Understanding Psoriasis

Psoriasis is a chronic inflammatory disease of the skin

What is Psoriasis?

Psoriasis is a chronic inflammatory skin disease, clinically characterized by patches on the skin covered by gray-silver scales. These patches are most commonly found on the limbs and scalp.

The plaques appear raised above the skin and vary in size: they may extend only a few centimeters, but it is not uncommon for them to cover much larger areas, even several tens of centimeters. Plaques on the scalp can be small or cover the entire head, and are characterized by a thickening of the outermost layer of the skin, called hyperkeratosis, which can even incorporate the hair.

  • Guttate psoriasis, more common in children and young adults, appears as small spots that can affect both the trunk and the limbs.
  • Palmoplantar psoriasis affects only the hands and feet.

Frequenza e diffusione della malattia

  • Although no precise data exist, it is estimated that about 2.5 million people in Italy are affected by various forms of psoriasis, with a prevalence of around 2.8%, similar to most highly industrialized Western countries.
  • 15–20% of patients develop a moderate to severe form.
    70–80% have a mild or moderate form.
  • Psoriasis predominantly affects young people: epidemiological surveys show that 75% of patients become ill before the age of 40.
  • Although not life-threatening, psoriasis has a strong impact on the patient’s psychological well-being, as the unpleasant appearance of the lesions can be difficult to live with. The aesthetic impact often causes discomfort in romantic relationships and professional activities.
  • The goal of those affected is to eliminate the problem permanently, to feel better about themselves, in interpersonal relationships, and to improve their quality of life.

Psoriasis in Italy

0
milioni
million people affected
15-
0
%
moderate–severe cases
0
%
under 40 years old

*Source: Italian Ministry of Health

Causes and Origins

Psoriasis is caused by an excessively rapid turnover of skin cells. The body continuously produces new cells in the deeper layers of the skin, which gradually move upward until they reach the surface. Meanwhile, the older cells in the outermost layer die and are shed through a natural process.

In healthy individuals, this entire process takes three to four weeks. In people with psoriasis, it is much faster—from 3 to 7 days. Due to this acceleration, cells that are not fully mature reach the surface, causing the characteristic plaques.

A crucial role is played by T lymphocytes, a specific group of immune system cells.
These T cells trigger an inflammatory process that disrupts cell reproduction mechanisms, causing redness and scaling.

Although it appears to affect only the skin, psoriasis is now considered a systemic disease, and can be associated with several related conditions: psoriatic arthritis, chronic inflammatory bowel diseases, eye diseases, metabolic syndrome, venous thromboembolism, cardiovascular diseases, and psychological disorders.

Known Treatments

There is currently no complete and definitive cure for psoriasis. Treatments aim to keep the disease under control as much as possible, and the choice of therapy depends on the patient and the characteristics of the disease. Here are the main treatment types:

Systemic Therapies

In more severe cases of psoriasis, or when topical treatments and phototherapy are ineffective, oral or injectable systemic medications are necessary.
These drugs can provide good disease control but may cause significant side effects because they act throughout the entire body.

Phototherapy

It is well known that light—natural or artificial—can relieve psoriasis symptoms.
Exposure to sunlight and the use of ultraviolet light in qualified medical settings are common treatments, often combined with other therapies.

Topical Treatment

Local treatment with creams, emollients, and ointments is used for milder and localized forms of psoriasis.
Therapy usually includes corticosteroid-based products, vitamin D analogues, and emollients.

Most Common Pharmacological Therapies (under strict medical supervision)

  • Immunosuppressants such as Methotrexate, a drug that reduces skin cell production and suppresses inflammation.
  • Cyclosporins, medications that reduce the immune response and therefore the attack of T lymphocytes on skin cells.
  • Retinoid drugs such as acitretin, which reduce skin cell production.
  • Biologic drugs, new-generation medications capable of reducing inflammation by selectively targeting the “overactive” immune cells.