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.
Most cases of psoriasis can be managed on 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 gel, to meet the individual patient’s preferences.
Depending on the extension and severity of the disease, other treatment options are phototherapy with ultraviolet radiation or systemic therapy such as methotrexate, cyclosporine or anti-TNF-α.