Psoriasis is a chronic inflammatory disease that can affect the skin with different manifestations. It usually appears with red patches (“erythematous”) with sharp borders, covered by white-silver scales. It can be characterized by pruritus, even if this is not a constant symptom.
Psoriasis is a very common disease, it affects 3% of worldwide population, and it is essentially caused by the interaction of factors linked to the immune system, genetical background and environment.
Being a chronic pathology with a genetic basis, the behaviour of psoriasis will be characterized by periods of worsening (sometimes linked to recognizable “triggering factors”) and improvement. The length and frequency of these periods are often unpredictable.

At present different therapeutic options exist to treat psoriasis; they are basically distinct in topical therapies, phototherapy (lamps that use specific ultraviolet rays), and systemic therapies with drugs. The aim of every Dermatologist is to find the most appropriate therapy, in order to induce a remission of cutaneous lesions and improve patient’s quality of life.

Psoriasis can be associated with other diseases involving other organs, with potentially serious complications. A comprehensive patient evaluation is therefore mandatory, with the help of laboratory examinations and specialist consultations.
The most important association is with psoriatic arthritis, characterized by a chronic inflammatory arthritis that can affect different joints. Psoriatic arthropathy has a prevalence varying from 5% to 42%; in particular, in Italy, one third of the population affected by psoriasis can develop a joint involvement.
In these cases, joint inflammation appears with pain, swelling and/or stiffness. Psoriatic arthritis represents a potentially debilitating disease, due to the development of bone erosions and articular deformities. These functional deficits deeply reduce patient’s quality of life, and an early diagnosis is necessary to prevent any serious complication.

The importance of the role of the Dermatologist for an early diagnosis of psoriatic arthritis is underlined by the fact that in more than 80% of cases cutaneous lesions precede the onset of articular symptoms.


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