Psoriasis

About the Disease

Psoriasis is a common, and sometimes severe, skin disease. It is thought to affect approximately 1 in 40 people worldwide, and affects all ethnic groups and both sexes. Typically its onset begins in adulthood, most commonly affecting those in their 20s, and then those in their 40s.Psoriasis is a papulosquamous eruption — that is to say, it is a skin rash that causes the development of raised, red, flaky, scaly patches of skin. These patches are most commonly found on areas including the elbows and knees, with other common areas including the scalp, navel, buttocks, and palms and soles. These areas often itch, flake, crack, and can be painful. Even if not painful, the patches are highly unsightly. Psoriasis patients report feeling treated as if they have a contagious skin infection. They report being told not to touch the food in the grocery store and not to touch other people for fear of “catching” the rash. They are treated like “lepers” and the resulting impact on a patient’s quality of life has been shown in studies to be greater than that of other “more serious” diseases such as diabetes and heart disease.

The Research

Recently, research has begun to explain what causes psoriasis. It has long been noted that the lesions of psoriasis resemble in many ways skin that has been traumatized — burned, or abraded. What was not understood was what triggers this misguided healing response. It is now known that psoriasis is an autoimmune disease; a disease in which the damage to the skin is actually caused by the patient’s own body, specifically by the immune system. Typically, the immune system is designed to protect us from infections, even cancer. It functions by attacking the invading “germ” or cancer cell. However, in some cases, the immune system appears to get “confused”. Instead of attacking the “bad guys” it begins to attack the patient’s own body. Depending on where the immune system is attacking, different diseases result. If the attack is on the nerves, it is multiple sclerosis, if on the islet cells in the pancreas, type I diabetes, if on the joints, rheumatoid arthritis. Psoriasis results from an attack on the skin. The actual patches of psoriasi are the skin's attempt to heal from this attack. Unlike a burn, however, here the attack never stops, so the skin never can heal and the lesions of psoriasis persist indefinitely.

Treatment

Treatments of psoriasis have targeted many points in the development of psoriasis. Treatments like topical cortisone creams attempt to reduce the inflammation in the skin that causes the redness and itching. Topical vitamin D medications try to slow the overly rapid growth of the skin cells in lesions of psoriasis. More recently, advances in our understanding of psoriasis have led to more directly targeted treatments. Biologic drugs are like guided cruise missiles, actually designed to turn off the immune system’s overactive attack on the skin. Drugs like Enbrel and Humira pinpoint critical steps in the development of the immune attack. This ability to target specific steps have led to much more effective treatments, particularly for the most severe cases. MedaPhase has played a crucial role in the development of these biologic drugs.