Wolf-Henning Boehncke

University of Geneva, Genève, Geneva, Switzerland

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Publications (136)503.04 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Numerous guidelines and recommendations exist for the treatment of psoriasis in various populations. One important population is patients with psoriatic arthritis (PsA) who have symptoms of both joint and skin disease. In patients with both facets of psoriatic disease, skin and joints must be treated separately, but also simultaneously. As several systemic therapies are approved for either one or both, the concept of treating both facets with the same drug is feasible. This review summarizes evidence from studies in patients with PsA on the efficacy of these drugs on psoriatic skin disease in these patients.
    The Journal of rheumatology. 11/2014; 41(11):2301-2305.
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    ABSTRACT: In the United States, access to care is the number one issue facing our patients with dermatological conditions. In part, this is because we do not have outcome measures that are useful in clinical practice and available in databases where payers and governmental agencies can compare the performance of physicians and treatments. There is a growing recognition that insufficient attention has been paid to the outcomes measured in clinical trials and subsequently in clinical practice. The International Dermatology Outcome Measures group includes all willing stakeholders: patients, physicians, payers, and pharmaceutical scientists. As reported herein, the group's goal is to develop outcome measures in dermatology that address the needs of all involved.
    The Journal of rheumatology. 06/2014; 41(6):1227-9.
  • Wolf-Henning Boehncke, Brian Kirby, Diamant Thaci
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    ABSTRACT: The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) organized its second Fellows Symposium adjacent to the European Academy of Dermatology and Venereology (EADV) congress in Istanbul in October 2013. Wolf-Henning Boehncke from Geneva, Brian Kirby from Dublin, and Diamant Thaci from Lübeck formed the faculty. The 9 best-ranked abstracts submitted to this symposium were presented and discussed in detail. Five abstracts focused on comorbidities in patients with psoriasis or psoriatic arthritis; summaries of all abstracts are included herein.
    The Journal of rheumatology. 06/2014; 41(6):1197-9.
  • Wolf-Henning Boehncke
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    ABSTRACT: It is now well established that psoriatic disease is associated with increased cardiovascular (CV) risk. Screening guidelines and expert recommendations for CV risk factors have been published, but these are primarily directed to specific specialists (e.g., cardiologists or diabetologists) and may not be well known in common practice. The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) and other organizations are interested in adapting current comorbidity screening guidelines for use by dermatologists and rheumatologists. The resulting checklists and algorithms will need to be evaluated for practicability and performance.
    The Journal of rheumatology. 06/2014; 41(6):1224-6.
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    ABSTRACT: Abstract is missing (Short).
    Acta Dermato-Venereologica 02/2014;
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    ABSTRACT: The German psoriasis registry PsoBest records the long-term efficacy, safety, patient benefit and treatment regimens of psoriasis. Patients with moderate or severe psoriasis are included in PsoBest when treatment with a conventional systemic agent or biologic is started for the first time. Observation time is five years. Standardized physician and patient case report forms are obtained every three to six months. Baseline data of patients included by 31 December 2012 are presented and compared to the national health care study PsoHealth 2007 (n = 2,009). 602 dermatology practices and clinics have been registered and 199 have recruited n = 2,556 patients (63 % by practices, 37 % by clinics). Initially, n = 808 received biologics (316 adalimumab, 34 efalizumab, 209 etanercept, 75 infliximab, 22 golimumab, 152 ustekinumab) and n = 1,651 conventional systemic therapy (928 fumaric acid esters, 518 methotrexate, 161 cyclosporine A, 191 other drugs or UV treatment). Compared to PsoHealth, patients in PsoBest had on average a higher disease severity (PASI 14.7 vs. 10.1; DLQI 11.0 vs. 7.5; EQ-5D VAS 54.0 vs. 64.5), shorter disease duration (18.2 vs. 21.3 yrs.), lower age (47.3 vs. 51.5), higher rates of psoriatic arthritis (20.5 vs. 19.1 %) and nail psoriasis (55.0 vs. 35.6 %). On average patients receiving biologics were younger, more often male and had higher disease severity and comorbidity. Patients in PsoBest represent patients with a high burden of disease.
