Psoriasis is a model disease in dermatology. It is a common disease that affects at least 2 to 3% of the population in the European Union. As a matter of fact, more than half of patients do not take care of themselves, either because the inefficacy of the treatments available discourages them or because such treatments strike them as being more restrictive than psoriasis itself, or because they are in remission.
It is an illness only present in humans, characterized by an excessive reaction of the skin to attacks from the internal and external environment, most often of genetic origin. These attacks can be immunologic, mechanic, metabolic, drug-induced or psychological. As such, understanding the physiopathology of psoriasis calls for a greater understanding of the interactions between the skin cells on the one hand and the interactions between the skin and the central nervous system (CNS) on the other. This excessive reaction is characterized by epidermal proliferation combined with incomplete terminal differentiation, as well as an excessive inflammatory response responsible for the chronic nature of the lesions. The way to understand psoriasis is to reach therefore a better appreciation of the messages that enable the skin cells to initiate an inflammatory response, and a better understanding of the way in which the inflammatory cells, responsible for innate and acquired immune responses, are capable of bringing about proliferation and abnormal epidermal differentiation. Taking an interest in psoriasis is thus taking an interest in all facets of skin physiology and in all the ways the skin reacts to environmental aggressions.
psoriasis care differs between countries. It is important to plan psoriasis care
together with the patient associations. Psoriasis day care centres have become
increasingly common, especially in Scandinavia
in recent years.|auteur193]
For over thirty years now, more than 300 publications endeavour to explore each year one aspect or another of psoriasis from a clinical, epidemiological, physiopathological or therapeutic point of view. There is no new technique for observing the skin that has not been immediately applied to the study of psoriasis—which is a privileged mirror of the progresses made in dermatology. Nor has psoriasis remained untouched by whims of fashion, all kind of scenarios having been suggested to explain it, from a scarring disease to an autoimmune illness, or even a genetic or psychosomatic disorder.
Psoriasis is at the origin of a medical revolution necessary to complete and enhance the effectiveness of evidence-based medicine; it is the so-called “patient-based medicine”. This concept refers to the development of techniques aiming to apply the scientific evidence-based medicine knowledge, built by studying populations, to an individual and specific patient.
Psoriasis is very rarely life threatening. Conversely, it is a disease that does affect, sometimes very severely, the quality of life. The patient is the judge of his or her quality of life, and it is, therefore, up to the patient, not to the doctor, to gauge the severity of psoriasis. This is a key point to decide the best therapeutic strategy. Psoriasis cannot be treated then without placing the patient, not the illness, at the centre of therapeutic negotiations. The 20th century has witnessed boundless efforts concentrating in the disease; the 21st century witnesses the development of medical techniques that allow the patient, in all its complexity, to be placed at the centre of therapeutic efforts. This revolution began in dermatology, revolving around psoriasis, and is spreading progressively to all chronic disorders and all disciplines.
It is difficult not to be passionate about psoriasis and those suffering from it. The aim of this book is to convey the passion of different experts on psoriasis in the world. The chosen strategy has been to ask experts in the world to react to this position paper. This way we hope to avoid the two scourges of therapy, recipes and one-way thought, by complementing and relativizing each chapter with the views of different experts. Above all, the goal of this book is to initiate a dialogue with the reader.
Professor Louis DUBERTRET
- 2019/08/12 Focus on...Latin American Clinical Practice Guidelines on the Systemic Treatment of Psoriasis
- 2019/06/03 Focus on...News from our SPIN Columbian members
- 2019/05/21 Focus on...SPIN2019 is now available on your screen!
- 2019/04/18 Focus on...SPIN Congress 2019 in Paris coming soon
- 2019/04/17 Focus on...Do not miss Spin Congress 2019 highlights
News from the web office
- 2017/06/05PIN becomes SPIN - Skin Inflammation & Psoriasis International Network
- 2016/10/29PSO 2016 Congress - Webcasts Available!
- 2016/05/26PIN Survey on Phototherapy
- 2016/02/20PIN Study on Therapeutic Patient Education
- 2016/02/19World Directory of Psoriasis Medical Resources - February 2016 Update
- 2019/04/18 Focus on...SPIN Congress 2019 in Paris coming soon
- 2018/07/16SPIN Symposium at the Spring continental meeting - Tehran, 25-27 April 2018
- 2018/02/222nd National Meeting of the Egyptian Society for Psoriasis
- 2018/02/211st Psoriasis Symposium - Sarajevo 2017
- 2017/06/2815th São Paulo Meeting of Psoriasis and Vitiligo
News from medical groups
- 2018/04/183rd Turkish National Psoriasis Symposium
- 2017/06/21Brazilian Center for Psoriasis Studies joins SPIN!
