Psoriasis is a chronic inflammatory skin disorder
that has a hereditary basis for susceptibility. A variety of environmental
triggering factors (e.g., trauma, infections, or medications), may
contribute to development of psoriatic lesions in predisposed individuals.1612 Psoriasis
manifests most frequently as symmetrically distributed, well-demarcated,
red, raised, and scaly plaques that can involve any cutaneous surface.
Psoriasis lesions can involve areas of skin ranging from small isolated
regions to virtually the entire skin surface. The severity and location
of psoriasis may depend on genetic and environmental factors and may
vary over time.1576,1577,1578 Psoriasis
may be seen as a disease with low morbidity. Recently, however, clinical
studies have suggested there are considerable physical, social, and
psychological burdens associated with this disease. These studies
have reported stress and disruption in the daily activities of psoriatic
patients.1579 The
cumulative effects of psoriasis on patients can contribute to decrements
in their self-esteem, in their daily activities, in their ability
to build social relationships and to work. The American Academy of
Dermatology recently published guidelines on the care and management
of psoriasis and psoriatic arthritis. According to these guidelines,
psoriasis can be as debilitating as other serious chronic illnesses,
such as heart disease, cancer, diabetes, and depression. Psoriasis
has been associated with a lack of self-esteem and self-consciousness
that can lead to an increased prevalence of mood disorders and other
psychosocial behaviors, such as smoking and alcohol overconsumption.11286 In
addition, studies have shown that patients with psoriasis have a higher
incidence of comorbid conditions, such as obesity, heart disease,
diabetes mellitus, hypertension, and malignancy.1611,1651,1686,11287 Psoriasis triggers in genetically predisposed individuals
include external and systemic factors. External trigger factors include
Köbner’s phenomenon, drug eruptions, and viral exanthems.
Systemic triggers include infection, endocrine anomalies, psychogenic
stress, and certain drugs.459,460,463,464,483,485,1579,1580,1581,1584,1585,1586,1587,1590,1592,1593,1594,1595,1596,1598,1604,1605,1606,1607,1608,1611,1612,1650,1652,1664,1658,1659,1685,1686,1693,1695,1696,1707
Content on this page was last reviewed
on
July 31, 2008.
Content on this page was last changed on
March 17, 2009.
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of psoriasis and guidelines of care for the treatment of psoriasis
with biologics.
J Am Acad Dermatol
. 2008;58(5):826-850.
Hannuksela-Svahn A, Pukkala E, Läärä E, Poikolainen
K, Karvonen J. Psoriasis, its treatment, and cancer in a cohort of
Finnish patients.
J Inv Dermatol.
2000;114(3):587-590.
Tavani A, La Vecchia C, Franceschi S, Serraino D, Carbone A. Medical
history and risk of Hodgkin’s and non-Hodgkin’s lymphomas.
Eur J Cancer Prev.
2000;9(1):59-64.
Gelfand JM, Berlin J, Van Voorhees A, Margolis DJ. Lymphoma rates
are low but increased in patients with psoriasis: results from a population-based
cohort study in the United Kingdom.
Arch Dermatol.
2003;139(11):1425-1429.
Zhang Y, Holford TR, Leaderer B, et al. Prior medical conditions
and medication use and risk of non-Hodgkin lymphoma in Connecticut
United States women.
Cancer Causes Control.
2004;15(4):419-428.
Boffetta P, Gridley G, Lindelof B. Cancer risk in a population-based
cohort of patients hospitalized for psoriasis in Sweden.
J
Invest Dermatol.
2001;117(6):1531-1537.
Nickoloff BJ, Nestle FO. Recent insights into the immunopathogenesis
of psoriasis provide new therapeutic opportunities.
J Clin
Invest.
2004;113(12):1664-1675.
Mease PJ, Menter MA. Quality-of-life issues in psoriasis and psoriatic
arthritis: outcome measures and therapies from a dermatological perspective.
J Am Acad Dermatol.
2006;54(4):685-704.
Grob JJ, Revuz J, Ortonne JP, Auquier P, Lorette G. Comparative study
of the impact of chronic urticaria, psoriasis and atopic dermatitis
on the quality of life.