    Journal der Deutschen Dermatologischen Gesellschaft 01/2014; 12(1):48-57. · 1.40 Impact Factor
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    Journal der Deutschen Dermatologischen Gesellschaft 01/2014; 12(1):48-58. · 1.40 Impact Factor
  • Wolf-Henning Boehncke, Sandra Boehncke
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    ABSTRACT: Psoriasis is among the most common skin diseases, exhibiting a wide spectrum of clinical manifestations. Joint involvement in the form of psoriatic arthritis is readily recognised, but both frequency and severity of this manifestation have long been underestimated. More recently, additional important diseases have been found to be associated with psoriasis, including the metabolic syndrome (or components thereof), cardiovascular diseases, lymphoma, and anxiety/depression. In the past, psoriasis treatment aimed at suppressing acute rashes. Current concepts regard psoriasis as a chronic systemic inflammatory condition and cardiovascular risk factor. In the light of this concept, long-term disease control through systemic maintenance therapy is increasingly recommended by experts. This approach became feasible with the approval of numerous biologics for the treatment of psoriasis. But to really address all medical needs of psoriasis patients, a truly interdisciplinary, comprehensive management approach is needed. Several national societies have already published algorithms to ensure that this need will be implemented in the daily practice of dermatologists and nondermatologists alike.
    Schweizerische medizinische Wochenschrift 01/2014; 144:w13968. · 1.88 Impact Factor
  • Wolf-Henning Boehncke, Michael P Schön
    Journal der Deutschen Dermatologischen Gesellschaft 12/2013; 11(12):1133-1134. · 1.40 Impact Factor
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    ABSTRACT: The endothelial wall plays a crucial role in various diseases as it serves as the barrier between circulatory system and organ tissue. Inflammation-driven insulin resistance and subsequent endothelial dysfunction represent a pathomechanism in cardiovascular diseases such as atherosclerosis and myocardial infarction. It was recently suggested that insulin resistance also contributes to the pathogenesis of psoriasis, a chronic inflammatory disease of the skin. However, it is not clear whether similar mechanisms at the endothelium contribute to the disease. In this study, we ask which endothelial cells are most suitable to address this question. We investigated the insulin response of four cell types (primary cells and cell lines) representing different vascular beds (micro- and macrovascular cells) in the presence of different pro-inflammatory cytokines. All four cell types used responded well to insulin; however, the ability to become resistant to insulin due to an inflammatory stimulus by cytokines involved in psoriasis (e.g. IL-1β, IL-12, IL-17, IL-23 and TNF-α) was very heterogeneous and could not be attributed to the differential expression of the cognate cytokine receptors. We conclude that this disparity is due to the different origins and properties of the endothelial cells used. Thus, endothelial cells should be carefully selected for the purpose of the respective study, particularly when it comes to analysing the pathogenesis of a disease and the search of new molecular targets for innovative therapies.
    Experimental Dermatology 11/2013; 22(11):714-8. · 3.58 Impact Factor
  • Philip J Mease, Wolf-Henning Boehncke, Dafna D Gladman
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    ABSTRACT: The 2012 Annual Meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) was held in June 2012 in Stockholm, Sweden, and attended by rheumatologists, dermatologists, and representatives of biopharmaceutical companies and patient groups from around the world. In this Prologue we introduce discussions that were held among meeting attendees. Prior to the 2012 meeting, 2 GRAPPA members organized a Fellows Symposium adjacent to the European Academy of Dermatology and Venerology meeting in Verona, where they discussed comorbidities and treatments of patients with psoriasis. The 2012 GRAPPA meeting began with a trainee symposium, where 30 rheumatology fellows and dermatology residents presented their research work. Other presentations and discussions included a review of arthritis mutilans; dermatology issues including screening tools for psoriatic arthritis (PsA) and the instruments to measure psoriasis severity; cardiovascular and other comorbidities of psoriasis and PsA; development of criteria to define inflammatory arthritis, enthesitis, dactylitis, and spondylitis; distinctions between peripheral spondyloarthritis and PsA; the status of an ultrasound outcome measure for dactylitis; and updates on several GRAPPA projects, including a study of biomarkers to predict structural damage in PsA, the ongoing video project, and several education initiatives.
