Psoriasis is a common genetically mediated inflammatory skin disease affecting nearly 2% of the population.[1] Significant variation is noted vis-à-vis environmental stimuli, diet, drugs, lifestyle, genetic predisposition, and climatic variations. The term “psoriasis” emerged from the Greek word “psora”, meaning “itch.”[2] The diagnosis of psoriasis is essentially clinical, although histopathological hallmarks like neutrophilic microabscesses, suprapapillary thinning, parakeratoses, and dilated blood vessels aid in the final diagnosis. Psoriasis affects both sexes and the pediatric population equally, with minor variations.
The first observation of psoriasis and comorbidity was in 1897, when Strauss reported the association of psoriasis with diabetes.[3] Subsequent associations were reported with ischemic heart disease, obesity, dyslipidemia, psoriatic arthritis, hepatic disorders, inflammatory bowel disease, chronic kidney disease, mood disorders, and sexual dysfunctions.[4]
Treatment of psoriasis in India has evolved from the Vedic age to modern-day biologics, but still, a cure is being desperately searched for, as with diabetes, hypertension, and many disorders. So, it is a lifetime disease, and one should learn to live with it healthily, controlling it to a level where it does not affect the quality of life of the patient. The treatment evolved from anointment (a treatment given by priests of mantras with touch and application of ghee) in the Vedic ages to phototherapy, immunosuppressives to IL 17, IL23, and other biologics in addition to JAK inhibitors to immunosuppressives like methotrexate to cyclosporine.
But looking at the complex pathophysiology of psoriasis, there is a search for a permanent cure. This symposium article will tend to unplug the complex disease of psoriasis and its multiple facets.
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References
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