Psoriasis: Epidemiology, Pathophysiology, and Management

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Table of Contents

Introduction
Epidemiology
Pathopyhsiology
Summary of Drugs and Therapies under Development
Unmet Medical Needs
References

Introduction

Human beings are exposed to more diseases than other living things. Their defence systems are not as strong as those of other living things. People expose themselves to various lifestyle and health risks that make them easy prey for disease. Psoriasis is a condition cause by an alteration in the immune system of a human being. This paper reviews the literatures presented by three authors about this disease.

Epidemiology

Psoriasis is an autoimmune disease that affects the skin and joints of the victim. This disease is believed to be hereditary and thus individuals that have a family history of this condition have high chances of being its victim. Initial studies of this disease focussed on keratinocyte hyperproliferation; however, recent studies are exploring the possibilities of the role played by the body’s immune system in triggering the occurrence of the disease (Blauvelt 2013). Therefore, recent therapeutic agents are focussing on the specific immune aspects of this disease to ensure they discover its occurrence and prevalence in different populations. This disease is prevalent in adults than children; however, it is lower in people aged below 12 years (Langley 2009). The location of populations exposes them to different possibilities of contacting the disease. Countries that are located far from the equator have higher prevalence rates compared to those that are close to it. Most people that are usually affected by this disease are aged between 30-39 and 50-69 years (Langley 2009). Reports from various sources indicate that the prevalence rate of this disease is increasing.

Pathopyhsiology

Psoriasis develops through various stages before it is full-blown and visible. First, the antigenic stimuli cause the activation of the plasmacytoid dendritic cells and other inactive immune cells that are usually located beneath the skin. Interferon which is a proinflammatory cytokine is produced by the inactive cells and this stimulates the myeloid dendritic cells that produce cytokines. This process causes the differentiation of the T cells that produce cytokines which stimulate keratinocytes that causes the inflammation of the skin (Blauvelt 2013). The process is repeated in various parts of the body and this causes the victim to have inflamed skin.

Summary of Drugs and Therapies under Development

Research has revealed that tumour necrosis factor (TNF) competitors have become first-line agents in the treatment of all forms of psoriasis. The levels of tumour necrosis factor alpha are usually high in individuals suffering from psoriasis. Tumour necrosis factor alpha (TNFα) is released from the T and antigen-presenting cells within the skin and thus it is a key player in the development of this disease. It facilitates entry of inflammatory cells into lesional skin and this triggers the release of other mediators. However, the uses of artificial TNFα inhibitors contained in drugs like stelara that restricts entry of inflammatory cells into lesional skin. There are hopes that this disease will be managed if the ongoing researches on developing other similar inhibition drugs succeed. Most authors and health scientists believe that the search for treatment of psoriasis is a trial and error procedure. Elise Nersesian argues that the patient’s age and severity of the infection determines the success and procedures that may be used to treat this condition. She adds that mild infections can be applied to the affected areas to reduce inflammation, reduce scales and balance the production of skin cells (Nersesian 2014).

However, there are ongoing researches by various health related institutions to develop medicated creams that will work in all psoriasis conditions regardless of their severity and ages of patients. This will reduce the spread of this disease and ensure there is proper control and management of it whenever patients suffer without the need of medical experts attending to them regularly. In addition, this author argues that research is ongoing under the supervision of professors from the University of New York to develop vaccines that will help children and adults not to fall victims to this disease. The effects of vitamin D, coal tar and retinoid in the affected area of the skin have confirmed that there is hope that this disease will be managed very soon. Other skin infections like measles, chickenpox and shingles have successfully been eliminated in most countries and this has given hope to researchers that psoriasis is on its way to extinction. Secondly, this author believes that UVB radiation has successfully been used to treat this disease.

In addition, she hopes that the ongoing development in the technology used in this process will improve the performance of this approach. Patients have been advised to expose their skins to direct sunlight to stop the production of cells and clear plaques. However, this remedy is not effective because not all parts of the body can be exposed to direct sunlight. In addition, there is the need to develop technology that will release radiation that will not only stop the cells from multiplying but also kill them. Systematic treatment is also another remedy used to manage this disease. Patients are usually injected or given pills like methotrexate and cyclosporine to suppress the cells of this disease and ensure they do not multiply. This author believes that this is possibly the best remedy for treating this disease, even though it is not as effective as most patients expect it to be. However, it is necessary to explain that this author highlights the fact that most medications and remedies do not treat this disease; instead they inhibit the production of its cells. Therefore, the areas that have already been affected cannot be treated, but they are left to dry as new skin replaces the damaged one.

Unmet Medical Needs

There are three main challenges that face the successful treatment of this disease. First, medical practitioners have not yet established the relationship between the hygienic conditions of patients and this disease. Therefore, there is no evidence whether poor sanitation contributes to the spread of this disease. Alice Gottlieb believes that lack of information on how to manage this disease makes it difficult for medical practitioners, patients and their families to understand how it can be cured (Gottlieb 2008). In addition, there is inadequate funding of medical research facilities to enable the relevant professionals to conduct research and establish better treatment for this disease. Therefore, doctors continue to struggle with old and poor approaches and this exposes patients to long pain. Lastly, there is no public knowledge on how people can manage this disease before it develops fully. This means that medical practitioners spend a lot of time and other resources to treat patients. Public awareness crusades on this and other skin infections will play important roles in determining the success of the initiatives established to cure this disease (Meffert 2014).