From pathogenesis to current treatment of the cutaneous psoriasis - a literature review
DOI:
https://doi.org/10.12775/JEHS.2023.49.01.004Keywords
Psoriasis, TherapeuticsAbstract
Introduction:
Psoriasis is a chronic inflammatory autoimmune disease that can be divided into several subtypes based on the areas of the body occupied by the lesions and the severity of the disease. The overall prevalence of psoriasis ranges from 0 to 11,8%. The disease occurs with equal frequency in both sexes. PsO cannot be completely cured, so many patients experience stigma and have diminished self-esteem due to the characteristic appearance of the lesions.
Aim of the study:
The purpose of the study is to summarize the available knowledge about classification and options for psoriasis treatment. The options in diagnosis and treatment, including the latest methods, were described and summarized.
Materials and methods:
Literature available in the PubMed database was reviewed using the following keywords: “Psoriasis”, “Nail Psoriasis”, “Psoriasis Vulgaris”, “Psoriasis Treatment”, “New Psoriasis Treatment”, “Psoriasis Classification”, “Biologic Therapy for Psoriasis”, “Systemic Therapy for psoriasis”.
Conclusions:
Psoriasis is a genetic skin condition mediated by the immune system. The underlying mechanisms entail intricate interactions between the innate and adaptive immune system. There are various indices for assessing the severity of psoriasis, the most commonly used of which is PASI(Psoriasis Area and Severity Index). Retinoids, cyclosporine and methotrexate are the non-biologic therapies most frequently employed for moderate to severe psoriasis treatment, while topical therapy, which includes mainly corticosteroids and vitamin D analogues, is a successful approach for effectively managing mild psoriasis.
References
Christophers E. Psoriasis—Epidemiology and clinical spectrum. Clin. Exp. Dermatol. 2001;26:314–320
https://doi.org/10.1046/j.1365-2230.2001.00832.x
Elder JT. Genome-wide association scan yields new insights into the immunopathogenesis of psoriasis. Genes Immun. 2009;10:201–9 https://doi.org/10.1038/gene.2009.11
Elder JT, Bruce AT, Gudjonsson JE, Johnston A, Stuart PE, Tejasvi T, et al. Molecular dissection of psoriasis: integrating genetics and biology. J Investigat Dermatol. 2010;130:1213–26
https://doi.org/10.1038/jid.2009.319
Griffiths CE, Christophers E, Barker JN. A classification of psoriasis vulgaris according to phenotype. Br. J. Dermatol. 2007;156(2): 258-262 https://doi.org/10.1111/j.1365-2133.2006.07675.x
Chandran V, Raychaudhuri SP. Geoepidemiology and environmental factors of psoriasis and psoriatic arthritis. J. Autoimmun. 2010; 34(3):314-321 https://doi.org/10.1016/j.jaut.2009.12.001
Raychaudhuri SK, Maverakis E, Raychaudhuri SP. Diagnosis and classification of psoriasis. Autoimmun. Rev. 2014;13(4-5): 490-495 https://doi.org/10.1016/j.autrev.2014.01.008
Lowes MA, Bowcock AM, Krueger JG. Pathogenesis and therapy of psoriasis. Nature. 2007;445:866–73
https://doi.org/10.1038/nature05663
Griffiths CE, Barker JN. Pathogenesis and clinical features of psoriasis. Lancet. 2007;370:263–71
https://doi.org/10.1016/S0140-6736(07)61128-3
Nestle FO, Kaplan DH, Barker J. Mechanisms of disease: psoriasis. New Engl J Med. 2009;361:496–509
https://doi.org/10.1056/NEJMra0804595
Ortonne J, Chimenti S, Luger T, Puig L, Reid F, Trueb RM. Scalp psoriasis: European consensus on grading and treatment algorithm. J. Eur. Acad. Dermatol. Venereol. 2009;23:1435–1444
https://doi.org/10.1111/j.1468-3083.2009.03372.x
