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Therapeutics in Dermatology
A reference textbook in dermatology

Psoriasis

21 May 2013, by DUBERTRET L.

Psoriasis affects 1 to 5 p. 100 of the population depending on the regions of the world, but it is difficult to estimate the percentage precisely because many patients do not treat their symptoms, either because they consider that the treatments cause more discomfort than the disease itself, or through discouragement.

Uncomplicated psoriasis plaques are red, typically covered with micaceous scales. Removal of the scales with a curette leads to redness and bleeding. The scales which are always present may differ considerably in appearance. They may be ostreaceous, forming a helmet on the scalp, for example, or scurfy, closely resembling those observed in patients with seborrhoeic dermatitis.

1 - HISTOLOGY

Psoriasis is characterised histologically by acanthosis and papillomatosis, indicative of excessively rapid renewal of the epidermis, associated with a differentiation disorder leading to continuous or discontinuous parakeratosis.

These abnormalities are associated with inflammatory cell infiltration at a very early stage of plaque development. The cell infiltrate originally consists of polynuclear neutrophils, which often accumulate to form micro-abscesses under the horny layer of the epidermis leading to major alterations of the membranes of the keratinocytes in the vicinity due to the release of lysosomal enzymes. These alterations permanently activate epidermal renewal. The other cells making up the infiltrate of the skin lesions consist of T lymphocyte subpopulations, particularly CD4 cell in the dermis and CD8 cells in the epidermis. The T lymphocytes play a major role in the pathophysiology of psoriasis although it is not known which roles the CD4 and CD8 cells play respectively, or how they participate in the maintenance of local inflammation and hyperproliferation.

Histologically, the lesions may be atypical in some areas of the body, particularly the palms of the hands or soles of the feet where spongiosis is often observed. Therefore, it is pointless to perform a skin biopsy to differentiate between psoriasis and eczema on the palms of the hands or soles of the feet.

2 - LINKS

EADV leaflets published in 2019, produced by the EADV Psoriasis Task Force:

- Psoriasis a closer look - What, how, where

- Skin care tips

- Chronic disease, chronic frustations

- Healthy psoriasis

- Psoriasis throughout life

- Accepting psoriasis

- Psoriasis and genetics

- Psoriasis and intimacy

- A variety of treatments

- Succesful treatments

- Psoriasis and comorbidities

 

World directory of Psoriasis Medical Resources for patients

2.1 - INTERNATIONAL

International Federation of Psoriasis Associations / IFPA

2.2 - NATIONAL PATIENTS ASSOCIATIONS 

ARGENTINA

www.aepso.org

AUSTRALIA

www.psoriasisaustralia.org.au

AUSTRIA

www.psoriasis-hilfe.at

BELGIUM

www.psoriasis-vl.be

www.gipso.info

BULGARIA

www.psoriasisbulgaria.org

CANADA

www.psoriasissociety.org

CHILE

Corporación de Psoriasis de Chile

CHINESE TAIPEI 

Psoriasis Association Taiwan

COLOMBIA

Fundación Colombiana de Psoriasis

Fundacion de Apoyo al Paciente con Psoriasis (FUNDAPSO)

CZECH REPUBLIC 

Psoriatic and Atopic Eczema Association Czech Republic (SPAE CZ)

DENMARK

Psoriasisforeningen

EL SALVADOR

Psonuves, Psoriasis Nueva Vida El Salvador

ESTONIA

EPsoL- Estonian Psoriasis Association

FINLAND

Psoriasisliitto

GERMANY

Psoriasis Selbsthilfe Arbeitsgemeinschaft e.V. (PSOAG)

Deutscher Psoriasis Bund e. V.

HONG KONG

Hong Kong Psoriasis Patients Association

HRVATSKA/CROATIA

Croatian Psoriasis Association

HUNGARY 

Psoriasis Club of Szeged (Szegedi Pszoriázis Klub)

ICELAND

Samtök Psoriasis og Exemsjúklinga (SPOEX)

INDONESIA 

Indonesian Psoriasis Care Foundation

IRELAND

Irish Skin Foundation

ISRAEL

Israel Psoriasis Association

ITALY 

ADIPSO

JAPAN

Japan Psoriasis Association

KENYA

Africa Psoriasis Organization

REPUBLIC OF KOREA

Korea Psoriasis Association

MALAYSIA

Psoriasis Association of Malaysia

MALTA

Psoriasis Association Malta

MEXICO

Asociación Mexicana contra la Psoriasis

NETHERLAND

Psoriasis Vereniging Nederland

NORWAY

The Psoriasis and Eczema Association of Norway (PEF)

The Psoriasis- and Eczema Youth Association of Norway (PEF-ung)

PANAMA

Fundación Psoriasis de Panama

PHILIPPINES 

Psoriasis Philippines (PsorPhil)

POLAND 

Polish Psoriasis Association

PORTUGAL

PSOPortugal - Associacao Portuguesa da Psoríase

PUERTO RICO

Asociación Puertorriqueña de Ayuda al Paciente de Psoriasis, APAPP

ROMANIA

SPERANTA - Asociatia Pacientilor cu Psoariazis din Romania

RUSSIA

Interaction - Regional Public Organization of the Help to People Having Psoriasis

The Interregional Charitable Non Governmental Organization
"Society of Patients with Psoriasis"

SCOTLAND

Psoriasis Scotland, PSALV

SINGAPORE

Psoriasis Association of Singapore

SLOVAKIA

Slovak Psoriatics and Atopics Association

SLOVENIA

Drustvo Psoriatikov Slovenije

SOUTH AFRICA

South African Psoriasis Association

SPAIN

Acció Psoriasi

SWEDEN

Psoriasisförbundet

SWITZERLAND 

Schweizerische Psoriasis und Vitiligo Gesellschaft

TURKEY

Türkiye Sedef Hastalan Dayanisma Dernegi

UKRAINE

Ukrainan Psoriasis Association

UNITED KINGDOM 

www.psoriasis-association.org.uk

www.britishskinfoundation.org.uk/psoriasis

www.papaa.org (psoriasis and psoriatic arthritis alliance)

UNITED STATES

National Psoriasis Foundation/USA

VIETNAM

PsorViet, Vietnam Psoriasis Network

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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