Psoriasis causes: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
No edit summary
Line 14: Line 14:
* The human genome has at least nine different loci , which lead to the development of psoriasis (PSORS1-9).  
* The human genome has at least nine different loci , which lead to the development of psoriasis (PSORS1-9).  
* PSORS-1, a part of the major histocompatibility complex (MHC) on chromosome 6p2, is the major genetic determinant of psoriasis, and is responsible for up to fifty percent of genetic susceptibility to the disease.<ref name="pmid16138103">{{cite journal |vauthors=Bowcock AM, Krueger JG |title=Getting under the skin: the immunogenetics of psoriasis |journal=Nat. Rev. Immunol. |volume=5 |issue=9 |pages=699–711 |year=2005 |pmid=16138103 |doi=10.1038/nri1689 |url=}}</ref>
* PSORS-1, a part of the major histocompatibility complex (MHC) on chromosome 6p2, is the major genetic determinant of psoriasis, and is responsible for up to fifty percent of genetic susceptibility to the disease.<ref name="pmid16138103">{{cite journal |vauthors=Bowcock AM, Krueger JG |title=Getting under the skin: the immunogenetics of psoriasis |journal=Nat. Rev. Immunol. |volume=5 |issue=9 |pages=699–711 |year=2005 |pmid=16138103 |doi=10.1038/nri1689 |url=}}</ref>
* Misssense mutations in CARD14 gene lead to activation of the NF-κB pathway


==== Immune system ====
==== Immune system ====
* Both innate and adaptive immunity is involved in the development of psoriasis.
* Both innate and adaptive immunity is involved in the development of psoriasis.
*   The cause of psoriasis is not fully understood, but there is some idea that common causes of psoriasis include [[Stress (medicine)|stress]], excessive alcohol consumption, and [[Tobacco smoking|smoking]]. Psoriasis is a fairly [[idiosyncratic]] disease. The majority of people's experience of psoriasis is one in which it may worsen or improve for no apparent reason. Studies of the factors associated with psoriasis tend to be based on small (usually hospital based) samples of individuals. These studies tend to suffer from representative issues, and an inability to tease out [[causal]] associations in the face of other (possibly unknown) intervening factors. Conflicting findings are often reported. Nevertheless, the first outbreak is sometimes reported following [[Stress (medicine)|stress]] (physical and mental), skin injury, and [[streptococcal infection]].  Conditions that have been reported as accompanying a worsening of the disease include infections, stress, and changes in season and [[climate]]. Certain medicines, including [[lithium salt]] and [[beta blocker]]s, have been reported to trigger or aggravate the disease. Excessive alcohol consumption, smoking and obesity may exacerbate psoriasis or make the management of the condition difficult.<ref>[http://www.skincarephysicians.com/psoriasisnet/triggers.html <nowiki>[1]</nowiki>] Psoriasis Triggers at Psoriasis Net. SkinCarePhysicians.com 9-28-05. American Academy of Dermatology, 2008.</ref><ref>{{cite journal |author=Behnam SM, Behnam SE, Koo JY |title=Smoking and psoriasis |journal=Skinmed |volume=4 |issue=3 |pages=174–6 |year=2005 |pmid=15891254 |doi= |url=http://www.lejacq.com/articleDetail.cfm?pid=SKINmed_4;3:174}}</ref> Individuals suffering from the advanced effects of the [[HIV|Human immunodeficiency virus]], or HIV, often exhibit psoriasis.<ref>[http://www.medscape.com/viewarticle/556533 <nowiki>[2]</nowiki>][http://dermatology.cdlib.org/132/reviews/HIV/fife.html <nowiki>[3]</nowiki>] Fife, Jeffes, Koo, Waller. Unraveling the Paradoxes of HIV-associated Psoriasis: A Review of T-cell Subsets and Cytokine Profiles. 5-18-07. Retrieved 5-13-08.</ref> This presents a paradox to researchers as traditional therapies that reduce [[T-cell]] counts generally cause psoriasis to improve. Yet, as CD4-T-cell counts decrease with the progression of HIV, psoriasis worsens.<ref>{{cite journal |author=Ortonne JP, Lebwohl M, Em Griffiths C |title=Alefacept-induced decreases in circulating blood lymphocyte counts correlate with clinical response in patients with chronic plaque psoriasis |journal=Eur J Dermatol |volume=13 |issue=2 |pages=117–23 |year=2003 |pmid=12695125 |doi= |url=http://www.john-libbey-eurotext.fr/medline.md?issn=1167-1122&vol=13&iss=2&page=117}}</ref> In addition, HIV is typically characterized by a strong [[T helper cell|Th2]] [[cytokine]] profile, whereas psoriasis vulgaris is characterized by a strong [[T helper cell|Th1]] secretion pattern.<ref>{{cite journal |author=Austin LM, Ozawa M, Kikuchi T, Walters IB, Krueger JG |title=The majority of epidermal T cells in Psoriasis vulgaris lesions can produce type 1 cytokines, interferon-gamma, interleukin-2, and tumor necrosis factor-alpha, defining TC1 (cytotoxic T lymphocyte) and TH1 effector populations: a type 1 differentiation bias is also measured in circulating blood T cells in psoriatic patients |journal=J. Invest. Dermatol. |volume=113 |issue=5 |pages=752–9 |year=1999 |month=November |pmid=10571730 |doi=10.1046/j.1523-1747.1999.00749.x |url=}}</ref> It's hypothesized that the diminished CD4-T-Cell presence causes an over-activation of CD8-T-Cells, which are responsible for the exacerbation of psoriasis in HIV positive patients. It is important to remember that most individuals with psoriasis are otherwise healthy and the presence of HIV accounts for less than 1% of cases. The prevalence of psoriasis in the HIV positive population ranges from 1 to 6 percent, which is about 3 times higher than the normal population.<ref>[http://www.nsc.gov.sg/cgi-bin/WB_ContentGen.pl?id=401&gid=83 <nowiki>[4]</nowiki>]  A Case Report of Severe Psoriasis in a Patient with AIDS: The Role of the HIV Virus and the Therapeutic Challenges Involved. Vol: 13 No 2, 2002. National Skin Center. Retrieved 05-13-08.</ref> Psoriasis occurs more likely in dry skin than oily or well-moisturized skin, and specifically after an external skin injury such as a scratch or cut. This is believed to be caused by an infection, in which the infecting organism thrives under dry skin conditions with minimal skin oil, which otherwise protects skin from infections. The case for psoriasis is opposite to the case of [[athlete's foot]], which occurs because of a fungus infection under wet conditions as opposed to dry in psoriasis. This infection induces inflammation, which causes the symptoms commonly associated with psoriasis, such as itching and rapid skin turnover, and leads to drier skin as the infecting organism absorbs the moisture that would otherwise go to the skin. To prevent dry skin and reduce psoriasis symptoms, it is advised to not use shower scrubs, as they not only damage skin by leaving tiny scratches, they also scrape off the naturally occurring skin oil. Additionally, moisturizers can be applied to moisturize the skin, and lotions used to promote skin oil gland functions. =====Drug Induced=====
* The key cytokines of immune system, which lead to psoriasis are tumor necrosis factor-alpha and interferon alpha.
**[[Pegylated interferon alfa-2b]]
* Within the immune system, development of psoriasis is based upon four key pathways/interactions:
**[[Siltuximab]]
** Antigen presentation
** NF-κB signaling
** IL-23/IL-17 axis
** Type I IFN pathway.
 