    The Journal of Rheumatology 08/2013; 40(8):1407-9. · 3.26 Impact Factor
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    ABSTRACT: Psoriasis is a common chronic inflammatory skin disease, associated with significant comorbidity, for example, metabolic syndrome (MetS) and coronary heart disease (CHD). This association implies that the risk to develop these diseases is commonly controlled or that the presence of one disease favours manifestation of the other. Therefore, we assessed the catalogue of genome-wide association studies (GWAS) to analyse whether psoriasis, MetS and CHD share susceptibility loci. Interestingly, genetic control of psoriasis is almost completely independent from both MetS and CHD. In contrast, MetS and CHD share 10 common loci. Like by GWAS analysis, psoriasis susceptibility genes showed close clustering in Ingenuity Pathway Analysis, while genes conferring susceptibility to MetS and CHD were interlinked separately. These findings lead to the hypothesis that the clinically observed co-occurrence of psoriasis with MetS and CHD may be due to a common environmental factor, for example, diet, which is known as a risk factor for all of these diseases.
    Experimental Dermatology 08/2013; 22(8):552-3. · 3.58 Impact Factor
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    ABSTRACT: At the 2012 annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) in Stockholm, Sweden, several GRAPPA members led a panel discussion on cardiovascular (CV) comorbidities of psoriasis and psoriatic arthritis (PsA). The panelists discussed the role of insulin resistance in the pathophysiology of psoriasis, the possible effect of tumor necrosis factor inhibitors on CV comorbidities, and the effect of 12/23 monoclonal antibodies on CV outcomes. The panelists also addressed how lessons from CV comorbidity research could be applied to other areas of comorbidity research in psoriasis and PsA and identified future research directions in this area.
    The Journal of Rheumatology 08/2013; 40(8):1434-7. · 3.26 Impact Factor
  • Wolf-Henning Boehncke, Brian Kirby
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    ABSTRACT: The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) organized a Fellows Symposium adjacent to the European Academy of Dermatology and Venerology (EADV) spring meeting in Verona, Italy, in 2012. Wolf-Henning Boehncke from Geneva and Brian Kirby from Dublin formed the faculty. Five papers were presented, followed by extended discussions among participants and faculty. Two contributions were on comorbidities of psoriasis patients and 2 on treatment of non-plaque-type psoriasis; the fifth presentation was a discussion of possible modes of action of vitamin D derivatives in the treatment of psoriasis. Summaries of all 5 papers are included here.
    The Journal of Rheumatology 08/2013; 40(8):1410-2. · 3.26 Impact Factor
  • Wolf-Henning Boehncke, Alan Menter
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    ABSTRACT: Psoriatic arthritis (PsA) increases the disease burden associated with psoriasis by further diminishing quality of life, increasing health care costs and cardiovascular risk, and potentially causing progressive joint damage. The presence of PsA influences psoriasis treatment by increasing overall disease complexity and, within the framework of current guidelines and recommendations, requiring the use of conventional disease-modifying anti-rheumatic drugs or tumor necrosis factor-α inhibitors in order to prevent progressive joint damage. Despite its important impact, PsA is still under-diagnosed in dermatology practice. Dermatologists are well positioned to recognize and treat PsA, given that it characteristically presents, on average, 10 years subsequent to the appearance of skin symptoms. Regular screening of psoriasis patients for early evident joint symptoms should be incorporated into daily dermatologic practice. Although drugs effective in PsA are available, not all patients may respond to treatment, and others may lose their initial response over time. New investigational therapies, such as inhibitors of interleukin-17A, interleukin-12/23, Janus kinase 3, or phosphodiesterase-4, may address unmet needs in psoriatic disease, with further research needed to determine the role of these agents in reducing joint damage and other comorbidities.
