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
Total glucosides of paeony: A review of its phytochemistry, role in autoimmune diseases, and mechanisms of action.
J Ethnopharmacol.
2020 Aug 10, 258:112913.
Paeoniae Radix Alba (PRA, called baishao in China), the root of Paeonia lactiflora Pall., has shown a rich medicinal value for more than 2000 years. PRA is used in local medicine and traditional medicine for autoimmune diseases associated with inflammation. At present, total glucosides of paeony (TGP), the main active ingredient of PRA, has been developed into a preparation for the treatment of autoimmune diseases, as TGP exhibits the effect of regulating immunity, anti-inflammatory, and (...)
see on pubmed
Immobilization of papain enzyme on a hybrid support containing zinc oxide nanoparticles and chitosan for clinical applications.
Carbohydr Polym.
2020 Sep 01, 243:116498.
A new hybrid bionanomaterial composed of zinc oxide nanoparticles (ZnO NPs) and chitosan was constructed after enzymatic immobilization of papain for biomedical applications. In this work, we report the preparation and characterization steps of this bionanomaterial and its biocompatibility in vitro. The properties of the immobilized papain system were investigated by transmission electron microscopy, zeta potential, DLS, UV-vis absorption spectroscopy, FTIR spectroscopy, and X-ray (...)
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Tackling the various classes of nano-therapeutics employed in topical therapy of psoriasis.
Drug Deliv.
2020 Dec , 27, (1):662-680.
Psoriasis is a dermatological chronic skin condition with underlying autoimmune etiology. It deeply affects patients' quality of life. Therefore, it was an interesting target for researchers throughout the past years. Conventionally, the treatment options include anti-inflammatory agents, immune suppressants, biologic treatment, and phototherapy. Nanotechnology offers promising characteristics that allow for tailoring a drug carrier to achieve dermal targeting, improved efficacy and (...)
see on pubmed
on Atopic Dermatitis
The clinical impact of cross-reactions between allergens on allergic skin diseases.
Curr Opin Allergy Clin Immunol.
2020 Aug , 20, (4):374-380.
The route of allergen sensing via the skin appears to influence the immune system towards mounting a type 2 response, especially in genetically predisposed individuals. Allergens recognized this way may derive from microbial, animal, food, or other plant sources and trigger atopic dermatitis. Allergens can be grouped into families depending on their structure and function, harboring significant structural and sequence similarities. Cross-reactivity between allergens is believed to arise as (...)
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Spectral diagnosis of health hazardous toxins in face foundation powders using laser induced breakdown spectroscopy and inductively coupled plasma-optical emission spectroscopy (ICP-OES).
Talanta.
2020 Sep 01, 217:121007.
In this work, we applied laser-induced breakdown spectroscopy (LIBS) to estimate the amount of toxic heavy metals (Pb, Cr, Ni) in five different brands of face foundation powders available in the local market using standard calibration curve (CC)-LIBS approach. These samples contain toxic elements like lead, chromium, nickel which are highly carcinogens to cause eczematous and atopic dermatitis. The strongest atomic transition lines of lead (405.7 line), chromium (425.4 nm line), and nickel (...)
see on pubmed
Update on canine filaggrin: a review.
Combarros D et al.
Update on canine filaggrin: a review.
Vet Q.
2020 Dec , 40, (1):162-168.
Human filaggrin (FLG) plays a key role in epidermal barrier function, and loss-of-function mutations of its gene are primarily responsible for the development of human atopic dermatitis (AD). FLG expression is also reduced in the epidermis of atopic patients, due to the transcriptional effect of Th2 type cytokines. Canine atopic dermatitis (CAD) is a prevalent skin disease that shares many clinical and pathogenic features with its human homologue. The aim of this review is discuss current (...)
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