An in-depth report on the causes, diagnosis, treatment, and prevention of psoriasis.
- Psoriasis is an inflammatory skin condition that affects about 2% of all Americans. It is the most prevalent autoimmune condition.
- There are several types of psoriasis. The most common type is plaque psoriasis, accounting for about 90% of cases. Other types are guttate, inverse, erythrodermic, and pustular.
- Doctors believe that psoriasis is caused by abnormalities in the immune system, enzymes, and other factors that regulate skin cell division. In basic terms, an abnormal immune response triggers inflammation and rapid production of immature skin cells.
- Genes play a role in the development of psoriasis. Researchers have discovered that a variation in a group of genes known as LCE can protect against the condition. One of these genes codes for proteins that help maintain the skin's barrier.
- Eight key psoriasis susceptibility genes (designated PSORS 1 to 8) seem to be involved with psoriasis. Several different mutations of these genes are associated with psoriasis.
- 35% of people with psoriasis have one or more family members with the disorder.
- There may be a link between being overweight and psoriasis.
- People with celiac disease have a higher risk of psoriasis. Gluten-free diets may help people with celiac disease reduce psoriasis symptoms along with symptoms related to celiac.
- People with psoriasis may be at higher risk for dyslipidemia, or high cholesterol/triglyceride levels.
- Treatment options for moderate to severe psoriasis include topical and systemic medications, phototherapy, and excimer laser. Combination therapies are often more effective than one treatment alone.
- Phototherapy, which involves exposure of the skin to ultraviolet light, can help improve the symptoms of psoriasis. Certain thin liquid moisturizers applied on the skin minutes before phototherapy can help improve the beneficial effects of therapy. These include Vaseline oil, mineral oil, and glycerol.
- Biologic drugs that target the root of the disease, the immune system, are the newest therapies considered in the treatment of psoriasis. Several drugs are approved and more are under study.
- Ustekinumab (Stelera) is a monoclonal antibody (biologic) injection approved in the U.S. for the treatment of moderate to severe plaque psoriasis and psoriatic arthritis. Its long term safety profile continues to be studied, but results so far are positive.
- Apremilast (OTEZLA), a PDE4 inhibitor, is an oral anti-inflammatory. It was recently approved by the FDA in 2014 for the treatment of moderate to severe plaque psoriasis.
- Researchers continue to investigate the effects of other dietary factors, such as omega-3 fatty acids (found in fish oil) and Vitamin D supplements, as well as lifestyle factors in treating psoriasis.
Psoriasis has been linked to an increased risk of:
- Heart attack and cardiovascular disease
- Crohn disease
- Ulcerative colitis
People with psoriasis should work with their doctors to prevent or manage these conditions.