Impact of Psoriasis
- Psoriasis is one of the commonest dermatoses
- Unlike atopic eczema, there is no evidence that psoriasis is becoming more prevalent.
- Average age of onset of psoriasis is in the mid twenties although it appears at a younger age in women, maybe by 3-4 years.
- Second peak of incidence is between the ages of 55-60 years
- 75% occur before the age of 40 years
- Seborrhoeic dermatitis appears to be more prevalent in families of patients with psoriasis
- 30% of patients with chronic plaque psoriasis have a family member with the disease
- 72% concordance in monozygotic twins and 30% in dizygotes
Clinical Features of Psoriasis
- Chronic plaque
- Palmoplantar pustulosis
- Generalised pustular
- Extensor surfaces of elbows and knees
- Lumbo-sacral region
- Flexures of genitalia
- Cardiovascular risk
- Other auto-immune disease
- Early detection, aggressive prevention through control of environmental factors and tight control of disease can halt the ‘metabolic march’ in psoriasis such as atopic dermatitis.
- 70% mild cases can be treated with topical treatments
- Goal of treatment is to reduce the extent or severity of psoriasis to such a level that it allows the patient to carry out their daily activities in an unhindered fashion.
- Psoriasis is a chronic disease which is currently incurable.
- Maintenance of long term patient safety will be the key to success of future treatments.
Common Topical Treatment
- Coal Tar
- Dithranol (Anthralin)
- Topical Corticosteroids
- Vitamin D3 Analogues
- Topical Retinoids
- Calcineurin Inhibitors
Second Line Treatment
- Systemic Retinoids
- Mycophenolate Mofetil
- Biologics Therapies
- Stem Cell Therapies