6533b7d1fe1ef96bd125c829

RESEARCH PRODUCT

Types, triggers and treatment strategies of psoriasis

subject

description

Psoriasis is a common chronic, immune mediated, inflammatory disease,characterized by periods of exacerbation and remission. Patients with psoriasis have asignificantly impaired quality of life; the disease is associated with substantial burden interms of disability or psychosocial stigmatization. Moreover, in a percentage of patientsthat varies between 5% and 42%, depending on the population studied, psoriatic arthritismay occur.Psoriasis is found worldwide but the prevalence varies among different ethnicgroups. It has a strong genetic component but environmental factors such as ß-haemolyticstreptococcal infection, HIV, stress, and drugs, including ß blockers, antimalarials andlithium can play an important role in the presentation of disease.Onset may occur at any age, although two peaks in incidence have been described,one in early adulthood, and the other between the ages of 55-60 years.Skin disease can be highly variable in morphology, distribution, and severity. Plaquetype psoriasis, characterized by papulosquamous plaques well-delineated fromsurrounding normal skin, is the most common form. It accounts for 80% of cases.However, the morphology can range from small tear shaped papules (guttate psoriasis) topustules (pustular psoriasis) and generalised erythema and scale (erythrodermicpsoriasis). In addition, these different forms of psoriasis may be localised or widespread.Approximately 80% of patients with psoriasis have mild to moderate disease, whereas20% have moderate to severe disease. About 25-50% of patients with psoriasis havedistinctive nail changes related to the disease. Psoriatic nail disease occurs mostcommonly in patients with psoriatic arthritis.Patients with mild disease can be treated with topical agents while systemic agents,including cyclosporine, methotrexate, and acitretin, or phototherapy are usually required in patients affected by moderate to severe psoriasis. With our increased understanding ofthe immunopathogenesis of psoriasis multiple biologic agents, which target specificmolecules necessary for the development of psoriatic lesions, have been introducedduring the past years.