Psoriasis

About Psoriasis

Psoriasis is a chronic autoimmune inflammatory skin disease affecting approximately 60 million people worldwide. It is characterized by rapid turnover of skin cells, forming thick, red, scaly plaques. The most common type, plaque psoriasis, affects approximately 80 to 90 percent of patients and typically appears on the scalp, elbows, knees, and lower back. Other types include guttate, inverse, pustular, and erythrodermic psoriasis. Up to about 30 percent of people with psoriasis develop psoriatic arthritis. The disease involves immune dysregulation with T cells and cytokines TNF, IL 17, IL 23 driving inflammation. Genetic factors including HLA Cw6 and environmental triggers streptococcal infection, stress, certain medications, skin trauma Koebner phenomenon, smoking, and obesity play roles. Treatment is guided by severity. Mild disease limited body surface area responds to topical corticosteroids and vitamin D analogs calcipotriene. Phototherapy UVB phototherapy, PUVA is effective for moderate disease. Severe disease requires systemic therapy: methotrexate, cyclosporine, apremilast Otezla, or biologics. Biologic therapies have revolutionized psoriasis treatment: TNF inhibitors adalimumab, etanercept, IL 17 inhibitors secukinumab Cosentyx, ixekizumab Taltz, brodalumab, and IL 23 inhibitors ustekinumab Stelara, guselkumab Tremfya, risankizumab Skyrizi. Many patients achieve complete or near complete skin clearance.