Psoriasis

Abstract

Psoriasis is a common, chronic papulosquamous skin disease occurring worldwide, presenting at any age, and leading to a substantial burden for individuals and society. It is associated with several important medical conditions, including depression, psoriatic arthritis, and cardiometabolic syndrome. Its most common form, chronic plaque or psoriasis vulgaris, is a consequence of genetic susceptibility, particularly in the presence of the HLA-C*06:02 risk allele, and of environmental triggers such as streptococcal infection, stress, smoking, obesity, and alcohol consumption. There are several phenotypes and research has separated pustular from chronic plaque forms. Immunological and genetic studies have identified IL-17 and IL-23 as key drivers of psoriasis pathogenesis. Immune targeting of these cytokines and of TNFα by biological therapies has revolutionised the care of severe chronic plaque disease. Psoriasis cannot currently be cured, but management should aim to minimise physical and psychological harm by treating patients early in the disease process, identifying and preventing associated multimorbidity, instilling lifestyle modifications, and employing a personalised approach to treatment.

Roles of Lipids in the Permeability Barriers of Skin and Oral Mucosa

“…Psoriasis is a relatively common inflammatory skin disease that affects over 60 million people worldwide [ 99 ]. Psoriasis has several clinical presentations; however, the most common type is plaque psoriasis or psoriasis vulgaris.…”

Alcohol in Psoriasis—From Bench to Bedside

“…Psychosocial stress, as one of the most important extrinsic factors that affect psoriasis, can prolong or even trigger psoriasis in susceptible individuals [3]. The etiopathogenesis of the psoriasis-psychological stress interaction includes the central and the peripheral hypothalamic-pituitary-adrenal (HPA) axis escalating inflammatory cytokines; activation of the sympathetic nervous system resulting in a defective adrenergic response and redistribution of leucocytes, moreover the stimulation of neuronal growth and alteration in neuropeptide and neurotrophin expression [48].…”

“…Regarding its clinical phenotypes, chronic plaque-type, guttate, erythrodermic and pustular psoriasis can be distinguished, while based on the localization, other variants such as inverse or flexural psoriasis, palmoplantar psoriasis, sebopsoriasis and nail psoriasis can be described as well [3]. According to the age of onset, psoriasis can be further subclassified into early-onset (≤40 years) and late-onset (>40 years) groups, underpinned by findings that a more pronounced genetic background is found in the early-onset one [4].…”

Immunomodulatory Properties of Host Defence Peptides in Skin Wound Healing

“…Other inflammatory skin conditions like psoriasis [4,5] and atopic dermatitis [6] are also characterised by dysregulation of the immune response, attacking healthy skin cells.…”