==== Environmental and behavioral ====
The enviromental factors implicated in the development or aggravation of psoriasis are:<ref>[http://www.skincarephysicians.com/psoriasisnet/triggers.html <nowiki>[1]</nowiki>] Psoriasis Triggers at Psoriasis Net. SkinCarePhysicians.com 9-28-05. American Academy of Dermatology, 2008.</ref><ref>{{cite journal |author=Behnam SM, Behnam SE, Koo JY |title=Smoking and psoriasis |journal=Skinmed |volume=4 |issue=3 |pages=174–6 |year=2005 |pmid=15891254 |doi= |url=http://www.lejacq.com/articleDetail.cfm?pid=SKINmed_4;3:174}}</ref><ref>[http://www.medscape.com/viewarticle/556533 <nowiki>[2]</nowiki>][http://dermatology.cdlib.org/132/reviews/HIV/fife.html <nowiki>[3]</nowiki>] Fife, Jeffes, Koo, Waller. Unraveling the Paradoxes of HIV-associated Psoriasis: A Review of T-cell Subsets and Cytokine Profiles. 5-18-07. Retrieved 5-13-08.</ref><ref>{{cite journal |author=Ortonne JP, Lebwohl M, Em Griffiths C |title=Alefacept-induced decreases in circulating blood lymphocyte counts correlate with clinical response in patients with chronic plaque psoriasis |journal=Eur J Dermatol |volume=13 |issue=2 |pages=117–23 |year=2003 |pmid=12695125 |doi= |url=http://www.john-libbey-eurotext.fr/medline.md?issn=1167-1122&vol=13&iss=2&page=117}}</ref><ref>{{cite journal |author=Austin LM, Ozawa M, Kikuchi T, Walters IB, Krueger JG |title=The majority of epidermal T cells in Psoriasis vulgaris lesions can produce type 1 cytokines, interferon-gamma, interleukin-2, and tumor necrosis factor-alpha, defining TC1 (cytotoxic T lymphocyte) and TH1 effector populations: a type 1 differentiation bias is also measured in circulating blood T cells in psoriatic patients |journal=J. Invest. Dermatol. |volume=113 |issue=5 |pages=752–9 |year=1999 |month=November |pmid=10571730 |doi=10.1046/j.1523-1747.1999.00749.x |url=}}</ref><ref>[http://www.nsc.gov.sg/cgi-bin/WB_ContentGen.pl?id=401&gid=83 <nowiki>[4]</nowiki>]  A Case Report of Severe Psoriasis in a Patient with AIDS: The Role of the HIV Virus and the Therapeutic Challenges Involved. Vol: 13 No 2, 2002. National Skin Center. Retrieved 05-13-08.</ref>
** Stress (physical and mental)
** Smoking
** Excessive alcohol consumption
** Infection (Streptococcal, HIV
** Seasonal variation
** Medications (Lithium, Beta blockers, pegylated interferon alpha-2b, Siltuximab)
** Obesity
** Skin injury
** Skin dryness


