A Brief Overview of Psoriasis: Clinical Manifestation, Pathogenesis and Treatment

Abstract

Psoriasis is a common immune-mediated inflammatory skin disorder. It forms skin lesions with raised scaly erythematous plaques or rashes affecting the elbows, scalp, knees, cervical, and navel area. The incidence rate of people affected with psoriasis is 2-3% in the USA but it is present worldwide. This abstract discusses the clinical symptoms, pathogenesis, and treatment.  The formation of plaque psoriasis (red scaly plaques) is the most frequent manifestation followed by guttate psoriasis (drop-like lesions), psoriatic arthritis (joints or bone erosion), and pustule psoriasis (vesicles and pustules formation). Genetic and environmental factors play an important part in the spread of psoriasis resulting in the activation of a unique innate and adaptive immune system. The pathogenesis of psoriasis is complex and involves the activation of T-cells and cytokines such as TNF-α, IL-17, and IL-23.  Cytokines also trigger the release of macrophages, keratinocytes, and dendritic cells. Recent approaches to grasp the genetic pathway underlying psoriasis have paved the way for targeted therapies, particularly biological agents, which inhibit specific cytokines and immune cells involved in the disease spread. Various traditional treatments, such as topical therapy mainly corticosteroids and vitamin D analogs, phototherapy, and systemic agents like (methotrexate and cyclosporin) are major for the control of psoriasis. However, patients with severe psoriasis are treated by biological therapies due to their positive advancement. Yet, it has still some side effects, and as a consequence, various research is still ongoing to develop a more effective and efficient treatment.