Psoriasis: epidemiology, natural history, and differential diagnosis

Abstract

Psoriasis is a chronic, immune-mediated, inflammatory disease which affects primarily the skin and joints. It occurs worldwide, but its prevalence varies considerably between different regions of the world. Genetic susceptibility as well as environmental factors play an important role in determining the development and prognosis of psoriasis. Genomewide association studies have identified many genetic loci as potential psoriasis susceptibility regions, including PSORS1 through PSORS7. Histocompatibility antigen (HLA) studies have also identified several HLA antigens, with HLA-Cw6 being the most frequently associated antigen. Epidemiological studies identified several modifiable risk factors that may predispose individuals to developing psoriasis or exacerbate pre-existing disease. These include smoking, obesity, alcohol consumption, diet, infections, medications and stressful life events. The exact mechanism by which they trigger psoriasis remains to be elucidated; however, existing data suggest that they are linked through Th1-mediated immunological pathways. The natural history of psoriasis varies depending on the clinical subtype as well as special circumstances, including pregnancy and HIV infection. In general, psoriasis is a chronic disease with intermittent remissions and exacerbations. The differential diagnosis is vast and includes many other immunemediated, inflammatory disorders.

Study of YKL-40 Expression in Chronic Plaque Psoriasis: Case Controlled Study

“…Others reported a big variation of positive family history from 2% to 91% [21][22]. Unlike our findings, Basko-Plluska and Petronic-Rosic [23] reported that patients with early disease onset tend to have positive family history of psoriasis while those with onset after the age of 40 usually have negative family history.…”

Serum metabolic fingerprinting of psoriasis and psoriatic arthritis patients using solid-phase microextraction—liquid chromatography—high-resolution mass spectrometry

“…Approximately 3% of North Americans are affected by psoriasis; a chronic, immune-mediated, inflammatory skin disease (Petronic-Rosic & Basko-Plluska, 2012;Rachakonda et al, 2014). While there are many variants of psoriasis-for example, psoriasis vulgaris, guttate psoriasis, palmoplantar pustulosis, and pustular psoriasis-psoriasis vulgaris is the most common, accounting for 85-90% of psoriasis-related conditions (Lowes et al, 2007).…”

“…Since PsA often develops after the onset of cutaneous psoriasis, recent research has focussed on converters-psoriatic patients who develop PsA-with the aim of identifying the mechanisms of arthritis development, developing early diagnosis methods, and implementing measures for impeding the disease's progression, as advances in these areas have the potential to improve patient care tremendously (Abji et al, 2016;Eder et al, 2016Eder et al, , 2017. However, progress towards these goals will require identifying more quantitative biomarkers associated with psoriatic disease pathophysiology and a deeper understanding of the biochemical relevance of these markers in driving disease progression (Petronic-Rosic & Basko-Plluska, 2012).…”