{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T01:10:39Z","timestamp":1789175439127,"version":"build-2803163510"},"reference-count":16,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,8,20]],"date-time":"2021-08-20T00:00:00Z","timestamp":1629417600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Treatment of recalcitrant moderate\u2010to\u2010severe psoriasis can be challenging. Combination therapy of biologics and immunosuppressive agents can be a new strategy for treating therapy\u2010resistant cases with comorbidities, where many systemic medications are contraindicated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>We report a case of a 62\u2010year\u2010old diabetic man with a 30\u2010year history of severe plaque psoriasis and psoriatic arthritis with cirrhosis and diabetic nephropathy that was treated successfully in combination with apremilast and etanercept after multiple previous unsuccessful treatment attempts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There are no data supporting the combination of apremilast and etanercept in the management of recalcitrant cases of moderate\u2010to\u2010severe psoriasis and multiple comorbidities including psoriatic arthritis, diabetic nephropathy, and cirrhosis. In patients who do not respond to multiple approaches for the treatment of psoriasis, combination therapy with biologic agents and new systemic medications may lead to dramatic disease control.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocd.14367","type":"journal-article","created":{"date-parts":[[2021,8,20]],"date-time":"2021-08-20T18:52:08Z","timestamp":1629485528000},"page":"2226-2228","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Combination therapy of recalcitrant severe psoriasis with psoriatic arthritis, diabetes nephropathy, and liver cirrhosis"],"prefix":"10.1111","volume":"21","author":[{"given":"Sebastian","family":"Zimmer","sequence":"first","affiliation":[{"name":"Department of Dermatology University Medical Center Mainz  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8646-1179","authenticated-orcid":false,"given":"Mohamad","family":"Goldust","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Medical Center Mainz  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4141-5520","authenticated-orcid":false,"given":"Shashank","family":"Bhargava","sequence":"additional","affiliation":[{"name":"Department of Dermatology R.D. Gardi Medical College  Ujjain India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Wegner","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Medical Center Mainz  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Grabbe","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Medical Center Mainz  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra","family":"Staubach\u2010Renz","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Medical Center Mainz  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,8,20]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2008.02.039"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa030409"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/14712598.2018.1445223"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2008.09019.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.2174\/1573397115666181130094455"},{"issue":"5","key":"e_1_2_10_7_1","first-page":"648","article-title":"Apremilast and secukinumab combined therapy in a patient with recalcitrant plaque psoriasis","volume":"15","author":"Rothstein BE","year":"2016","journal-title":"J Drugs Dermatol"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.5070\/D3216027825"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-0585"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2010.03613.x"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2008.08564.x"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.119446"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40291-018-0354-8"},{"issue":"10","key":"e_1_2_10_14_1","first-page":"1078","article-title":"Open\u2010label study to evaluate the efficacy of etanercept treatment in subjects with moderate to severe plaque psoriasis who have failed therapy with apremilast","volume":"17","author":"Bagel J","year":"2018","journal-title":"J Drugs Dermatol"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.14015"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.14738"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.17092"}],"container-title":["Journal of Cosmetic Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocd.14367","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jocd.14367","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocd.14367","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T23:45:48Z","timestamp":1692661548000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jocd.14367"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,20]]},"references-count":16,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,5]]}},"alternative-id":["10.1111\/jocd.14367"],"URL":"https:\/\/doi.org\/10.1111\/jocd.14367","archive":["Portico"],"relation":{},"ISSN":["1473-2130","1473-2165"],"issn-type":[{"value":"1473-2130","type":"print"},{"value":"1473-2165","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,20]]},"assertion":[{"value":"2021-06-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}