Psoriasis is a chronic, noncommunicable, painful, disfiguring and disabling disease for which there is nocure and with great negative impact on patients’ quality of life (QoL). It can occur at any age, and is most common in the age group 50–69 1. The reported prevalence of psoriasis in countries ranges between 0.09% 2 and 11.4%3, making psoriasis a serious global problem.
The etiology of psoriasis remains unclear, although there is evidence for genetic predisposition 4. The role of the immune system in psoriasis causation is also a major topic of research. Although there is a suggestion that psoriasis could be an autoimmune disease, no autoantigen that could be responsible has been defined yet. Psoriasis can also be provoked by external and internal triggers, including mild trauma, sunburn, infections, systemic drugs and stress 5.
Psoriasis involves the skin and nails, and is associated with a number of comorbidities. Skin lesions are localized or generalized, mostly symmetrical, sharply demarcated, red papules and plaques, and usually covered with white or silver scales. Lesions cause itching, stinging and pain. Between 1.3%6 and 34.7%7 of individuals with psoriasis develop chronic, inflammatory arthritis (psoriatic arthritis) that leads to joint deformations and disability. Between 4.2% and 69% of all patients suffering from psoriasis develop nail changes 8,9,10. Individuals with psoriasis are reported to be at increased risk of developing other serious clinical conditions such as cardiovascular and other noncommunicable diseases (NCDs) 5, 11,12.
Treatment of psoriasis is still based on controlling the symptoms. Topical and systemic therapies as well as phototherapy are available. In practice, a combination of these methods is often used. The need for treatment is usually lifelong and is aimed at remission. So far, there is no therapy that would give hope for a complete cure of psoriasis. Additionally, care for patients with psoriasis requires not only treating skin lesions and joint involvement, but it is also very important to identify and manage common comorbidity that already exists or may develop, including cardiovascular and metabolic diseases as well as psychological conditions.
1. Institute for Health Metrics and Evaluation (IHME). Global Burden of Disease Study 2010: Results by Cause 1990–2010. Seattle: IHME; 2012.
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3. Danielsen K, Olsen AO, Wilsgaard T, Furberg AS. Is the prevalence of psoriasis increasing? A 30–year follow-up of a population–based cohort. Br J Dermatol. 2013;168:1303–10.
4. Harden JL, Krueger JG, Bowcock AM. The immunogenetics of psoriasis: a comprehensive review. J Autoimmun. 2015;64:66–73.
5. Boehncke W-H, Schon MP. Psoriasis. Lancet. 2015;386(9997):983–94.
6. Bedi TR. Clinical profile of psoriasis in North India. Indian J Dermatol Venereol Leprol. 1995;61(4):202–5.
7. Pariser D, Schenkel B, Carter C, Farahi K, Brown TM, Ellis CN, and Psoriasis Patient Interview Study Group. A multicenter, non-interventional study to evaluate patient-reported experiences of living with psoriasis. J Dermatol Treat. 2015;1–8.
8. Alshami MA. Clinical profile of psoriasis in Yemen, a 4-year retrospective study of 241 patients. J Eur Acad Dermatol Venereol. 2010;24(Suppl. 4):14.
9. Falodun OA. Characteristics of patients with psoriasis seen at the dermatology clinic of a tertiary hospital in Nigeria: a 4-year review 2008–2012. J Eur Acad Dermatol Venereol. 2013;27(Suppl. 4).
10. Reich K, Kruger K, Mossner R, Augustin M. Epidemiology and clinical pattern of psoriatic arthritis in Germany: a prospective interdisciplinary epidemiological study of 1511 patients with plaque-type psoriasis. Br J Dermatol. 2009;160(5):1040–7.
11. Augustin M, Radtke MA, Glaeske G, Reich K, Christophers E, Schaefer I et al. Epidemiology and Comorbidity in Children with Psoriasis and Atopic Eczema. Dermatology. 2015;231(1):35–40.
12. Vena GA, Altomare G, Ayala F, Berardesca E, Calzavara-Pinton P, Chimenti S et al. Incidence of psoriasis and association with comorbidities in Italy: a 5-year observational study from a national primary care database. Eur J Dermatol. 2010;20(5):593–8.
CP-84792 Approved date 2019-3-29