- 2017/06/21Costa Rica Psoriasis Group - Meet them!
- 2017/02/02Works of the 1st Senegalese Psoriasis Day published!
- 2016/07/29Swiss S1 Guidelines for Systemic treatment of psoriasis vulgaris
News from patients associations
- 2017/02/08France Psoriasis - 2016 World Psoriasis Day
- 2016/05/26Senegal Patients Association joins PIN!
- 2015/08/04Epidermia Greece: a new partner association of PIN
- 2015/08/01Canadian Association of Psoriasis Patients joins PIN!
- 2015/04/09AEPSO Argentina launches digital map to find people with psoriasis in the country
Recent publications on Psoriasis and Atopic Dermatitis
JAK-inhibitors in dermatology: current evidence and future applications.
J Dermatolog Treat. 2019 Nov , 30, (7):648-658.
The Janus kinase (JAK) and signal transducer and activator of transcription (STAT) pathway is a ubiquitous intracellular signaling network. Selective JAK-inhibitors have anti-inflammatory properties and have been approved in many countries for the treatment of rheumatoid arthritis (tofacitinib, baricitinib) and myelofibrosis or polycythemia vera (ruxolitinib). The aim of the publication was to summarize and critically analyze the efficacy and safety of JAK-inhibitors in skin diseases, such (...)see on pubmed
Patient preferences for attributes of topical anti-psoriatic medicines.
J Dermatolog Treat. 2019 Nov , 30, (7):659-663.
Patient preferences should be considered when prescribing topical treatments to drive up adherence and improve clinical outcomes. The aim of this work was to identify the most important attributes of topical medicines for psoriasis treatment in the patients' view, and explore the sociodemographic and clinical determinants of these preferences. A questionnaire for the evaluation of the relevancy given to specific attributes of topical medicines used for psoriasis treatment was developed (...)see on pubmed
Salidroside inhibits MAPK, NF-κB, and STAT3 pathways in psoriasis-associated oxidative stress via SIRT1 activation.
Redox Rep.. 2019 Dec , 24, (1):70-74.
To unveil the role of SIRT1 in limiting oxidative stress in psoriasis and to further discuss the therapeutic prospects of salidroside in psoriasis. Literature from 2002 to 2019 was searched with "psoriasis", "oxidative stress", "SIRT1", "salidroside" as the key words. Then, Oxidative stress in psoriasis and the role of SIRT1 were summarized and the potential role of salidroside in the disease was speculated. Oxidative stress might contribute to the pathogenesis of psoriasis. High levels (...)see on pubmed
A case of infective endocarditis associated with atopic dermatitis perioperatively treated with dupilumab.
J Dermatolog Treat. 2019 Nov , 30, (7):674-676.
Several case reports and reviews support a relationship between atopic dermatitis (AD) and infective endocarditis (IE). Here, we present a case of severe AD suspected of causing IE. A 21-year-old man with severe AD was admitted to our hospital due to unidentified fever, syncope, and headache. He was diagnosed with IE with cerebral embolism and mitral regurgitation. Before elective cardiac surgery, he was subcutaneously administered dupilumab for 2 months to control AD. Dupilumab improved (...)see on pubmed
Effect of cinnamamides on atopic dermatitis through regulation of IL-4 in CD4 cells.
J Enzyme Inhib Med Chem. 2019 Dec , 34, (1):613-619.
This study aimed to evaluate the effects of cinnamamides on atopic dermatitis (AD) and the mechanisms underlying these effects. To this end, the actions of two cinnamamides, (E)-3-(4-hydroxyphenyl)-N-phenylethyl acrylamide (NCT) and N-trans-coumaroyltyramine (NCPA), were determined on AD by orally administering them to mice. Oral administration of the cinnamamides ameliorated the increase in epidermal and dermal thickness as well as mast cell infiltration. Cinnamamides suppressed serum (...)see on pubmed
Sublingual immunotherapy of atopic dermatitis in mite-sensitized patients: a multi-centre, randomized, double-blind, placebo-controlled study.
Artif Cells Nanomed Biotechnol. 2019 Dec , 47, (1):3540-3547.
Allergen-specific immunotherapy is widely used for allergic rhinitis and asthma treatment worldwide. This study explored the efficacy and safety of sublingual immunotherapy (SLIT) with the extracts of ( Drops) on house dust mites (HDM)-induced atopic dermatitis (AD). 239 patients with HDM-induced AD were recruited and exposure to a multi-centre, randomized, double-blind, and placebo-controlled clinical trials for 36 weeks, which were randomly divided into placebo and sublingual Drops (...)see on pubmed