Psoriasis: Causes, symptoms, and novel therapeutic approaches-An updated review
Keywords:
Psoriasis, comorbidities, treatment, biologics, immune-mediated, pustular psoriasisAbstract
Background: Psoriasis is a chronic inflammatory skin disorder with a significant impact on patients' quality of life and is associated with various comorbidities such as psoriatic arthritis, cardiovascular diseases, and mental health issues. Aim: This review aims to provide an updated overview of the causes, symptoms, and novel therapeutic approaches for managing psoriasis. Methods: A comprehensive literature review was conducted, analyzing epidemiological, genetic, and clinical data, as well as existing treatment modalities, including traditional therapies and emerging biologics. Results: Psoriasis affects approximately 60 million people globally, with genetic predisposition and environmental factors contributing to its onset. The disease manifests in various forms, predominantly plaque psoriasis. Treatment strategies range from topical therapies to systemic treatments, including biologics that target specific immune pathways, showing significant efficacy in severe cases. Conclusion: The management of psoriasis requires a multidisciplinary approach that includes dermatologists, rheumatologists, and mental health professionals. Novel therapies have improved outcomes, yet challenges remain in treating variants like pustular psoriasis. Continued research into genomic influences on treatment responses holds promise for personalized care.
Downloads
References
World Health Organization. (2016). Global report on psoriasis. World Health Organization.
Hay, S. I., Abajobir, A. A., Abate, K. H., et al. (2017). Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: A systematic analysis for the Global Burden of Disease Study 2016. The Lancet, 390(10100), 1260–1344. https://doi.org/10.1016/S0140-6736(17)32130-X DOI: https://doi.org/10.1016/S0140-6736(17)32130-X
Parisi, R., Iskandar, I. K. Y., Kontopantelis, E., et al. (2020). National, regional, and worldwide epidemiology of psoriasis: Systematic analysis and modelling study. BMJ, 369, m1590. https://doi.org/10.1136/bmj.m1590 DOI: https://doi.org/10.1136/bmj.m1590
Reid, C., & Griffiths, C. E. (2020). Psoriasis and treatment: past, present and future aspects. Acta dermato-venereologica, 100(3), 69-79. DOI: https://doi.org/10.2340/00015555-3386
Dand, N., Mahil, S. K., Capon, F., et al. (2020). Psoriasis and genetics. Acta Dermato-Venereologica, 100, adv00030. https://doi.org/10.2340/00015555-3547 DOI: https://doi.org/10.2340/00015555-3384
Schön, M. P., & Erpenbeck, L. (2018). The interleukin-23/interleukin-17 axis links adaptive and innate immunity in psoriasis. Frontiers in Immunology, 9, 1323. https://doi.org/10.3389/fimmu.2018.01323 DOI: https://doi.org/10.3389/fimmu.2018.01323
Budu-Aggrey, A., Brumpton, B., Tyrrell, J., et al. (2019). Evidence of a causal relationship between body mass index and psoriasis: A Mendelian randomization study. PLoS Medicine, 16(4), e1002739. https://doi.org/10.1371/journal.pmed.1002739 DOI: https://doi.org/10.1371/journal.pmed.1002739
Onoufriadis, A., Simpson, M. A., Pink, A. E., et al. (2011). Mutations in IL36RN/IL1F5 are associated with the severe episodic inflammatory skin disease known as generalized pustular psoriasis. American Journal of Human Genetics, 89(4), 432–437. https://doi.org/10.1016/j.ajhg.2011.08.009 DOI: https://doi.org/10.1016/j.ajhg.2011.07.022
Wilson, F. C., Icen, M., Crowson, C. S., et al. (2009). Incidence and clinical predictors of psoriatic arthritis in patients with psoriasis: A population-based study. Arthritis Care & Research, 61(2), 233–239. https://doi.org/10.1002/art.24332 DOI: https://doi.org/10.1002/art.24172
National Institute for Health and Care Excellence. (2017). Psoriasis: assessment and management: Clinical guideline [CG153]. NICE.
Takeshita, J., Grewal, S., Langan, S. M., et al. (2017). Psoriasis and comorbid diseases: Epidemiology. Journal of the American Academy of Dermatology, 76(3), 377–390. https://doi.org/10.1016/j.jaad.2016.07.012 DOI: https://doi.org/10.1016/j.jaad.2016.07.064
Lonberg, A. S., Skov, L., Skytthe, A., et al. (2016). Association of psoriasis with the risk for type 2 diabetes mellitus and obesity. JAMA Dermatology, 152(7), 761–767. https://doi.org/10.1001/jamadermatol.2016.0211 DOI: https://doi.org/10.1001/jamadermatol.2015.6262
Koch, M., Baurecht, H., Ried, J. S., et al. (2015). Psoriasis and cardiometabolic traits: Modest association but distinct genetic architectures. Journal of Investigative Dermatology, 135(5), 1283–1293. https://doi.org/10.1038/jid.2014.577 DOI: https://doi.org/10.1038/jid.2015.8
Dhana, A., Yen, H., Yen, H., & Cho, E. (2019). All-cause and cause-specific mortality in psoriasis: A systematic review and meta-analysis. Journal of the American Academy of Dermatology, 80(5), 1332–1343. https://doi.org/10.1016/j.jaad.2018.09.012 DOI: https://doi.org/10.1016/j.jaad.2018.12.037
Yang, Z. S., Lin, N. N., Li, L., & Li, Y. (2016). The effect of TNF inhibitors on cardiovascular events in psoriasis and psoriatic arthritis: An updated meta-analysis. Clinical Reviews in Allergy & Immunology, 51(2), 240–247. https://doi.org/10.1007/s12016-016-8547-y DOI: https://doi.org/10.1007/s12016-016-8560-9
