Psoriasis

Psoriasis is a chronic inflammatory skin disease of an autoimmune nature. It is characterized by the formation of red, small-plate spots on the skin, which are covered with silvery-white scales. Psoriasis can affect not only the skin, but also nails, joints and even internal organs. This disease tends to recur, which leads to a significant deterioration in the quality of life of patients. Psoriasis is not only a cosmetic problem; it also complicates concomitant diseases, such as psoriatic arthritis, which requires a comprehensive approach to treatment and management.

History of the disease and interesting historical facts

The history of psoriasis goes back a long way. The first mentions of skin diseases that could be described as psoriasis date back to ancient civilizations such as Egypt and Greece. The physician Hippocrates described skin diseases in his writings that could meet modern criteria for psoriasis. In the Middle Ages, psoriasis was often confused with other skin diseases, which made it difficult to diagnose. In the 19th century, Swedish dermatologist K. F. Clausetten distinguished psoriasis from other skin diseases such as eczema and improved its classification methods. In the 1930s, active research into the pathogenesis of psoriasis began, which contributed to the development of the first effective treatments. It is important to note that psoriasis has been perceived differently in different historical periods, and attitudes towards patients with this disease have fluctuated from stigmatization to scientific interest.

Epidemiology

According to recent studies, psoriasis affects approximately 2-3% of the world's population, but its prevalence may vary depending on the geographic region and ethnicity. For example, in Europe, the incidence rate can reach 2-5%, while in some Asian countries it is lower than 1%. Studies show that men and women suffer from psoriasis with approximately the same frequency, but clinical manifestations may differ. In addition, early onset of the disease is more common in men, while women are more likely to encounter psoriasis at a later age. Psoriasis has a pronounced systemic component and is associated with an increased risk of developing other diseases, including cardiovascular diseases and metabolic syndrome.

Genetic predisposition to this disease

Genetic studies show that patients with psoriasis have a high rate of transmission of the disease in families. Several genes have been found to be associated with the risk of developing psoriasis, including genes associated with the immune response, such as HLA-Cw6. Studies have indicated the presence of polygenic mechanisms, where multiple genes can influence susceptibility to the disease. Specific mutations, such as those affecting inflammatory signaling pathways, also play a role in the pathogenesis of psoriasis. For example, a SNP in the IL23R gene has been shown to be associated with an increased risk of psoriasis. Thus, genetic factors significantly contribute to the onset and progression of the disease.

Risk factors for the development of this disease

There are many risk factors that can contribute to the development of psoriasis. These include:

• Heredity - the presence of psoriasis in the family increases the likelihood of its development.
• Stress - emotional factors can trigger an exacerbation of symptoms.
• Infections - Streptococcal skin infections are often associated with the development of psoriasis.
• Physical factors - injuries, burns, sunburn can contribute to the manifestation of the disease.
• Chemicals - Long-term exposure of the skin to harsh chemicals may increase the risk.
• Lifestyle factors such as smoking and excessive alcohol consumption are also associated with increased risk.

Diagnosis of this disease

Diagnosis of psoriasis is based on a clinical examination, during which the doctor pays attention to characteristic symptoms, such as:

• Plates on the skin covered with silvery scales.
• Itching and flaking of the affected areas of the skin.
• Changes in nails (pytherygium, thickening, spots).
• Joint damage - in case of psoriatic arthritis.

Laboratory tests may include a complete blood count to rule out associated diseases and a skin biopsy to confirm the diagnosis. Radiological examinations are necessary to diagnose psoriatic arthritis. It is important to conduct a differential diagnosis by excluding other skin diseases such as eczema, fungal infections, and dermatitis.

Treatment

Treatment for psoriasis may involve several methods, depending on the severity of the disease.

General treatment involves lifestyle changes, including:

• Eating a diet rich in omega-3 fatty acids.
• Quitting smoking and drinking alcohol in moderation.
• Stress management through exercise and relaxation.

Pharmacological treatment includes the use of:

• Topical corticosteroid preparations.
• Immunosuppressants such as methotrexate.
• Biologics such as IL-17 inhibitors.

Surgical treatment is generally not used for psoriasis, except in cases of psoriatic arthritis, where joint surgery may be indicated. In addition, Vitamin D and UV therapy are also used in treatment.

List of medications used to treat this disease

The most commonly used drugs include:

• Creams with corticosteroids.
• Tazorac (tetrahydroteratonic acid).
• Methotrexate.
• Adalimumab.
• Usteknumab.

Disease monitoring

Monitoring psoriasis is an important part of the overall patient management strategy. Monitoring steps should include regular examinations by a dermatologist to assess the severity of the disease and the effectiveness of treatment. The prognosis for patients with psoriasis varies; many patients can achieve stable remission, but flare-ups can occur at any time. Complications can include the development of psoriatic arthritis, which significantly reduces quality of life.

Age-related features of the disease

Psoriasis can manifest itself at any age, but there are two peaks of incidence: early (from 15 to 30 years) and late (from 50 to 60 years). In children, psoriasis often has a milder form and may disappear in adolescence. In older people, psoriasis can be more aggressive and associated with concomitant diseases.

Questions and Answers

• What is psoriasis? Psoriasis is a chronic inflammatory skin disease characterized by the formation of scaly patches on the skin, which can also affect the joints and nails.
• What are the main treatments for psoriasis? Treatment may include topical steroids, systemic therapeutic agents, biologics, and lifestyle changes.
• What are the risk factors associated with the development of psoriasis? Risk factors include heredity, stress, infectious diseases, skin trauma and certain chemicals.
• How is psoriasis diagnosed? Diagnosis is based on clinical examination, assessment of symptoms, laboratory tests and differential diagnosis.
• What is the impact of psoriasis on patients' quality of life? Psoriasis can significantly reduce quality of life, causing physical and emotional suffering and increasing the risk of associated diseases.