The plethora of triggering events, of physiopathological pathways and of clinical manifestations turns attention from the disease to the patient, who finally realizes his or her own psoriasis.
The patient must be made aware that psoriasis is not contagious, that it does not put life at risk, that it is an excessive skin reaction—often genetically programmed—to environmental factors which are important to identify. Psoriasis can reveal itself at any time of life. Whatever the situation, it will be possible to treat it, to relieve it, but no definitive cure can be promised. When explaining to a patient that there is no cure, one needs to be mindful that he will generally understand that he cannot be treated— which is something very different though. Equally, the patient must realize that psoriasis is “the skin regenerating too quickly” and that any drug, with its very different mechanisms, will only slow down this cutaneous regeneration. That is why, if the treatment is halted as soon as the skin has regained its normal appearance, the patient risks a very rapid relapse, or even a rebound. These explanations will allow the patient to understand that the fundamental is to carry on treatments, even once the skin appears to have become normal again, in order to give the skin’s natural anti-inflammatory mechanisms time to re-establish themselves.
The acceleration in epidermal regeneration caused by various attacks and, more particularly, by scratching, must be properly understood by the patient, given the impossibility of getting rid of a psoriasis plaque if it is regularly scratched. Finally, the patient must understand that although psoriasis is not endangering his life, it may be impairing his quality of life, therein lying the gravity of the illness. He must therefore learn, step by step, with the help of his dermatologist and GP, to manage all the aspects of his way of life leading to psoriasis flares on his hyperreactive skin. He must understand that, beyond the discomfort engendered by the disease and its treatment, the aim is to succeed in finding a better quality of life.
[|I very much enjoyed patient information issues, as we have for too long treated psoriasis as a trivial disorder. As mentioned by Professor Dubertret in his initial paragraphs at the end of his historical overview, time needs to be spent with each and every patient utilizing literature from patient organizations, eg National Psoriasis Foundation and similar national foundations, to educate patients. Psoriasis being a lifelong disease requires time and patience from physicians, which in the 21st century is frequently not readily available.|auteur215]
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Recent publications on Psoriasis and Atopic Dermatitis
on Psoriasis
Mimicking cigarette smoke exposure to assess cutaneous toxicity.
Prieux R et al.
Mimicking cigarette smoke exposure to assess cutaneous toxicity.
Toxicol In Vitro.
2020 Feb , 62:104664.
Cigarette smoke stands among the most toxic environmental pollutants and is composed of thousands of chemicals including polycyclic aromatic hydrocarbons (PAHs). Despite restrict cigarette smoking ban in indoor or some outdoor locations, the risk of non-smokers to be exposed to environmental cigarette smoke is not yet eliminated. Beside the well-known effects of cigarette smoke to the respiratory and cardiovascular systems, a growing literature has shown during the last 3 decades its (...)
see on pubmed
Penta-O-galloyl-β-D-glucose from Paeonia lactiflora Pall. root extract enhances the expression of skin barrier genes via EGR3.
J Ethnopharmacol.
2020 Feb 10, 248:112337.
Paeonia lactiflora Pall. has long been used to treat inflammatory skin diseases, such as psoriasis.
see on pubmed
CARD14/CARMA2sh and TANK differentially regulate poly(I:C)-induced inflammatory reaction in keratinocytes.
J. Cell. Physiol..
2020 Mar , 235, (3):1895-1902.
CARD14/CARMA2sh (CARMA2sh) is a scaffold protein whose mutations are associated with the onset of human genetic psoriasis and other inflammatory skin disorders. Here we show that the immunomodulatory adapter protein TRAF family member-associated NF-κB activator (TANK) forms a complex with CARMA2sh and MALT1 in a human keratinocytic cell line. We also show that CARMA2 and TANK are individually required to activate the nuclear factor κB (NF-κB) response following exposure to (...)
see on pubmed
on Atopic Dermatitis
Mimicking cigarette smoke exposure to assess cutaneous toxicity.
Prieux R et al.
Mimicking cigarette smoke exposure to assess cutaneous toxicity.
Toxicol In Vitro.
2020 Feb , 62:104664.
Cigarette smoke stands among the most toxic environmental pollutants and is composed of thousands of chemicals including polycyclic aromatic hydrocarbons (PAHs). Despite restrict cigarette smoking ban in indoor or some outdoor locations, the risk of non-smokers to be exposed to environmental cigarette smoke is not yet eliminated. Beside the well-known effects of cigarette smoke to the respiratory and cardiovascular systems, a growing literature has shown during the last 3 decades its (...)
see on pubmed
Sublingual Immunotherapy for Other Indications: Venom Large Local, Latex, Atopic Dermatitis, and Food.
Immunol Allergy Clin North Am.
2020 Feb , 40, (1):41-57.
There is some evidence to support the use of sublingual immunotherapy (SLIT) in food allergy, although its role is unclear. One randomized, double-blind, placebo-controlled trial supports the safe and efficacious use of dust mite SLIT in children with mild to moderate atopic dermatitis, but these data have not been confirmed. Although there are several randomized, double-blind, placebo-controlled trials to support the use of SLIT-LATEX, this product is not available in the United States and (...)
see on pubmed
The Cost-Effectiveness of Allergen Immunotherapy Compared with Pharmacotherapy for Treatment of Allergic Rhinitis and Asthma.
Immunol Allergy Clin North Am.
2020 Feb , 40, (1):69-85.
This article evaluates the cost-effectiveness of allergy immunotherapy (AIT) in the treatment of allergic rhinitis, asthma, and other allergic conditions. An extensive search of the PubMed and Medline databases (up to December 2018) was conducted. There is strong evidence in the collective literature, which included individual studies and systematic reviews, that AIT is cost-effective in the management of allergic rhinitis and asthma as compared with standard drug treatment alone. The (...)
see on pubmed