Boehncke WH, Schon MP. Psoriasis. Lancet. 2015;386:983–94 https://doi.org/10.1016/S0140-6736(14)61909-7
Armesto S, Esteve A, Coto-Segura P, Drake M, Galache C, Martínez-Borra J, et al. Nail psoriasis in individuals with psoriasis vulgaris: a study of 661 patients. Actas Dermosifiliogr. 2011;102:365-72 https://doi.org/10.1016/j.ad.2011.02.007
Kaeley GS, Eder L, Aydin SZ, Rich P, Bakewell CJ. Nail psoriasis: diagnosis, assessment, treatment options, and unmet clinical needs. J Rheumatol. 2021;48:1208–20
https://doi.org/10.3899/jrheum.201471
Sobolewski P, Walecka I, Dopytalska K. Nail involvement in psoriatic arthritis. Rheumathology. 2017;55:131-5 https://doi.org/10.5114/reum.2017.68912
Bronckers IM, Paller AS, van Geel MJ, van de Kerkhof PC, Seyger MM. Psoriasis in children and adolescents: diagnosis, management and comorbidities. Paediatr Drugs. 2015;17(5):373–384 https://doi.org/10.1007/s40272-015-0137-1
Merola JF, Qureshi A, Husni ME. Underdiagnosed and undertreated psoriasis: nuances of treating psoriasis affecting the scalp, face, intertriginous areas, genitals, hands, feet, and nails. Dermatol Ther. 2018;31(3):e12589 https://doi.org/10.1111/dth.2018.31.issue-3
Omland SH, Gniadecki R. Psoriasis inversa: a separate identity or a variant of psoriasis vulgaris? Clin Dermatol. 2015;33(4):456–461 https://doi.org/10.1016/j.clindermatol.2015.04.007
Choon SE, Lebwohl MG, Marrakchi S, Burden AD, Tsai TF, Morita A, et al. Study protocol of the global Effisayil 1 Phase II, multicentre, randomised, double-blind, placebo-controlled trial of spesolimab in patients with generalized pustular psoriasis presenting with an acute flare. BMJ Open. 2021;11:e043666 https://doi.org/10.1136/bmjopen-2020-043666
Hoegler KM, John AM, Handler MZ, Schwartz RA. Generalized pustular psoriasis: a review and update on treatment. J Eur Acad Dermatol Venereol. 2018; 32:1645–51 https://doi.org/10.1111/jdv.14949
Robinson A, Van Voorhees AS, Hsu S, Korman NJ, Lebwohl MG, Bebo BF, et al. Treatment of pustular psoriasis: from the Medical Board of the National Psoriasis Foundation. J Am Acad Dermatol. 2012;67:279–88 https://doi.org/10.1016/j.jaad.2011.01.032
Freitas E, Rodrigues MA, Torres T. Diagnosis, screening and treatment of Patients with Palmoplantar Pustulosis (PPP): a review of current practices and recommendations. Clin Cosmet Investig Dermatol. 2020;13:561–78 https://doi.org/10.2147/CCID.S240607
Smith MP, Ly K, Thibodeaux Q, Bhutani T, Liao W, Beck KM. Acrodermatitis continua of Hallopeau: clinical perspectives. Psoriasis. 2019;9:65–72 https://doi.org/10.2147/PTT.S180608
Navarini AA, Burden AD, Capon F, Mrowietz U, Puig L, Köks S, et al. European consensus statement on phenotypes of pustular psoriasis. J Eur Acad Dermatol Venereol. 2017;31:1792–9 https://doi.org/10.1111/jdv.14386
Dupire G, Droitcourt C, Hughes C, Le Cleach L. Antistreptococcal interventions for guttate and chronic plaque psoriasis. Cochrane Database Syst Rev. 2019 Mar 05;3(3):CD011571 https://doi.org/10.1002/14651858.CD011571.pub2
Rosenbach M, Hsu S, Korman NJ, et al. Treatment of erythrodermic psoriasis: from the medical board of the National Psoriasis Foundation. J Am Acad Dermatol. 2010;62(4):655–662 https://doi.org/10.1016/j.jaad.2009.05.048
Stinco G, Errichetti E. Erythrodermic psoriasis: current and future role of biologicals. BioDrugs. 2015;29(2):91–101 https://doi.org/10.1007/s40259-015-0119-4
Singh RK, Lee KM, Ucmak D, Brodsky M, Atanelov Z, Farahnik B, et al. Erythrodermic psoriasis: pathophysiology and current treatment perspectives. Psoriasis. 2016;6:93–104 https://doi.org/10.2147/PTT.S101232