Br J Dermatol.
2005;152(2):289-295.
Lundberg L, Johannesson M, Silverdahl M, Hermansson C, Lindberg M.
Health-related quality of life in patients with psoriasis and atopic
dermatitis measured with SF-36, DLQI and a subjective measure of disease
activity.
Acta Derm Venereol.
2000;80(6):430-434.
Gupta MA, Gupta AK, Watteel GN. Perceived deprivation of social touch
in psoriasis is associated with greater psychologic morbidity: an
index of the stigma experience in dermatologic disorders.
Cutis
. 1998;61(6):339-342.
Perrott SB, Murray AH, Lowe J, Mathieson CM. The psychosocial impact
of psoriasis: physical severity, quality of life, and stigmatization.
Physiol Behav.
2000;70(5):567-571.
Herron MD, Hinckley M, Hoffman MS, et al. Impact of obesity and smoking
on psoriasis presentation and management.
Arch Dermatol.
2005;141(12):1527-1534.
Mallbris L, Akre O, Granath F, et al. Increased risk for cardiovascular
mortality in psoriasis inpatients but not in outpatients.
Eur J Epidemiol.
2004;19(3):225-230.
Crown WH, Bresnahan BW, Orsini LS, Kennedy S, Leonardi C. The burden
of illness associated with psoriasis: cost of treatment with systemic
therapy and phototherapy in the US.
Curr Med Res Opin.
2004;20(12):1929-1936.
Javitz HS, Ward MM, Farber E, et al. The direct cost of care for
psoriasis and psoriatic arthritis in the United States.
J
Am Acad Dermatol.
2002;46(6):850-860.
Vardy D, Besser A, Amir M, Gesthalter B, Biton A, Buskila D. Experiences
of stigmatization play a role in mediating the impact of disease severity
on quality of life in psoriasis patients.
Br J Dermatol.
2002;147(4):736-742.
Rapp SR, Feldman SR, Exum ML, Fleischer AB Jr., Reboussin DM. Psoriasis
causes as much disability as other major medical diseases.
J Am Acad Dermatol.
1999;41(3 Pt 1):401-407.
Evers AWM, Lu Y, Duller P, van der Valk PGM, Kraaimaat FW, van de
Kerkhof PCM. Common burden of chronic skin diseases? Contributors
to psychological distress in adults with psoriasis and atopic dermatitis.
Br J Dermatol.
2005;152(6):1275-1281.
Krueger G, Koo J, Lebwohl M, Menter A, Stern RS, Rolstad T. The impact
of psoriasis on quality of life: results of a 1998 National Psoriasis
Foundation patient-membership survey.
Arch Dermatol.
2001;137(3):280-284.
Akay A, Pekcanlar A, Bozdag KE, Altintas L, Karaman A. Assessment
of depression in subjects with psoriasis vulgaris and lichen planus.
J Eur Acad Dermatol Venereol.
2002;16(4):347-352.
Feldman SR, Fleischer AB Jr., Reboussin DM, et al. The economic impact
of psoriasis increases with psoriasis severity.
J Am Acad
Dermatol.
1997;37(4):564-569.
Gelfand
JM, Neimann AL, Shin DB, Wang X, Margolis DJ, Troxel AB. Risk of myocardial
infarction in patients with psoriasis.
JAMA
. 2006;296(14):1735-1741.
Poikolainen K, Karvonen J, Pukkala E. Excess mortality related to
alcohol and smoking among hospital-treated patients with psoriasis.
Arch Dermatol.
1999;135(12):1490-1493.
Menter A, Gottlieb A, Feldman SR, et al. Guidelines of care for the
management of psoriasis and psoriatic arthritis: Section 1. Overview
of psoriasis and guidelines of care for the treatment of psoriasis
with biologics.
J Am Acad Dermatol
. 2008;58(5):826-850.
Menter A, Gottlieb A, Feldman SR, et al. Guidelines of care for the
management of psoriasis and psoriatic arthritis: Section 1. Overview
of psoriasis and guidelines of care for the treatment of psoriasis
with biologics.
J Am Acad Dermatol
. 2008;58(5):826-850.