From the Guidelines
Psoriasis is primarily an autoimmune condition with genetic and environmental factors, where the immune system mistakenly attacks healthy skin cells, causing them to multiply too quickly. The etiology of psoriasis is complex and multifactorial, involving a combination of genetic predisposition and environmental triggers. According to 1, at least 8 chromosomal loci have been identified as being linked to psoriasis, with the HLA-Cw6 allele being the major susceptibility gene.
Key Factors
- Genetic predisposition: about 30% of patients have a family history of the condition, with several specific genes identified as increasing susceptibility 1
- Environmental triggers: stress, skin injuries, certain medications, infections (particularly streptococcal throat infections), smoking, heavy alcohol consumption, and cold weather 1
- Immune system dysfunction: involves T-cells and inflammatory cytokines, particularly TNF-alpha, interleukin-17, and interleukin-23, which are targets for modern biologic treatments 1
Pathogenesis
The pathogenesis of psoriasis involves a dysregulated interplay among the epidermis and dermis, the cutaneous microvasculature, and the immune system, leading to hyperproliferation of epidermal keratinocytes and scaling, thickened plaques, and erythema 1.
Management
Understanding the etiology of psoriasis helps develop effective management strategies targeting the underlying immune dysfunction, including biologic treatments that inhibit T-cell function, tumor necrosis factor (TNF)-alfa, and interleukin-12 and interleukin-23 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Etiology of Psoriasis
The etiology of psoriasis is complex and multifactorial, involving both genetic and environmental factors.
- Genetic predisposition plays a significant role in the development of psoriasis, with certain genetic variants increasing the risk of developing the disease 2, 3, 4.
- Environmental factors, such as stress, infection, and lifestyle factors, can also trigger the onset of psoriasis in genetically predisposed individuals 5, 3, 4, 6.
- The interplay between immune cells and cytokines is critical in the pathogenesis of psoriasis, with factors such as Th1/Th2 homeostasis, the Th17/Treg balance, and the IL-23/Th17 axis playing important roles 5, 3.
- Epigenetic factors, including dysregulated DNA methylation levels, abnormal histone modification, and microRNAs expressions, have also been implicated in the development of psoriasis 5, 4.
- The microbiome and changes in microbiota have been shown to contribute to the development and maintenance of psoriasis, highlighting the complex interplay between genetic, environmental, and epigenetic factors 4, 6.
Key Factors Involved in Psoriasis Etiology
- Immune dysregulation: hyperproliferation and angiogenesis are key features of psoriasis, resulting from immune dysregulation 2.
- Genetic factors: genetic predisposition increases the risk of developing psoriasis, with certain genetic variants associated with the disease 2, 3, 4.
- Environmental factors: environmental triggers, such as stress, infection, and lifestyle factors, can trigger the onset of psoriasis in genetically predisposed individuals 5, 3, 4, 6.
- Epigenetic factors: epigenetic alterations contribute to the development and maintenance of psoriasis, including changes in DNA methylation, histone modification, and microRNAs expressions 5, 4.
- Microbiome: changes in microbiota contribute to the development and maintenance of psoriasis, highlighting the complex interplay between genetic, environmental, and epigenetic factors 4, 6.