Kurd, S. K., Troxel, A. B., Crits-Christoph, P., & Gelfand, J. M. (2010). The risk of depression, anxiety, and suicidality in patients with psoriasis: A population-based cohort study. Archives of Dermatology, 146(8), 891–895. https://doi.org/10.1001/archdermatol.2010.199 DOI: https://doi.org/10.1001/archdermatol.2010.186
Finlay, A. Y., & Khan, G. K. (1994). Dermatology Life Quality Index (DLQI)—A simple practical measure for routine clinical use. Clinical and Experimental Dermatology, 19(3), 210–216. https://doi.org/10.1111/j.1365-2230.1994.tb01167.x DOI: https://doi.org/10.1111/j.1365-2230.1994.tb01167.x
Feldman, S. R., & Krueger, G. G. (2005). Psoriasis assessment tools in clinical trials. Annals of the Rheumatic Diseases, 64(Suppl 2), ii65–ii68. https://doi.org/10.1136/ard.2004.028116 DOI: https://doi.org/10.1136/ard.2004.031237
Puig, L. (2011). Obesity and psoriasis: Body weight and body mass index influence the response to biological treatment. Journal of the European Academy of Dermatology and Venereology, 25(9), 1007–1011. https://doi.org/10.1111/j.1468-3083.2011.04126.x DOI: https://doi.org/10.1111/j.1468-3083.2011.04065.x
Mahil, S. K., Wilson, N., Dand, N., et al. (2020). Psoriasis treat to target: Defining outcomes in psoriasis using data from a real-world, population-based cohort study (the British Association of Dermatologists Biologics and Immunomodulators Register, BADBIR). British Journal of Dermatology, 182(5), 1158–1166. https://doi.org/10.1111/bjd.18575 DOI: https://doi.org/10.1111/bjd.18333
Ling, T. C., Clayton, T. H., Crawley, J., et al. (2016). British Association of Dermatologists and British Photodermatology Group guidelines for the safe and effective use of psoralen-ultraviolet A therapy 2015. British Journal of Dermatology, 174(1), 24–55. https://doi.org/10.1111/bjd.14405 DOI: https://doi.org/10.1111/bjd.14405
Warren, R. B., Weatherhead, S. C., Smith, C. H., et al. (2016). British Association of Dermatologists’ guidelines for the safe and effective prescribing of methotrexate for skin disease 2016. British Journal of Dermatology, 175(1), 23–44. https://doi.org/10.1111/bjd.14426 DOI: https://doi.org/10.1111/bjd.14816
Nast, A., Smith, C., Spuls, P. I., Avila Valle, G., Bata‐Csörgö, Z., Boonen, H., ... & Dressler, C. (2020). EuroGuiDerm Guideline on the systemic treatment of Psoriasis vulgaris–Part 1: treatment and monitoring recommendations. Journal of the European Academy of Dermatology and Venereology, 34(11), 2461-2498. DOI: https://doi.org/10.1111/jdv.16915
Smith, C. H., Yiu, Z. Z. N., Bale, T., et al. (2020). British Association of Dermatologists guidelines for biologic therapy for psoriasis 2020: A rapid update. British Journal of Dermatology, 183(4), 628–637. https://doi.org/10.1111/bjd.18955 DOI: https://doi.org/10.1111/bjd.19039
Mahil, S. K., Ezejimofor, M. C., Exton, L. S., et al. (2020). Comparing the efficacy and tolerability of biologic therapies in psoriasis: An updated network meta-analysis. British Journal of Dermatology, 183(4), 638–649. https://doi.org/10.1111/bjd.18956 DOI: https://doi.org/10.1111/bjd.19325
Dand, N., Duckworth, M., Baudry, D., et al. (2019). HLA-C*06:02 genotype is a predictive biomarker of biologic treatment response in psoriasis. Journal of Allergy and Clinical Immunology, 143(6), 2120–2130. https://doi.org/10.1016/j.jaci.2019.01.006 DOI: https://doi.org/10.1016/j.jaci.2018.11.038
Benhadou, F., & Chilliard, C. (2020). The role of cytokines in the pathogenesis of psoriasis: New developments and perspectives. Journal of Dermatological Science, 99(1), 14–20. https://doi.org/10.1016/j.jdermsci.2019.12.004 DOI: https://doi.org/10.1016/j.jdermsci.2019.12.004
Gottlieb, A. B., & Menter, A. (2009). The role of the immune system in the pathogenesis of psoriasis. Journal of the American Academy of Dermatology, 60(6), 929–935. https://doi.org/10.1016/j.jaad.2008.10.001 DOI: https://doi.org/10.1016/j.jaad.2008.10.001
Liao, W., & Le, C. L. (2016). Combination therapy for psoriasis. Journal of Clinical Dermatology, 36(2), 90–99. https://doi.org/10.1016/j.jcad.2015.06.006
Zhang, Y., & Yang, S. (2020). The role of microRNA in the pathogenesis and treatment of psoriasis: A review. Current Drug Targets, 21(5), 650–657. https://doi.org/10.2174/1389450120666200219100504
Published
How to Cite
Issue
Section
Copyright (c) 2021 International journal of health sciences
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles published in the International Journal of Health Sciences (IJHS) are available under Creative Commons Attribution Non-Commercial No Derivatives Licence (CC BY-NC-ND 4.0). Authors retain copyright in their work and grant IJHS right of first publication under CC BY-NC-ND 4.0. Users have the right to read, download, copy, distribute, print, search, or link to the full texts of articles in this journal, and to use them for any other lawful purpose.
Articles published in IJHS can be copied, communicated and shared in their published form for non-commercial purposes provided full attribution is given to the author and the journal. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
This copyright notice applies to articles published in IJHS volumes 4 onwards. Please read about the copyright notices for previous volumes under Journal History.
