General psoriasis-A Disturbing diseases 2024

Table of Contents

Introduction to psoriasis
Epidemiology
Disease Mechanism and Causes
Treatment
Caring
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Introduction to psoriasis

In view of the prevalence of skin diseases in modern times, today I would like to introduce you to one of the skin-related diseases – psoriasis. This term may be unfamiliar to the general public, but don’t worry, we’ll explain it to you today.

Psoriasis is a chronic skin disease with red patches and white scales, which is why it is also called “psoriasis”. Different types of psoriasis can be classified according to the type of psoriasis and symptoms: Guttate psoriasis, psoriasis erythroderma, pustular psoriasis, and chronic plaque psoriasis. Chronic plaque psoriasis is the most common form of psoriasis, accounting for about 80% of cases.

Among them, psoriasis is an autoimmune disease and is not contagious. In addition, chronic dermatitis patients are at high risk for psoriasis, and 2.5 percent of psoriasis patients have a combination of psoriatic arthritis.

Epidemiology

Psoriasis can occur in a wide range of ages, from young to old, with the most common age groups being 30-39 and 50-69. The prevalence rate is almost the same for both sexes, with no significant gender differences.

Prevalence statistics for adults range from 0.5 to 11.4% and for children from 0 to 1.4%. Statistics also show that the farther away from the equator, the higher the prevalence rate. In Taiwan, the prevalence rate is 30.3 per 100,000 people (about 0.03%) and is increasing year by year. This trend may be related to the change and advancement of diagnostic methods. Currently, the PASI score is used as the basis for diagnosis, with a score of less than 3 being considered mild and more than 10 being considered severe.

Disease Mechanism and Causes

Due to the obvious hyperplasia and flaking of the epidermis, psoriasis was early thought to be related to “abnormalities in the metabolic proliferation of epidermal cells”. Nowadays, due to advances in medical diagnostic techniques, it has been found that psoriasis is caused by an “abnormal immune response” or a “specific antigen that continuously activates the immune response”, resulting in abnormal inflammation of the skin.

Congenital psoriasis is associated with the PSORS1 and HLA-Cw6 genes. Also, low vitamin D levels, stress, alcohol consumption, smoking, and drug use are linked to acquired psoriasis.

Treatment

Treatment for psoriasis includes phototherapy, medication, and systemic therapy.

Phototherapy

Phototherapy is a treatment using UV light, which can slow down skin keratinization and induce T-cell apoptosis. Narrow UVB is the most commonly used today and is the most effective with the lowest side effects. This combination is low in energy and long in duration.

Medication, and systemic therapy

It contains topical steroids, vitamin D derivatives, A acids, moisturizers, tar and biologics, among which biologics are suitable for moderate to severe patients.

The following table provides a brief summary of the types and mechanisms of biologic agents. (Biologics are mostly cellular immune transmission factor inhibitors)

Mechanism	TNF-α Inhibitors	IL-23 Inhibitors	IL-17 Inhibitors
Drugs	Etanercept Infliximab Adalimumab Certolizumab	Ustekinumab Guselkumab Tildrakizumab Risankimumab	Secukinumab Ixekizumab Brodalumab
Long-term use comparison	Low	High	Medium
Price	Low	High	Medium
Use with caution	Tuberculosis, HIV patients, hepatitis B/C patients	Tuberculosis, HIV patients, hepatitis B/C patients, use with caution	Tuberculosis, HIV patients, hepatitis B/C patients, use with caution
Contraindicated use	Not recommended for women who are pregnant or expecting a baby	Contraindicated for women who are pregnant or expecting to become pregnant	Contraindicated in women who are pregnant or expecting to become pregnant, or in patients with ulcerative colitis
Side effects	Injection site redness and rash	Injection site redness and rash	Injection site redness and rash

Caring

You might think that psoriasis is very scary after reading the article above. It is true that there is no cure for psoriasis, but don’t worry, with medication, regular visits, diet and lifestyle, moderate exercise, and avoidance of alcohol and tobacco, you can keep your symptoms under control and maintain your quality of life.

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PASI score 🔗