Psoriasis has a long history. The name psoriasis was coined by a dermatologist Ferdinand von Hebra in 1841. It has been described by Hippocrates and initially felt to be a communicable disease or a punishment for sinful behavior. Evidence exists that some of the people afflicted with Biblical Leprosy may instead have had psoriasis. Since then the causes of psoriasis continued to evolve. Until recently, psoriasis was felt to be due to over active replication of skin cells. Only with new research has the evidence pointed to the fact that psoriasis is an autoimmune disorder. Maybe new research will point us in other directions.
There is a definite genetic predisposition in the development of psoriasis. From identical twin studies, if one of the twins has psoriasis, the chance the other identical twin will develop psoriasis is between around 70%. Currently, researchers have linked the disease to many genes, each of which appears to increase the risk of development of psoriasis. However, they are not the sole cause of psoriasis. There still appears to be an environmental trigger that affects psoriasis. While there are many theories of the trigger, the exact cause remains unclear.
The most commonly associated disease with psoriasis is psoriatic arthritis. Currently it is estimated that around 30% of all patients with psoriasis develop arthritis, with average age is in the mid to late 30’. 70% present after the development of skin lesions. Classically, it presents itself as joint stiffness in the morning and is a result of inflammation at the insertion of the tendon to the bone (enthesistis). In more severe cases, joint destruction can be seen. Arthritis mutilans is a rare extreme case of psoriasis where you lose much of your ability to move your joints. Many medications that treat psoriasis can also treat the arthritis and it is important you discuss both symptoms with your doctor.
Heart break of psoriasis: This was printed advertisement that first appears in Tegrin, a coal tar preparation. It has remained a commonly used phrase for psoriasis. Psoriasis has always been a challenge to treat and up until relatively recently, most treatments were either not effective, difficult to implement or considered too risky to use. Given this, many people who had psoriasis suffered quietly, wearing long sleeve shirt during hot summer days. Many gave up on treatment. This is bears out in data which show most people who have severe disease are not seeking treatment.
In addition, psoriasis can have significant effects on quality life. A National psoriasis foundation study showed psoriasis can affect various activities of daily living.
Finally there is increasing data showing that many with moderate to severe disease are not being treated aggressively.