==References==
==References==

Revision as of 13:14, 14 June 2017

Psoriasis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Psoriasis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

X-ray

Ultrasound

CT scan

MRI

Other Imaging Studies

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Psoriasis causes On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Psoriasis causes

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Psoriasis causes

CDC on Psoriasis causes

Psoriasis causes in the news

Blogs on Psoriasis causes

Directions to Hospitals Treating Psoriasis

Risk calculators and risk factors for Psoriasis causes

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Psoriasis is caused due to complex interactions between the genetics, immune system and environmental factors.

Causes

Common Causes

Genetics

  • The human genome has at least nine different loci , which lead to the development of psoriasis (PSORS1-9).
  • PSORS-1, a part of the major histocompatibility complex (MHC) on chromosome 6p2, is the major genetic determinant of psoriasis, and is responsible for up to fifty percent of genetic susceptibility to the disease.[1]
  • Misssense mutations in CARD14 gene lead to activation of the NF-κB pathway

Immune system

  • Both innate and adaptive immunity is involved in the development of psoriasis.
  • The key cytokines of immune system, which lead to psoriasis are tumor necrosis factor-alpha and interferon alpha.
  • Within the immune system, development of psoriasis is based upon four key pathways/interactions:
    • Antigen presentation
    • NF-κB signaling
    • IL-23/IL-17 axis
    • Type I IFN pathway.

Environmental and behavioral

The enviromental factors implicated in the development or aggravation of psoriasis are:[2][3][4][5][6][7]

    • Stress (physical and mental)
    • Smoking
    • Excessive alcohol consumption
    • Infection (Streptococcal, HIV
    • Seasonal variation
    • Medications (Lithium, Beta blockers, pegylated interferon alpha-2b, Siltuximab)
    • Obesity
    • Skin injury
    • Skin dryness

References

  1. ↑ Bowcock AM, Krueger JG (2005). "Getting under the skin: the immunogenetics of psoriasis". Nat. Rev. Immunol. 5 (9): 699–711. doi:10.1038/nri1689. PMID 16138103.
  2. ↑ [1] Psoriasis Triggers at Psoriasis Net. SkinCarePhysicians.com 9-28-05. American Academy of Dermatology, 2008.
  3. ↑ Behnam SM, Behnam SE, Koo JY (2005). "Smoking and psoriasis". Skinmed. 4 (3): 174–6. PMID 15891254.
  4. ↑ [2][3] Fife, Jeffes, Koo, Waller. Unraveling the Paradoxes of HIV-associated Psoriasis: A Review of T-cell Subsets and Cytokine Profiles. 5-18-07. Retrieved 5-13-08.
  5. ↑ Ortonne JP, Lebwohl M, Em Griffiths C (2003). "Alefacept-induced decreases in circulating blood lymphocyte counts correlate with clinical response in patients with chronic plaque psoriasis". Eur J Dermatol. 13 (2): 117–23. PMID 12695125.
  6. ↑ Austin LM, Ozawa M, Kikuchi T, Walters IB, Krueger JG (1999). "The majority of epidermal T cells in Psoriasis vulgaris lesions can produce type 1 cytokines, interferon-gamma, interleukin-2, and tumor necrosis factor-alpha, defining TC1 (cytotoxic T lymphocyte) and TH1 effector populations: a type 1 differentiation bias is also measured in circulating blood T cells in psoriatic patients". J. Invest. Dermatol. 113 (5): 752–9. doi:10.1046/j.1523-1747.1999.00749.x. PMID 10571730. Unknown parameter |month= ignored (help)
  7. ↑ [4] A Case Report of Severe Psoriasis in a Patient with AIDS: The Role of the HIV Virus and the Therapeutic Challenges Involved. Vol: 13 No 2, 2002. National Skin Center. Retrieved 05-13-08.

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Psoriasis_causes&oldid=1317540"