Psoriasis is a chronic, non-infectious disease, a dermatosis, which affects mainly the skin. It is now assumed to have autoimmune nature. Psoriasis is usually manifested by appearance of extremely dry red lumps, raised above the surface of the skin, the so-called papules, which merge among themselves, forming plaque. These papules are sites of chronic inflammation and abnormal proliferation of lymphocytes, macrophages, and keratinocytes of the skin, as well as excessive angiogenesis (formation of new small capillaries) in the underlying layer of the skin.
Psoriasis is a chronic disease characterized by alternating periods of spontaneous or induced by some or other therapeutic effects remission and periods of spontaneous or induced by some adverse external influences (alcohol, intercurrent infections, and stress) recurrences or exacerbations. The severity of the disease may vary in different patients and even in the same patient during periods of remission and exacerbation in a very wide range, from small local lesions to the patient’s body fully covered with psoriatic plaques.
Often over time the disease have a tendency to progress (especially in the absence of treatment) manifested in frequent exacerbations and the enlargement of the skin lesions area. In certain patients, there is a continuous course of disease without spontaneous remissions, or even continuous progression. Psoriasis often also affects the nails on the hands and/or feet (psoriatic onychodystrophy). Psoriatic onychodystrophy can be isolated and occur in the absence of the skin lesions. Psoriasis can also cause inflammatory lesions of joints, the so-called psoriatic arthropathy or psoriatic arthritis. From 10 to 15% of patients suffering from psoriasis also suffer from psoriatic arthritis.
In the psoriasis development, the hereditary component plays significant role, and many of the genes that are associated with the development of psoriasis or directly involved in its development are already known, but it remains unclear how these genes interact during the development of the disease. Most of the known genes, associated with psoriasis, one way or another, affect the immune system, particularly the function of t-lymphocytes and the major histocompatibility complex (MHC). The main value of the genetic research of psoriasis is that they allow to identify the molecular mechanisms and signaling cascades involved in disease development, for further study and possible future development of new drugs affecting these new molecular targets.
It has been shown that psoriasis is able to degrade the quality of life of patients in the same way as other serious chronic illness: depression, cardiac arrest, hypertension, heart failure, or diabetes mellitus type 2. Depending on the severity and location of psoriatic lesions, the patients with psoriasis may experience considerable physical and/or psychological discomfort, difficulties with social and occupational adaptation and even disability. Severe itching and pain can interfere with basic functions: self-care, walking, and sleeping. Psoriatic plaques on the exposed parts of the hands or feet may prevent the patient to do certain work, some sports, to care for family members pets or home.
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