One of the best known autoimmune skin diseases is psoriasis, which is characterized by various alterations in epidermal growth and differentiation. In particular, eritodescamativas plaques usually appear, that is to say, red and with pearly scales, which are normally very well defined and that grow on the elbows or knees.
The causes that give rise to psoriasis are actually a combination of genetic and environmental factors , but it is known that part of the origin is in “an imbalance that conditions a greater inflammatory response through the Th17 pathway at the skin level,” says Mar Llamas, dermatologist of the Psoriasis Group of the Spanish Association of Dermatology and Veneorology (AEDV). This means that, “after an initial stimulus that gives rise to the disease, cytokines that we call regulatory are produced. In turn, these give rise to a maturation of naive lymphocytes to T h 17 lymphocytes, which will promote the creation of new effector cytokines ”. It is the latter that are the real culprits for the typical changes that we see in psoriasis plaque, such as thickening of the skin, erythema and the classic peeling.
It is estimated that in Spain the prevalence of psoriasis is equal to or somewhat higher than 2%, and that it affects men as well as women. Of course, when this skin condition is more intense, “it seems that there is a higher proportion of men: 60% versus 40%,” the expert specifies.
As mentioned, psoriasis also has a genetic component: up to a third of patients show a family history , and, although it is a chronic disease, they do not always have outbreaks again: “There are those who can have isolated outbreaks (for For example, with a streptococcal infection) ”, insists Dr. Llamas. And he adds: “Thus, it cannot be said that it is exactly a disease for life.” For this reason and because fortunately today there is a great therapeutic arsenal “that will allow us to control it and for the patient to forget about the pathology by not giving them problems.”
In addition to genetic factors, there are certain environmental contexts that can promote it, such as stress, obesity, tobacco, and alcohol.
Available treatments
Regarding the treatments, there are several alternatives: the most typical are cosmetic active ingredients, such as urea; or medical-aesthetic treatments, such as phototherapy with narrow band ultraviolet B or with ultraviolet A, which are sometimes associated with pills called psoralens. Another classic is topical treatments with corticosteroids or derivatives of vitamin D cream.
A particularity of psoriasis is that it is a disease highly influenced by the mood: ” Everything that is a problem in other spheres triggers hormones related to the cortisol axis, and can lead to an outbreak of psoriasis, ” says the doctor. , who adds that this also becomes a vicious circle that constantly feeds on itself: more psoriasis, more stress, and again more flare-ups). For this reason, “patients with psoriasis may also have more anxiety and depression,” concludes the dermatologist.
