Psoriasis: Much More Than a Skin Problem

Psoriasis affects about 2 to 3% of the world's population. Far from being a simple cosmetic problem, it is a systemic inflammatory disease associated with an increased risk of cardiovascular diseases, diabetes, and depression.

The mechanism involved

The immune system overreacts and accelerates the renewal of skin cells. Normally, this cycle takes about 28 days. In psoriasis, it is reduced to 3-4 days, causing the accumulation of dead cells in thick plaques.

Different forms

• Plaque psoriasis (80% of cases): red patches covered with white scales, often on elbows, knees, and scalp
• Guttate psoriasis: small disseminated lesions, common in children after an infection
• Inverse psoriasis: affects skin folds (armpits, groin)
• Psoriatic arthritis: joint involvement affecting 20-30% of patients

Current treatments

Management is graduated:

1. Topicals: topical corticosteroids, vitamin D analogs
2. Phototherapy: narrowband UVB
3. Systemic treatments: methotrexate, cyclosporine
4. Biologics: anti-TNF, anti-IL17, anti-IL23 — therapeutic revolution of the last 15 years

Psoriasis is not contagious. Reducing social stigma is an integral part of management.