Psoriasis

Psoriasis is a common, chronic, immune-mediated inflammatory disease that primarily involves the skin.1  The negative impact of this condition on people’s lives can be immense.1 Psoriasis affects people of all ages, and in all countries.1 The reported prevalence of psoriasis in countries ranges between 0.09% and 11.43%,1 making psoriasis a serious global problem affecting an estimated 125 million people worldwide.2

Genetically determined by multi-factorial inheritance, psoriasis can be triggered by bacterial infections (due to the secretion of bacterial toxins), inflammatory insults, psychological stress, the use of certain drugs, certain diseases, alcohol consumption and over-exposure to the sun.

An autoimmune skin condition, psoriasis is believed to be mediated by T-cells. However, scientists are only beginning to understand the exact cellular mechanisms behind the disease.

What we do know is that dermal changes due to psoriasis are characterised by an increase in vascularisation and the infiltration of T-cells, neutrophils, macrophages, and mast cells. The keratinocytes undergo hyperproliferation, and this causes premature and incomplete keratinisation. At the same time, levels of cytokines, and other inflammatory mediators in the skin, are not regulated.

Psoriasis has a significant impact on patient’s quality of life.3

Although the systemic nature of psoriasis often remains unrecognised, the inflammatory processes involved may be associated with the development of comorbidities such as metabolic diseases, psychological disorders and cardiovascular diseases and risk factors, which are higher in people with moderate-to-severe psoriasis when compared to the general population. 4,5,6 

Treating psoriasis

An integrated approach to psoriasis care, addressing the chronic burden of disease on each individual’s life, is essential to relieve patients and reduce the use of healthcare resources.1

Psoriasis can be managed using topical treatment with vitamin D analogues, corticosteroids or combination products. Nowadays, the topical treatments come in a variety of formulations such as creams, ointments or gels, to meet the individual patient’s preferences.

Depending on the extension and severity of the disease, other treatment options are phototherapy with ultraviolet radiation, systemic therapy (e.g. oral tablets) or biologic treatments (via injections).
 

1. World Health Organization. Global report on psoriasis. Available at: http://apps.who.int/iris/bitstream/10665/204417/1/9789241565189_eng.pdf [Accessed June 2017]
2. The International Federation of Psoriasis Associations. World Psoriasis Day. Available from: https://ifpa-pso.com/our-actions/world-psoriasis-day/ [Accessed July 2017]
3. Strober B, et al. J Am Acad Dermatol. 2016; 75:77–81
4. Reich K. Eur Acad Dermatol Venereol. 2012; 26(2):3-11
5. Kimball AB, et al. Br J Dermatol. 2014;171(1):137-147
6. Feldman S, et al. J Man Care and Specialty Pharm. 2015;21(10):874-888

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