    American Journal of Clinical Dermatology 06/2013; · 2.52 Impact Factor
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    ABSTRACT: BACKGROUND: Among the most frequent adverse effects of subcutaneous heparin treatment, heparin-induced skin lesions occur with an incidence of 10.3% in nonpregnant female patients. Clinical observations suggest an even higher risk during pregnancy. OBJECTIVES: We sought to determine the incidence and causes of heparin-induced skin reactions during pregnancy in a prospective cohort study. METHODS: Pregnant women with subcutaneous heparin treatment were prospectively examined for skin reactions. If a skin lesion was observed, further diagnostics were performed (skin biopsy, subcutaneous provocation, clinical/laboratory assessment for thrombosis, bleeding, and heparin-induced thrombocytopenia [HIT]). Safety parameters were also analyzed (cross-allergies, frequency of thromboembolic and bleeding complications, HIT, and pregnancy outcome). RESULTS: Among 111 pregnant patients, 22 (19.8%) had heparin-induced skin reactions (95% CI, 13% to 29%). All lesions were caused by allergic delayed-type hypersensitivity (DTH) reactions and not by HIT or other rare conditions. The median time of onset was 50.5 days (range, 5-184 days). The cross-reactivity rate was 33.3%. While nadroparin treatment exhibited a higher DTH risk than dalteparin (hazard ratio [HR], 26.7; 95% CI, 3.4-211.0; P = .00187), enoxaparin treatment was not significantly different from dalteparin treatment (HR, 5.6; 95% CI, 0.3-96.1; P = .238). Three thromboembolic events and 1 major bleeding event occurred. CONCLUSIONS: Among patients receiving long-term heparin anticoagulation during pregnancy, heparin-induced skin lesions are frequent (incidence, 19.8%) and are all caused by allergic DTH reactions. Nadroparin has the highest frequency of skin lesions (approximately 65% at 100 days), which is significantly higher than that of dalteparin (HR, 26.7). Therefore nadroparin use should be avoided in pregnancy when possible.
    The Journal of allergy and clinical immunology 05/2013; · 12.05 Impact Factor
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    ABSTRACT: Corticosteroids are regularly used for treatment of autoimmune diseases, such as bullous pemphigoid (BP). In BP, autoantibodies bind to type XVII collagen (COL17), located at the dermal-epidermal junction (DEJ). A crucial role of neutrophils in experimental BP has been established. Specifically, reactive oxygen species (ROS) and proteolytic granule enzymes mediate tissue injury. Therefore, we investigated effects of methylprednisolone (MP) on neutrophils, which are likely to be affected by topical treatment. First, MP inhibited dermal-epidermal separation ex vivo in cryosections of human skin induced by co-incubation of BP autoantibodies with neutrophils from healthy volunteers. Next, MP inhibited neutrophil activation in vitro induced by immune complexes (IC) of COL17 and autoantibodies. This neutrophil activation was associated with phosphorylation of ERK1/2, p38 MAPK and Akt. In turn, inhibition of ERK1/2, p38 MAPK or Akt phosphorylation inhibited neutrophil activation by IC in vitro and dermal-epidermal separation ex vivo. Additionally, we observed an increase of p38 phosphorylation in dermal infiltrates of BP patients. Treatment of mice with either MP or inhibitors of p38- or ERK1/2 phosphorylation impaired induction of autoantibody- or irritant-induced neutrophil-dependent inflammation. We here identify inhibition of Akt, ERK1/2 and p38 MAPK phosphorylation as molecular mechanisms to promote MP's therapeutic effects.Journal of Investigative Dermatology accepted article preview online, 28 February 2013; doi:10.1038/jid.2013.91.
