Psoriasis is a skin disorder that causes skin cells to multiply up to 10 times faster than normal. This makes the skin build up into bumpy red patches covered with white scales. They can grow anywhere, but most appear on the scalp, elbows, knees, and lower back. Psoriasis cannot be passed from person to person; however, it does sometimes happen to members of the same family.
Incidence and Prevalence
There are very few studies on the incidence of psoriasis. Since the registration of psoriasis cases is not compulsory, it is quite difficult to find reliable data. A review of published literature revealed only a handful of credible studies on the incidence of psoriasis. One study showed that the overall sex- and age-adjusted incidence rate of psoriasis in Minnesota in the United States, between 1980 and 1983, was estimated at 0.60 per 1000 person-years (Bell, Sedlack, Beard, Perry, Michet, and Kurland. Vena, Altomare, Ayal, Berardesca, Calzavara-Pinton, Chimenti, et al. Incidence of psoriasis and association with comorbidities in Italy: a 5-year observational study from a national primary care database. European, Dermatol. 2010;20 (5):593–8. Incidence of psoriasis in Rochester, Minn, 1980–1983. Arch Dermatol. 1991; 127(8):1184–7).
However, researchers have learned a lot more in recent years about psoriasis and the role the immune system plays in this condition. These new discoveries have led to safer, more targeted, and more effective psoriasis treatments. Despite all of the therapies available, studies show that many people receiving treatment for psoriasis are dissatisfied with their treatment or only modestly satisfied (Medically reviewed by Cobb — Written by Cafasso and Watson — Updated on March 2020) [https://www.healthline.com/health/psoriasis/moderate-to-severe/all-you-need-to-know-latest-psoriasis-treatment#takeaway].
Psoriasis can affect relationships at home, school or work as well as sexual relationships and thus reduce the quality of life and cause psychological strain (Kimball, Jacobson, Weiss, Vreeland, and Wu. The psychosocial burden of psoriasis. Am J Clin Dermatol. 2005; 6(6):383–92. Patients are frequently stigmatised and excluded from normal social environments, including schools, workplaces, and swimming pools. As a result, they often avoid social activities and commonly report experiencing loneliness, isolation, feelings of being unattractive, and frustration.
Biologics are made from substances found in living things, such as proteins, sugars, or nucleic acids. Once in the body, these medications block a part of the immune system that contributes to your psoriasis symptoms.
Biologics interfere with the following:
- Tumour necrosis factor-alpha (TNF-alpha), which is a protein that promotes inflammation in the body
- T cells, which are white blood cells
- Interleukins, which are cytokines (small inflammatory proteins) involved in psoriasis
This interference helps ease inflammation.
Although there are quite a number of these biologics available and also being produced, they all have side effects of which upper respiratory infection is most common, which is of concern for the author.
Janus kinase inhibitors, also known as JAK inhibitors, are a type of medication that functions by inhibiting the activity of one or more of the Janus kinase family of enzymes (JAK1, JAK2, JAK3, TYK2), thereby interfering with the JAK-STAT signaling pathway. These inhibitors have therapeutic applications in the treatment of cancer and inflammatory diseases such as rheumatoid arthritis. JAK inhibitors are another group of disease-modifying drugs. They work by targeting pathways that help the body make more inflammatory proteins.
They’re already used to treat:
- psoriatic arthritis
- rheumatoid arthritis
- ulcerative colitis
A few are in phase II and phase III trials for moderate to severe psoriasis. Ones being studied for psoriasis are the oral drugs tofacitinib (Xeljanz), baricitinib (Olumiant), and abrocitinib. A topical JAK inhibitor is also under investigation.
So far, studies have found JAK inhibitors to be effective for psoriasis. They’re about as safe as existing biologic drugs. One advantage is that they come in pill form and don’t have to be given as injections. The studies performed so far have been short term. Additional research is needed to know whether JAK inhibitors continue to be effective over longer periods of time.
Staying informed about the newest options for treating psoriasis is crucial to managing psoriasis. There isn’t a one-size-fits-all therapy for psoriasis. It’s likely that a person has to try out many different treatments before finding one that works the best and doesn’t cause side effects. New discoveries in psoriasis happen all the time.
(Medically reviewed by Cobb — Written by Cafasso and Watson — Updated on March 2020) [https://www.healthline.com/health/psoriasis/moderate-to-severe/all-you-need-to-know-latest-psoriasis-treatment#takeaway].