Psoriasis – a chronic condition with no cure
February 18, 2013
Psoriasis affects approximately 2%
of the population.
It may occur at any age but usually
two peaks are seen at 15-25 and 50-
60 years.
It affects males and females
equally, it is multifactorial involving
genetic predisposition and
environmental factors.
The exact cause of psoriasis
remains unknown, however genetic
predisposition plays an important
role with up to 50% of patients aware
of a relative who is also affected.
Psoriasis is usually characterised by
relapse and remission and for up to
one third of patients, emotional
stress can precipitate psoriasis.
Infections, for example
streptococcal sore throat, candida
and malessezia furfur can also
precipitate psoriasis and some
medications can trigger or aggravate
the condition, for example lithium,
beta blockers, antimalarials, NSAIDs
and the withdrawal of oral or topical
steroids.
A significant proportion of psoriatic
patients are obese and have
increased risk of ischemic heart
disease, due to presence of
insulin resistance (metabolic syndrome)
and lifestyle factors such as a history of
smoking and alcohol intake may also
be associated with the development
of psoriasis.
The aim of treatment is to control
relapses and maintain remissions.
Some people suffer a single
episode and then psoriasis clears
forever; most cases tend to persist
with variable extension over time.
A minority of patients continue to
have severe unrelenting debilitating
disease.
Specific treatments for psoriasis
include topical measures such as
phototherapy, systemic medication
and the new biologics.
Treatment can also include more
general advice like cleansers,
moisturisers, keratolytic agents,
sunshine or occlusive and wet
dressings.
This
week’s contributor
is Dr Phillip
Artemi, Honorary
Secretary of the
Australasian College
of Dermatologists.
Speaker at the Annual Therapeutic
Update Conference -1-3 March.
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