    Journal of Investigative Dermatology 02/2013; · 6.19 Impact Factor
  • Wolf-Henning Boehncke
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    ABSTRACT: Severe psoriasis carries cardiovascular risks. Dermatologists should consider more than just patients' outer layers, argues Henning Boehncke.
    Nature 12/2012; 492(7429):S55. · 38.60 Impact Factor
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    ABSTRACT: Heparins are widely used for prophylaxis and treatment of thromboembolic diseases. Besides bleeding complications, heparin-induced skin lesions are the most frequent unwanted adverse effects of subcutaneous heparin treatment. Evidence suggests that these lesions are more common than previously thought. Lesions are most frequently due to either allergic reactions or to possibly life-threatening heparin-induced thrombocytopenia. Early recognition and adequate treatment are highly important, because although both complications initially show a similar clinical picture, their treatment should be fundamentally different. Furthermore, risk factors associated with the patient, drug, and treatment regimen have been identified. We review the clinical range of heparin-induced skin lesions, emphasise evidence and controversies in epidemiology, diagnosis, and differential diagnosis, and discuss the management of patients with these skin lesions.
    The Lancet 05/2012; · 39.21 Impact Factor
  • Wolf-Henning Boehncke, Sandra Boehncke
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    ABSTRACT: Psoriasis and psoriatic arthritis are associated with an increased cardiovascular mortality. Although the underlying pathogenesis is not yet fully understood, it is clear that these seemingly organ-specific disorders cause a systemic inflammatory burden as mirrored by elevated biomarkers in the patients' blood. Emerging evidence points toward insulin resistance and endothelial dysfunction as direct consequences; these in turn drive the process of atherosclerosis. As psoriasis and psoriatic arthritis therefore represent cardiovascular risk factors, they must be taken into account by primary care physicians when defining treatment goals for the comorbidities of the respective patients (e.g., arterial hypertension or dyslipidemia). Secondary and tertiary care physicians need to consider a more comprehensive treatment approach, including aspects of lifestyle intervention. Finally, effective long-term anti-inflammatory, disease-modifying therapy may contribute to reducing patients' cardiovascular risk.
    Current Rheumatology Reports 05/2012; 14(4):343-8.

Publication Stats

2k Citations
503.04 Total Impact Points

Institutions

  • 2014
    • University of Geneva
      • Division of Dermatology
      Genève, Geneva, Switzerland
  • 2013
    • St Vincent's University Hospital
      Dublin, Leinster, Ireland
  • 1998–2013
    • Goethe-Universität Frankfurt am Main
      • • Center for Internal Medicine
      • • Klinik für Dermatologie, Venerologie und Allergologie
      Frankfurt am Main, Hesse, Germany
  • 2006–2012
    • Charité Universitätsmedizin Berlin
      • Department of Dermatology, Venerology and Allergology
      Berlin, Land Berlin, Germany
  • 2011
    • Beverly Hospital, Boston MA
      Beverly, Massachusetts, United States
  • 2010
    • Universität zu Lübeck
      • Department of Dermatology
      Lübeck, Schleswig-Holstein, Germany
    • Karolinska Institutet
      Solna, Stockholm, Sweden
  • 2006–2009
    • Christian-Albrechts-Universität zu Kiel
      • • Institute of Pharmacy
      • • Universitäts-Hautklinik Kiel
      Kiel, Schleswig-Holstein, Germany
  • 2002–2007
    • University Hospital Frankfurt
      Frankfurt, Hesse, Germany
  • 1994–2006
    • Universität Ulm
      • Institute for Laser Technologies in Medicine & Metrology
      Ulm, Baden-Württemberg, Germany
  • 2004
    • Harvard Medical School
      Boston, Massachusetts, United States