{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T18:04:02Z","timestamp":1791396242882,"version":"4.3.3"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T00:00:00Z","timestamp":1758067200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Psoriasis severity and symptoms are widely known to vary seasonally. However, evidence on the impact of seasonality on treatment outcomes is limited, with vague season definitions. It also remains unclear whether seasons represent static meteorological levels or dynamic trends.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the impact of a novel temperature trend-defined seasonality on psoriasis treatment responses at 2 and 3 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were derived from the Shanghai Psoriasis Effectiveness Evaluation CoHort (SPEECH), a prospective, multicenter registry assessing the effectiveness of biologics (adalimumab, ustekinumab, secukinumab and ixekizumab), conventional systemic therapies (acitretin and methotrexate), and phototherapy. Patients were categorized into warming (consistent temperature increase), transition (non-unidirectional changes), and cooling (consistent temperature decrease) groups based on ambient temperature trends during the treatment period. Effectiveness was defined as achieving Psoriasis Area and Severity Index (PASI) 75 (\u2265 75% improvement in PASI), PASI 90 (\u2265 90% improvement in PASI), Physician\u2019s Global Assessment (PGA) of 0\/1, and Dermatology Quality of Life Index minimal important difference (DLQI MID) (\u2265 4 points improvement) at 2 and 3 months. Covariate balancing propensity score (CBPS) weighting was applied to balance baseline covariates, and odds ratios (ORs) with 95% confidence intervals (CIs) were estimated. Interaction analyses evaluated potential factors that may stratify treatment response.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the 3-month analysis of 1411 patients, the cooling group showed significantly lower odds of achieving PASI 75 (adjusted OR 0.70, 95% CI 0.61\u20130.80, <jats:italic>P<\/jats:italic> &amp;lt;.001), PASI 90 (adjusted OR 0.68, 95% CI 0.59\u20130.79, <jats:italic>P<\/jats:italic> &amp;lt;.001), PGA 0\/1 (adjusted OR 0.65, 95% CI 0.57\u20130.75, <jats:italic>P<\/jats:italic> &amp;lt;.001), and DLQI MID (adjusted OR 0.86, 95% CI 0.75\u20130.99, <jats:italic>P<\/jats:italic>\u00a0= .032) compared to the warming group. The transition group showed intermediate outcomes. Body mass index (BMI) significantly modified treatment effectiveness, with higher BMI associated with poorer responses, whereas treatment type did not alter the seasonal effect. Findings were largely consistent at 2 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Cooling trends are associated with reduced treatment efficacy independently of static temperature, humidity, and ultraviolet levels. This BMI-modified effect underscores the importance of personalized management strategies addressing both environmental and patient-specific factors.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2025.1641225","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T05:45:45Z","timestamp":1758087945000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of temperature trend-defined seasonality on psoriasis treatment outcomes: a multicenter longitudinal study"],"prefix":"10.3389","volume":"16","author":[{"given":"Xinyi","family":"Song","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuye","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(20)32549-6","article-title":"Psoriasis","volume":"397","author":"Griffiths","year":"2021","journal-title":"Lancet (London England)"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-3384","article-title":"Psoriasis and genetics","volume":"100","author":"Dand","year":"2020","journal-title":"Acta dermato-venereologica"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1159\/000106419","article-title":"Environmental factors and psoriasis","volume":"35","author":"Dika","year":"2007","journal-title":"Curr problems Dermatol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"567","DOI":"10.3892\/etm.2021.9999","article-title":"Infection-provoked psoriasis: induced or aggravated (Review)","volume":"21","author":"Teng","year":"2021","journal-title":"Exp Ther Med"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2019.05.006","article-title":"How lifestyle factors and their associated pathogenetic mechanisms impact psoriasis","volume":"39","author":"Madden","year":"2020","journal-title":"Clin Nutr (Edinburgh Scotland)"},{"key":"B6","doi-asserted-by":"publisher","first-page":"87","DOI":"10.2147\/ptt.S126727","article-title":"Drug-induced psoriasis: clinical perspectives","volume":"7","author":"Balak","year":"2017","journal-title":"Psoriasis (Auckland NZ)"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1111\/srt.13102","article-title":"Psoriasis and seasonal variation: A systematic review on reports from northern and central europe-little overall variation but distinctive subsets with improvement in summer or wintertime","volume":"28","author":"Jensen","year":"2022","journal-title":"Skin Res technology: Off J Int Soc Bioengineering Skin (ISBS) [and] Int Soc Digital Imaging Skin (ISDIS) [and] Int Soc Skin Imaging (ISSI)"},{"key":"B8","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1111\/j.1365-4632.2004.01828.x","article-title":"Seasonal variation of dermatologic disease in the USA: A study of office visits from 1990 to 1998","volume":"43","author":"Hancox","year":"2004","journal-title":"Int J Dermatol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2015.06.001","article-title":"Seasonal variation of acne and psoriasis: A 3-year study using the physician global assessment severity scale","volume":"73","author":"Pascoe","year":"2015","journal-title":"J Am Acad Dermatol"},{"key":"B10","article-title":"Common skin diseases reveal seasonal variation in internet search interest","volume":"20","author":"Muddasani","year":"2022","journal-title":"Skinmed"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1590\/abd1806-4841.20187309","article-title":"Seasonality