From the Guidelines
Psoriasis is a chronic inflammatory skin disease characterized by inappropriate activation of cutaneous T cells and dendritic cells with subsequent release of a variety of cytokines, leading to rapid skin cell turnover and red, scaly patches. The pathophysiology of psoriasis involves T-cell activation and inflammatory cytokines like TNF-alpha, IL-17, and IL-23, which explains why targeted biologics are effective 1. Key features of psoriasis include:
- Chronic inflammatory skin disease
- Involves T-cell activation and inflammatory cytokines
- Characterized by rapid skin cell turnover and red, scaly patches
- Can have significant impact on quality of life, comparable to cancer, arthritis, and heart disease 1
- Often requires systemic treatment for moderate to severe cases, with options including phototherapy, methotrexate, cyclosporine, and biologics like adalimumab, etanercept, and ustekinumab 1. The most recent and highest quality study, the joint AAD-NPF guidelines of care for the management and treatment of psoriasis with awareness and attention to comorbidities, published in 2019, provides the best available evidence for understanding the pathophysiology of psoriasis 1.
From the Research
Pathophysiology of Psoriasis
The provided studies do not directly discuss the pathophysiology of psoriasis. However, they do provide information on the treatment and management of the disease.
Treatment Options
- Topical therapies, such as corticosteroids, vitamin D analogs, and calcineurin inhibitors, are commonly used to treat mild to moderate psoriasis 2, 3, 4.
- Combination therapies, such as the use of topical corticosteroids with vitamin D analogs, can be effective in treating psoriasis 2, 3.
- Phototherapy, including narrowband UVB and excimer laser, can be used to treat more severe cases of psoriasis 5.
- Systemic treatments, such as methotrexate, can be used to treat moderate to severe psoriasis 5, 6.
Disease Management
- The goal of treatment is to control the clinical symptoms of the skin, reduce systemic disease potential, and improve the patient's quality of life 3.
- A targeted approach to treatment, taking into account the individual patient's needs and disease severity, is necessary 4.
- Topical treatments can be used in combination with other therapies, such as phototherapy and systemic agents, to enhance treatment efficacy 3, 5.