12:00 AM
Mar 12, 2001
 |  BioCentury  |  Tools & Techniques

Psoriasis still up for grabs

Though the pathogenesis of psoriasis has been studied extensively, data from the multitude of trials presented at a scientific meeting last week shows that no one has yet found a magic bullet. While psoriasis might be an indication that could be revolutionized by the identification of patient cohorts that respond better to particular types of treatment, until that information surfaces, treatment is likely to consist of combinations of drugs.

Psoriasis lesions, which are characterized by thickened, scaly and inflamed skin, originally were thought to arise from primary disorders of keratinization that led to local inflammation. However, it is now believed that the opposite is true: autoreactive T lymphocytes cause local inflammation with resultant angiogenesis and increased proliferation of keratinocytes.

The disease is characterized as mild, moderate, or severe depending on the percent of body surface involved, with mild cases involving no more than 2 percent of body surface area, moderate disease involving 2-10 percent, and severe disease involving more than 10 percent. The most common form is plaque psoriasis, which manifests as areas of thickened, inflamed, scaly, and pruritic (itchy) skin.

Treatment of mild psoriasis includes topical administration of steroids, vitamin A, or calcipotriene, a synthetic vitamin D3 compound. Exposure to UV light improves symptoms in some patients, providing the basis for PUVA (psoralen combined with UVA treatment). More severely affected patients are given systemic immunosuppressants including methotrexate or cyclosporine.

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