Mrowietz U, Kragballe K, Reich K, Spuls P, Griffiths CE, Nast A, Franke J, Antoniou C, Arenberger P, Balieva F, et al. Definition of treatment goals for moderate to severe psoriasis: A European consensus. Arch. Dermatol. Res. 2011;303:1–10 https://doi.org/10.1007/s00403-010-1080-1
Chularojanamontri L, Silpa-archa N, Wongpraparut C, Limphoka P. Long-term Safety and Drug Survival of Acitretin in Psoriasis: A Retrospective Observational Study. Int. J. Dermatol. 2019;58:593–599 https://doi.org/10.1111/ijd.14349
Revicki D, Willian MK, Saurat JH, Papp KA, Ortonne JP, Sexton C, Camez A. Impact of adalimumab treatment on health-related quality of life and other patient-reported outcomes: Results from a 16-week randomized controlled trial in patients with moderate to severe plaque psoriasis. Br. J. Dermatol. 2008;158:549–557 https://doi.org/10.1111/j.1365-2133.2007.08236.x
Saurat JH, Stingl G, Dubertret L, Papp K, Langley RG, Ortonne JP, Unnebrink K, Kaul M, Camez A, Investigators CS. Efficacy and safety results from the randomized controlled comparative study of adalimumab vs. Methotrexate vs. Placebo in patients with psoriasis (champion) Br. J. Dermatol. 2008;158:558–566 https://doi.org/10.1111/j.1365-2133.2007.08315.x
Raaby L, Zachariae C, Østensen M, Heickendorff L, Thielsen P, Grønbæk H, Skov L, Kyvsgaard N, Madsen J, Heidenheim M, et al. Methotrexate Use and Monitoring in Patients with Psoriasis: A Consensus Report Based on a Danish Expert Meeting. Acta Derm. Venereol. 2017;97:426–432 https://doi.org/10.2340/00015555-2599
Ho VC, Griffiths CE, Berth-Jones J, Papp KA, Vanaclocha F, Dauden E, Beard A, Puvanarajan L, Paul C. Intermittent short courses of cyclosporine microemulsion for the long-term management of psoriasis: A 2-year cohort study. J. Am. Acad. Dermatol. 2001;44:643–651 https://doi.org/10.1067/mjd.2001.112400
Maza A, Montaudié H, Sbidian E, Gallini A, Aractingi S, Aubin F, Bachelez H, Cribier B, Joly P, Jullien D, et al. Oral Cyclosporin in Psoriasis: A Systematic Review on Treatment Modalities, Risk of Kidney Toxicity and Evidence for use in Non-plaque Psoriasis. J. Eur. Acad. Dermatol. Venereol. 2011;25:19–27 https://doi.org/10.1111/j.1468-3083.2011.03992.x
Papp K, Reich K, Leonardi CL, Kircik L, Chimenti S, Langley RG, Hu C, Stevens RM, Day RM, Gordon KB, et al. Apremilast, an oral phosphodiesterase 4 (PDE4) inhibitor, in patients with moderate to severe plaque psoriasis: Results of a phase III, randomized, controlled trial (Efficacy and Safety Trial Evaluating the Effects of Apremilast in Psoriasis [ESTEEM] 1) J. Am. Acad. Dermatol. 2015;73:37–49 https://doi.org/10.1016/j.jaad.2015.03.049
Gall JS, Kalb RE. Infliximab for the Treatment of Plaque Psoriasis. Biologics. 2008;2:115–124 https://doi.org/10.2147/BTT.S2116
Langley RG, Elewski BE, Lebwohl M, Reich K, Griffiths CE, Papp K, Puig L, Nakagawa H, Spelman L, Sigurgeirsson B, et al. Secukinumab in plaque psoriasis—Results of two phase 3 trials. N. Engl. J. Med. 2014;371:326–338 https://doi.org/10.1056/NEJMoa1314258
Wang WM, Jin HZ. Biologics in the treatment of pustular psoriasis. Expert Opin Drug Saf. 2020;19(8):969–980 https://doi.org/10.1080/14740338.2020.1785427
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Wiktoria Jakubowska, Piotr Pisera, Aleksandra Kiełkowicz, Filip Pactwa, Zuzanna Popińska, Daniel Ślusarczyk, Bartłomiej Żmuda, Michał Żuberek
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 230
Number of citations: 0