of the hospitalizations at a dermatologic ward (2007-2017)","volume":"93","author":"Brito","year":"2018","journal-title":"Anais brasileiros dermatologia"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-006450","article-title":"Epidemiology of psoriasis and palmoplantar pustulosis: A nationwide study using the Japanese national claims database","volume":"5","author":"Kubota","year":"2015","journal-title":"BMJ Open"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1093\/bjd\/ljad188","article-title":"Measurement properties of the patient global assessment numerical rating scale in moderate-to-severe psoriasis","volume":"189","author":"Yu","year":"2023","journal-title":"Br J Dermatol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1111\/rssb.12027","article-title":"Covariate balancing propensity score","volume":"76","author":"Imai","year":"2014","journal-title":"J R Stat Soc Ser B-Statistical Method"},{"key":"B15","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1080\/07350015.2021.2002159","article-title":"Optimal covariate balancing conditions in propensity score estimation","volume":"41","author":"Fan","year":"2022","journal-title":"J Business Economic Stat"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1056\/nejm198806303182605","article-title":"An assessment of clinically useful measures of the consequences of treatment","volume":"318","author":"Laupacis","year":"1988","journal-title":"New Engl J Med"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.7326\/m16-2607","article-title":"Sensitivity analysis in observational research: introducing the E-value","volume":"167","author":"VanderWeele","year":"2017","journal-title":"Ann Internal Med"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2020.11.010","article-title":"Missing data in clinical research: A tutorial on multiple imputation","volume":"37","author":"Austin","year":"2021","journal-title":"Can J Cardiol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.2307\/2336190","article-title":"A stagewise rejective multiple test procedure based on a modified bonferroni test","volume":"75","author":"Hommel","year":"1988","journal-title":"Biometrika"},{"key":"B20","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1016\/j.jaut.2017.06.001","article-title":"Seasonality and autoimmune diseases: the contribution of the four seasons to the mosaic of autoimmunity","volume":"82","author":"Watad","year":"2017","journal-title":"J Autoimmun"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1159\/000250983","article-title":"Psoriasis in north India","volume":"155","author":"Bedi","year":"1977","journal-title":"Geographical Variations. Dermatologica"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.16791","article-title":"Diurnal and seasonal variation in psoriasis symptoms","volume":"35","author":"Ferguson","year":"2021","journal-title":"J Eur Acad Dermatol Venereology: JEADV"},{"key":"B23","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1111\/j.1346-8138.1998.tb02357.x","article-title":"Factors influencing psoriasis: an analysis based upon the extent of involvement and clinical type","volume":"25","author":"Park","year":"1998","journal-title":"J Dermatol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"11670","DOI":"10.3390\/ijms252111670","article-title":"Psoriasis and seasonality: exploring the genetic and epigenetic interactions","volume":"25","author":"Nied\u017awied\u017a","year":"2024","journal-title":"Int J Mol Sci"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.13229","article-title":"Seasonal variations in dermatologic and dermatopathologic diagnoses: A retrospective 15-year analysis of dermatopathologic data","volume":"55","author":"Harvell","year":"2016","journal-title":"Int J Dermatol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1088\/0031-9155\/37\/1\/001","article-title":"Ultraviolet radiation in the treatment of skin disease","volume":"37","author":"Green","year":"1992","journal-title":"Phys Med Biol"},{"key":"B27","article-title":"The mechanisms of action of phototherapy in the treatment of the most common dermatoses","author":"Bulat","year":"2011","journal-title":"Collegium antropologicum"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2009.05.047","article-title":"Latitude and psoriasis prevalence","volume":"65","author":"Jacobson","year":"2011","journal-title":"J Am Acad Dermatol"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.12741","article-title":"Seasonal variability in the biophysical properties of forehead skin in women in guangzhou city, China","volume":"54","author":"Wan","year":"2015","journal-title":"Int J Dermatol"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2007.08311.x","article-title":"Comparison of the depth profiles of water and water-binding substances in the stratum corneum determined in vivo by raman spectroscopy between the cheek and volar forearm skin: effects of age, seasonal changes and artificial forced hydration","volume":"158","author":"Egawa","year":"2008","journal-title":"Br J Dermatol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1007\/s11033-022-07549-0","article-title":"Low humidity altered the gene expression profile of keratinocytes in a three-dimensional skin model","volume":"49","author":"Shinohara","year":"2022","journal-title":"Mol Biol Rep"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.17434","article-title":"Actipso: definition of activity types for psoriatic disease: A novel marker for an advanced disease classification","volume":"35","author":"Mrowietz","year":"2021","journal-title":"J Eur Acad Dermatol Venereology: JEADV"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1641225\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T05:45:47Z","timestamp":1758087947000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1641225\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,17]]},"references-count":32,"alternative-id":["10.3389\/fimmu.2025.1641225"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2025.1641225","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,17]]},"article-number":"1641225"}}