Psoriasis is a T-cell mediated immune disease, a chronic inflammatory condition in which the patient’s immune system triggers an inappropriate immune response, leading to a loss of control over skin cell production. Psoriasis is characterized by the abnormal growth of keratinocytes (a type of skin cell) and an inflammatory reaction resulting in the formation of thick, red, scaly patches of skin.

Clinically, patients present scaly plaques that are inflamed and sometimes itchy or painful due to deep inflammation. Patients with psoriasis are heavily stigmatized and often have difficulty living normal lives.

Psoriasis affects about 2% of the population. It is a non-contagious and chronic skin disease, which requires a long-term, safe and effective therapy. There is currently no cure for psoriasis. Patients with mild forms of the disease are traditionally treated with topical therapy (steroids, coal tar, vitamin D3 analogues, retinoids), followed by phototherapy with ultraviolet B (UVB) as second-line therapy. In more moderate to severe cases, defined not only by the degree of body surface affected but also by the localization of the plaques and patient quality of life, systemic treatments such as methotrexate, ciclosporin and PUVA (Psoralen + UVA) are used.

These treatments may help control the symptoms and improve quality of life in the short term, but benefits are often not long lasting and are in many cases limited by toxicity, intolerance and the need for frequent laboratory monitoring.

The newer biological agents target the disease by modulating T-cell function or cytokine release and offer new hope for patients

Psoriasis at a glance:

• 1 in 50 people or more than 100 million patients worldwide are affected by psoriasis
• Psoriasis can develop at any age but most commonly appears between the ages of 15 and 35 years.
• The cause of psoriasis is unknown but it is believed to have a genetic component. Factors such as psychological stress, skin trauma, medications and infections tend to make it worse.
• The disease comes in many forms and is categorized by physicians as mild, moderate or severe, depending on the levels on scaliness, redness and percentage of body surface covered, as well as the localization of plaques and disease burden to the patient.
• Psoriasis Area and Severity Index (PASI) is the name of an objective scaling system commonly used in clinical trials to grade severity of psoriasis

Resources:

• The National Psoriasis Foundation, USA (NPF)
• The European Federation of Psoriasis Associations (EUROPSO)
• The American Academy of Dermatology (AAD)
• The European Academy of Dermatology & Venereology (EADV)
• The European Society for Dermatology Research (ESDR)
• Serono Symposia International (SSI)
• World Psoriasis Day (WPD)

Merck Serono treatment options:

• Raptiva®