{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T04:57:40Z","timestamp":1780981060105,"version":"3.54.1"},"reference-count":48,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100009647","name":"Ministry of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009647","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Experimental Dermatology"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Genetic studies mutations (IL36RN, CARD14 and AP1S3) account for only 28.6% of generalised pustular psoriasis (GPP) leaving much of its pathogenesis remained to be elucidated. Emerging evidence suggests Th17\u2013mediated inflammation, potentially driven by specific HLA class alleles, may underlie dysregulated IL\u201036 signalling. This study explores the genotypic and phenotypic features of autochthonous GPP in Sarawak. A cross\u2010sectional case\u2013control study was conducted in Sarawak's three main dermatology centres. GPP patients (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200943) fulfilling ERASPEN criteria between 1997 and June 2024 were included (23 with GPP alone); 20 with concomitant psoriasis vulgaris. HLA genotyping (HLA\u2010A, \u2010B, \u2010C, \u2010DR) was performed via polymerase chain reaction and sequence\u2010specific oligonucleotide probe hybridisation (PCR\u2010SSO) methods at the Institute of Medical Research (IMR). HLA frequencies were compared to 90 Sarawakian controls from Malaysian Stem Cell Registry. Female predominance was noted (1:4.4). Median age at GPP onset was 29\u2009years. Family history of psoriasis was reported in 30.2%, with 16% females developing GPP during pregnancy. Treatment responses: corticosteroids (100%), ciclosporin (82.1%), acitretin (60%) and methotrexate (50%). While biologics were effective in 10 patients. Common alleles included HLA\u2010DRB1*12:02, HLA\u2010A*11:01 and HLA\u2010C*07:02 while HLA\u2010C06:02 was not observed. HLA\u2010A*02:07 and HLA\u2010B*46:01 were observed only in concomitant psoriasis patients. HLA\u2010A*11:02 was seen in patients with ciclosporin non\u2010response, HLA\u2010A*24:02 in those with poorer responses to acitretin and methotrexate and HLA\u2010B*38:02 in psoriatic arthritis. Lower frequencies of HLA\u2010B*35:05 and HLA\u2010C*04:01 were observed among Dayak patients. The absence of HLA\u2010C*06:02 and variation in allele frequencies in this cohort may reflect population\u2010specific patterns but require validation in larger studies.\n                  <\/jats:p>","DOI":"10.1111\/exd.70258","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T11:45:36Z","timestamp":1777463136000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Population\u2010Specific\n                    <scp>HLA<\/scp>\n                    Profiles in Generalised Pustular Psoriasis in Sarawak, Malaysia"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6476-8073","authenticated-orcid":false,"given":"Ingrid Pao Lin","family":"Ting","sequence":"first","affiliation":[{"name":"Department of Dermatology Sarawak General Hospital, Sarawak, Ministry of Health Malaysia  Kuching Malaysia"},{"name":"Dermatology Unit Miri Hospital, Sarawak, Ministry of Health Malaysia  Miri Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6134-2192","authenticated-orcid":false,"given":"Hock Gin","family":"Teo","sequence":"additional","affiliation":[{"name":"Dermatology Unit Sibu Hospital, Sarawak, Ministry of Health Malaysia  Sibu Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bee Tee","family":"Koay","sequence":"additional","affiliation":[{"name":"Transplantation Immunology Unit, Allergy and Immunology Research Centre (AIRC) Institute for Medical Research, National Institutes of Health  Selangor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norfarhana","family":"Khairul\u2010Fahmy","sequence":"additional","affiliation":[{"name":"Transplantation Immunology Unit, Allergy and Immunology Research Centre (AIRC) Institute for Medical Research, National Institutes of Health  Selangor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masita","family":"Arip","sequence":"additional","affiliation":[{"name":"Transplantation Immunology Unit, Allergy and Immunology Research Centre (AIRC) Institute for Medical Research, National Institutes of Health  Selangor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norhazlin","family":"Mustafa","sequence":"additional","affiliation":[{"name":"Transplantation Immunology Unit, Allergy and Immunology Research Centre (AIRC) Institute for Medical Research, National Institutes of Health  Selangor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7760-3238","authenticated-orcid":false,"given":"Min Moon","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Dermatology Sarawak General Hospital, Sarawak, Ministry of Health Malaysia  Kuching Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2024.0915"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.17471"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.1301481"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cyto.2016.05.023"},{"issue":"17","key":"e_1_2_12_6_1","first-page":"3478","article-title":"IL\u201036 Signaling Amplifies Th1 Responses by Enhancing Proliferation and Th1 Polarization of Naive CD4+ T Cells","volume":"120","author":"Vigne S.","year":"2012","journal-title":"Blood, the Journal of the American Society of 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