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
Integrated analysis of gene expression profiles identifies transcription factors potentially involved in psoriasis pathogenesis.
J. Cell. Biochem.. 2019 Aug , 120, (8):12582-12594.
Psoriasis is a common inflammatory skin disease mediated by cells and molecules in both the innate and adaptive immune systems. Recently, gene expression profile analysis revealed a large set of immune-related differentially expressed genes (DEGs) in psoriasis. However, the associations between these DEGs and their transcriptional regulation mechanisms have not been completely elucidated. In this study, several psoriasis Gene Expression Omnibus data sets were systematically analyzed using (...)see on pubmed
Models of human psoriasis: Zebrafish the newly appointed player.
Dev. Comp. Immunol.. 2019 Aug , 97:76-87.
Psoriasis is a human chronic, immune disease with severe cutaneous and systemic manifestations. Its prevalence, among the world population, highly varies with ethnicity and geography, but not sex from remarkable low levels in Asia to 2.3% in Spain, or an impressive 11.5% in Norway. The pathogenesis of psoriasis derives from complex genetic and environmental interactions, which creates aberrant crosstalk between keratinocytes and variated immune cell, resulting in open amplified inflammatory (...)see on pubmed
A vivid cytokines interaction model on psoriasis with the effect of impulse biologic (TNF-α inhibitor) therapy.
J. Theor. Biol.. 2019 Aug 07, 474:63-77.
Psoriasis is a chronic skin condition that produces plaques of condensed, scaling skin due to excessively rapid proliferation of keratinocytes. During the disease progression, keratinocyte proliferation is influenced by many immune cells and cytokines. This article deals with a five dimensional deterministic model, which has been derived using quasi-steady-state approximation for describing the dynamics of psoriasis in various cytokines environment. Equilibrium analysis of the system shows (...)see on pubmed
Prenatal perfluorooctanoic acid exposure is associated with early onset atopic dermatitis in 5-year-old children.
Chemosphere. 2019 Sep , 231:25-31.
Atopic dermatitis (AD) is the most common childhood skin disease and the first step of atopic march. Perfluoroalkyl substance (PFAS) exposure is associated with atopic diseases, including AD. However, whether PFAS exposure is related to earlier AD onset remains unclear. We aimed to investigate the association between prenatal PFAS exposure and earlier onset of AD in children in a 5-year follow-up study. From 2001 to 2005, 1264 mother-infant pairs were recruited from eight Taiwanese (...)see on pubmed
Synthesis of chitosan derivatives with organoselenium and organosulfur compounds: Characterization, antimicrobial properties and application as biomaterials.
Carbohydr Polym. 2019 Sep 01, 219:240-250.
In this study, Schiff bases of chitosan (CS) were synthesized using citronellal, citral, and their derivatives containing selenium and sulfur. Organoselenium and organosulfur compounds show attractive biological and pharmaceutical activities, which can be beneficial to CS-based materials. From the characterization analyses, it was found that the CS-derivatives containing organoselenium and organosulfur compounds exhibited the highest conversion degrees (23 and 28%). Biological assays were (...)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