Triggermechanismen der Psoriasis

Psoriasis vulgaris is a chronic, common skin disease, which affects the patient’s quality of life to the highest degree. Several exogenous factors and endogenous hormonal changes may act as triggers for psoriasis.The skin possesses a true endocrine system, which is very important in multiple systemic diseases. A number of conditions are associated with psoriasis, and its severity can also be influenced by hormones. Even though the sex hormones and prolactin have a major role in psoriasis pathogenicity, there are a lot of other hormones which can influence the psoriasis clinical manifestations: glucocorticoids, epinephrine, thyroid hormones, and insulin.

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“…Other risk factors for psoriasis onset are skin injuries, in the context of Köbner phenomenon [ 30 , 31 ].…”

Section: Introductionmentioning

confidence: 99%

The role of hormones in the pathogenesis of psoriasis vulgaris

Roman

Constantin

Marina

et al. 2015

Medicine and Pharmacy Reports

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“…A study involving 61 twin pairs indicated a concordance rate approximately two to three times higher in monozygotic twins compared to dizygotic twins [34,35]. Additionally, many environmental triggers have been implicated in the pathogenesis of psoriasis, including trauma or injury, infections caused by staphylococcal and streptococcal species, and social factors such as stress, alcohol consumption, obesity, and tobacco use [36]. Though there have been limited studies on the initiation phase of psoriatic skin lesions [37][38][39], the maintenance phase has been well established and has thus led to the development of many effective treatments.…”

Section: Guselkumab Use In Plaque Psoriasismentioning

confidence: 99%

Guselkumab, a Novel Monoclonal Antibody Inhibitor of the p19 Subunit of IL-23, for Psoriatic Arthritis and Plaque Psoriasis: A Review of Its Mechanism, Use, and Clinical Effectiveness

Kerut,

Wagner,

Daniel

et al. 2023

Cureus

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Psoriatic arthritis and plaque psoriasis are autoimmune conditions affecting multiple organs, including the skin. The pathophysiology and etiology of these conditions are not fully understood; however, numerous factors are believed to play a critical role, including genetics and environmental risk factors. Furthermore, research suggests the IL-23/IL-17 pathway partially mediates these diseases. Once the IL-23 receptor is bound and activated, two subunits, p19, and p40, act through different signaling pathways. Ultimately, inflammation is produced through the effector molecule, IL-17, other cytokines, and tumor necrosis factor (TNF). Traditionally, these chronic conditions have been treated with TNF-α inhibitors and methotrexate, a dihydrofolate reductase inhibitor. Although successful in inhibiting the immune system, these drugs can have many adverse effects due to their broad targets. In recent years, more targeted therapy has become popular. Guselkumab is a monoclonal antibody that inhibits the p19 subunit of IL-23. It has been FDA-approved to treat both plaque psoriasis and psoriatic arthritis. Clinical trials showing guselkumab’s efficacy have been promising, even showing improvement in symptoms of plaque psoriasis patients resistant to adalimumab, a TNF-α inhibitor. Guselkumab has also been shown to be well tolerated with a similar safety profile as other biologics inhibiting the immune system. In addition to its efficacy in treating plaque psoriasis and psoriatic arthritis, the mechanism of action offers a targeted approach that may minimize the broad immunosuppressive effects often associated with traditional therapies, providing a potential advantage in the long-term management of these autoimmune conditions.

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“…12 A possível exacerbação da psoríase pelo uso de anti-inflamatórios não hormonais, tetraciclinas e inibidores da ECA deve ser vista com cautela, pois, apesar da alta frequência da utilização dessas medicações, esparsos são os relatos que associam seu uso à piora da psoríase. 13 Na patogenia, há uma aceleração do ciclo germinativo epidérmico, um aumento das células em proliferação e um encurtamento do tempo de renovação celular na epiderme tanto da lesão quanto na pele "normal" do paciente com psoríase. Acredita-se que essa hiperproliferação de queratinócitos se deva a um aumento da quantidade de fator de crescimento epidérmico (EGF), de fator de crescimento e transformação alfa (TGF-alfa) e da participação de citocinas pró-inflamatórias (IL-1, IL-6, IFN-gama), que atuariam como mitógenos para essas células.…”

Section: Etiopatogeniaunclassified

Psoríase na infância e na adolescência

Romiti

Maragno

Arnone

et al. 2009

An. Bras. Dermatol.

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Resumo: A psoríase é doença inflamatória crônica, imunologicamente mediada, recorrente e de caráter universal. Aproximadamente um terço dos adultos acometidos refere início da doença antes dos 16 anos de idade. Quanto mais precoce, mais grave tende a ser a evolução do quadro. Em crianças, as lesões podem ser fisicamente desfigurantes, causando prejuízos psicológicos e evidente comprometimento da qualidade de vida. As medicações sistêmicas utilizadas na psoríase, bem como a fototerapia, têm indicação limitada na infância, devido aos efeitos cumulativos das drogas, à baixa aceitação e ao risco de teratogenicidade. Nesta seção, discutiremos as principais manifestações clínicas da psoríase na infância e na adolescência, bem como os diagnósticos diferenciais, opções terapêuticas e prognóstico. Palavras-chave: Adolescente; Criança; Epidemiologia; Infância; Psoríase; Quadro clínico; Terapêutica Abstract: Psoriasis is a chronic, immunologically mediated, recurrent and universal inflammatory disorder. Approximately one third of adults refer onset before 16 years of age. The sooner the onset, the worse is the prognosis. In children, lesions may be physically disfiguring, leading to psychological impairment and evident loss of quality of life. Systemic therapy used in psoriasis, as well as phototherapy, has limited use in children due to accumulative effects of drugs, low acceptance, and risk of teratogenicity. In this section, we discuss the main clinical aspects of psoriasis in childhood and adolescence, differential diagnosis, therapeutic options, and prognosis.

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Triggermechanismen der Psoriasis

Cited by 11 publications

References 30 publications

The role of hormones in the pathogenesis of psoriasis vulgaris

The role of hormones in the pathogenesis of psoriasis vulgaris

Guselkumab, a Novel Monoclonal Antibody Inhibitor of the p19 Subunit of IL-23, for Psoriatic Arthritis and Plaque Psoriasis: A Review of Its Mechanism, Use, and Clinical Effectiveness

Psoríase na infância e na adolescência

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