What is it?
Psoriasis is a chronic, inflammatory, non-contagious, and non-infectious skin disease. The causes of psoriasis are of immunological nature: they involve the Langherans cells and T-lymphocytes that produce pro-inflammatory cytokines. This leads to a proliferation of keratinocytes and the accelerated growth of skin cells with a cell turnover that is reduced from 28 to 4 days.
What does it look like?
The typical lesion of psoriasis is an erythema (red patch) with net margins covered in white, silvery scales caused by the abnormal thickening of the stratum corneum due to the accumulation of cells. Commonly affected areas are: elbows, knees, hands, tailbone area, scalp, feet. When psoriasis is associated with joint pain, it is called psoriatic arthritis.
What causes it?
Psoriasis is a pathology caused by different factors, including:
- genetic factors: there is a familial genetic predisposition for psoriasis. First-grade relatives of patients with psoriasis have a ten times higher risk of developing psoriasis.
- environmental factors: emotional and psychogenic (grief, accidents), physical (injuries, trauma, lesions), pharmacological (NSAIDs, beta-blockers, lithium), infectious (fevers, strep throat among children).
Besides, psoriasis can be aggravated by lifestyle factors like smoking, alcohol consumption, obesity, stress, and unhealthy eating. People with high BMI (Body Mass Index) have a higher risk of developing psoriasis.
How can it be treated?
The therapy depends on the severity of the disease, the frequency of relapses, the ability of the patient to follow the treatment, the patient’s expectations, and the effects of the previous treatments.
Psoriasis is a very challenging pathology to treat. Normally, therapies try to promote a reduction of the inflammatory infiltrate and the hyperproliferation of keratinocytes.
There are several therapies available:
- for light forms of psoriasis: topical therapies with emollients, keratolytics, retinoids, vitamin D analogues, corticosteroids, dithranol, topical calcineurin inhibitors
- for mild forms of psoriasis: UVB narrowband phototherapy and PUVA therapy
- for severe forms of psoriasis: systemic therapies with cyclosporine, methotrexate, acitretin, and biologic drugs.
These treatments provide good results, but the high frequency of side-effects usually prompts patients to stop the use of medications for a certain period of time, or seek natural treatments like thermal hydrotherapy.