Dependence on Generative Artificial Intelligence Among Medical Students and Its Association With Critical Thinking: A Cross-Sectional Study.

Psoriasis is a chronic systemic inflammatory dysregulation characterized by erythematous plaques and silvery scales, representing a significant global health burden. While primarily manifesting in the dermis, psoriasis is increasingly recognized as a multi-systemic disorder involving joints, the gastrointestinal tract, and cardiovascular health., Beyond physical symptoms, the systemic nature of the disease extends to neuropsychiatric comorbidities; the psychological stress and social stigma associated with visible lesions significantly elevate the risk of depression and anxiety in affected individuals. Therapies for psoriasis, including topical glucocorticoids, systemic immunosuppressants, and biologics, can achieve satisfactory short-term efficacy. Biologics targeting the interleukin (IL)-23/IL-17 immune pathway have revolutionized the therapeutic landscape for psoriasis. Although they offer remarkable efficacy, issues such as recurrence and complications arising from treatment are also challenging. Its unpredictable cycle of relapse is a major clinical challenge. A classic trigger for psoriasis relapse, particularly guttate psoriasis, is upper respiratory infection with (abbreviated as SP, also known as , GAS). This long-observed clinical correlation suggests a sophisticated remote immune communication where a localized infection in the nasopharyngeal mucosa reinitiates a robust inflammatory cascade in the skin. Paradoxically, while biologics like secukinumab effectively suppress skin inflammation, they may concurrently increase susceptibility to respiratory infections. This creates a difficult clinical dilemma: the most effective treatments may make patients more vulnerable to very infections that can worsen their psoriasis. A key unanswered question is how a remote infection reinitiates skin inflammation, especially in people taking immune-modifying drugs. Finding an answer is not only of academic interest but also a pressing clinical necessity to mitigate treatment-related risks and prevent relapse.