photosensitizers (e.g., chlorin e6, IR820, ZnPc-F7) aim to improve selectivity, penetration, and tolerability.

Recent work focuses on optimizing PDT through smarter delivery systems, rational combinations, and better use of light. Nanocarrier platforms—such as mesoporous silica, polydopamine-based systems, and lipid nanocarriers—enhance PS stability, localization, and ROS generation, enabling synergistic photochemotherapy and dual photothermal. These photodynamic strategies can improve lesion control, barrier repair, and inflammatory downregulation. Combination regimens with conventional or biologic therapies may permit dose reduction and broader disease control. The review concludes that nanotechnology-driven innovation, refined light-source protocols, and deeper understanding of the cutaneous microenvironment are needed to move PDT toward more precise, scalable, and patient-friendly roles in psoriasis care.

Reference: Tomar Y, Innani S, Jain A, Rao VKP, Singhvi G. Unlocking the Potential of Photodynamic Therapy in Psoriasis: Mechanistic Insights, Wide-Ranging Applications, Challenges and Future Directions. J Drug Deliv Sci Technol. 2025;112:107260. doi: 10.1016/j.jddst.2025.107260.

Psoriasis is a chronic, immune-mediated disease in which biologic therapies like secukinumab have become key options for patients with moderate to severe plaque involvement. However, as more patients remain on these agents long term, questions around if, and when, to safely taper doses are increasingly important for both clinical and economic reasons. In this retrospective study, 75 patients who had received secukinumab 300 mg weekly for 5 weeks and then every 4 weeks, and maintained a Psoriasis Area and Severity Index (PASI) 90 response for at least 6 months, were evaluated for tapering outcomes. Of these patients, 40 (53.3%) successfully tapered their secukinumab dose while maintaining adequate disease control. No serious adverse events were reported during the observation period.

Several factors emerged as predictors of successful tapering. Lower BMI, earlier initiation of tapering after achieving PASI 90, and a longer period of stable treatment before dose reduction were all associated with higher success rates. Seasonal patterns also appeared relevant: taper attempts made in autumn and winter were more likely to fail, while those in spring and summer had better outcomes. Rapid achievement of PASI 90 early in therapy further correlated with successful tapering, suggesting that patients with robust initial responses may be better candidates for dose reduction. Together, these findings support the idea that, under the right clinical conditions and careful monitoring, secukinumab dose tapering can be a feasible way to maintain psoriasis control while potentially lowering treatment burden, costs, and long-term risk of adverse effects.

Reference: Chen J, Xiao Z, Zeng X, et al. Predictors of Successful Secukinumab Dose Tapering in Moderate-to-Severe Psoriasis: A Retrospective Study. Psoriasis (Auckl). 2025 Oct 17;15:527-534. doi: 10.2147/PTT.S531447. PMID: 41133130; PMCID: PMC12540611.