Psoriasis Genetic Factors, Triggering Factors, Treatment Options and Comorbidities

Yıl 2019, Cilt: 6 Sayı: 2, 11 - 20, 15.12.2019

Tuba Sevimoğlu , Büşra Çetin Vildan Enisoğlu Atalay

Öz

Psoriazis is a chronic, immun-related disease that affects both skin and joints and alters the patients’s quality of life. Traditional genetic analysis methods show 10 chromosomal areas (PSORS1-PSOR10) and multiple genes including IL15, IL13 and CDKAL1 gene groups related to this disease. Pathophysiology of psoriazis is characterized with abnormal keratinocyte proliferation in dermis and epidermis which has more significant roles for dendritic and T cells than other cells. Psoriazis is accepted as a multisystem disease. The most common comorbidity is psoriatic arthritis. Although there is no cure for psoriazis yet, lesions caused by this disease can be inhibited with topical treatments, systemic treatments, phototherapies and herbals. Also local formulas of plant extract mixes were efficiently used to treat patients with severe psoriazis. Treatments can be applied as a combination or monotherapy. 

Anahtar Kelimeler

Psoriazis, Treatment methods, Comorbidity, Drugs, Plants

Psoriazis Genetik Faktörler, Tetikleyici Faktörler, Tedavi Seçenekleri ve Komorbiditeleri

Öz

Psoriazisin patofizyolojisi, diğer
hücreler arasında dendritik hücreler ve T hücreleri için önemli rolleri olan
doğal ve adaptif bağışıklık sistemlerini içeren dermis ve epidermisdeki anormal
keratinosit proliferasyonu ile karakterizedir. Psoriazis multisistemik hastalık
olarak kabul edilmektedir. Sık rastlanan komorbitelerin başında psoriatik
artrit gelir. Psoriazise tam anlamıyla
çözüm bulunamamış olsa da topikal tedaviler, sistemik tedaviler, fototerapiler
ve bitkilerle psoriazisin neden olduğu lezyonlar azaltılmaya çalışılmaktadır. Ayrıca,
bitkilerin yerel formülleri şiddetli
psoriazisi olan hastaları tedavi etmek için etkin şekilde kullanılmıştır. Tedaviler kombinasyon
halinde veya monoterapi olarak uygulanabilir. Bu derlemede psoriazisin genetik
ve tetikleyici faktörleri, komorbiditeleri ve tedavi seçenekleri
tartışılmıştır. Psoriazis, cilt veya eklemlerde bazen her ikisinde de ortaya çıkan kronik, bağışıklık sistemi
aracılı bir hastalıktır. Geleneksel gensel bağlantı analizleri çalışmalarıyla,
istatistiksel olarak bu hastalıkla ilişkili olduğu saptanan 10 kromozomal bölge
(PSORS1-PSORS10) ve IL15, IL13, CDKAL1 gen gruplarını da kapsayan birçok gen psoriazis
hastalığı ile ilişkilidir.

Anahtar Kelimeler

Psoriazis, Tedavi yöntemleri, ilaç, komorbidite, bitki

Kaynakça

• 1. Akarsu S, Ünlü Bıçak M, Turna İ, Yücel F, Özkan AŞ. Psoriaziste dar band ultraviyole B tedavisinde haftalık düşük ve yüksek oranlı doz artış protokollerinin karşılaştırılması. TURKDERM 2015; 49 (2): 101-106.
• 2. Alwawi EA, Mehlis SL, Gordon KB. Treating psoriasis with adalimumab. Therapeutics and clinical risk management 2008; 4 (2): 345-51.
• 3. Bağlam S. Psoriasis Şiddetinin Sistemik İnflamasyon Göstergesi Olan Nötrofil Lenfosit Oranı ve Crp ile Bağlantısının Retrospektif Değerlendirilmesi, İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi ve Zührevi Hastalıkları Anabilim Dalı, Uzmanlık Tezi (Basılmış) 2016.
• 4. Bulur I, Gülekon A, Erdem Ö, Yücel AA, Çelik S, Aral A. Psoriazis vulgariste osteopontin ve ilişkili sitokin düzeylerinin tedavi, hastalik aktivitesi ve komorbiditeler ile ilişkisi. Turkderm Deri Hastalıkları ve Frengi Arşivi 2013; 47 (3): 142-147.
• 5. Boehncke W-H, Schön MP. Psoriazis. Lancet 2015; 386 (9997): 983-994. 6. Chong HT, Kopecki Z, Cowin AJ. Lifting the silver flakes: The pathogenesis and management of chronic plaque Psoriazis. BioMed Research International.2013: 168321.
• 7. Dogra S, Mahajan R, 2013. Systemic methotrexate therapy for Psoriazis: Past, present and future. Clinical and Experiment Dermatolology 2013; 38 (6): 573- 588.
• 8. Duffin KC, Woodcock J, Krueger GG. Genetic variations associated with Psoriazis and psoriatic arthritis found by genome-wide association. Dermatology Therapy 2010; 23 (2): 101-113.
• 9. Dhir V, Aggarwal A. Psoriatic Arthritis: a Critical Review. Clinal Reviews in Allergy Immunology 2013; 44 (2): 141-148
• 10. Fry L, Baker BS. Triggering Psoriazis: the role of infections and medications. Clinics in Dermatology 2007; 25 (6): 606-615.
• 11. Fitch E, Harper E, Skorcheva I, Kurtz SE, Blauvelt A. Pathophysiology of Psoriazis: Recent advances on IL-23 and TH17 cytokines. Current Rheumatology 2007; 9 (6): 461-467.
• 12. Golden JB, McCormick TS, Ward NL. IL-17 in Psoriazis: Implications for therapy and cardiovascular co-morbidities. Cytokine 2013; 62 (2): 195-201.
• 13. Gürer MA, Adişen E. Psoriazis, genel bilgiler, epidemiyoloji. Turkderm Deri Hastalıkları ve Frengi Arşivi 2008; 42 (2): 15-17.
• 14. Gudjonsson JE, Johnston A, Sigmundsdottir H, Valdimarsson H. Immunopathogenic mechanisms in Psoriazis. Clinical Experimental Immunology 2004; 135 (1): 1-8.
• 15. Galadari I, Sharif MO, Galadari H,. Psoriazis: A fresh look. Clinics in Dermatology 2005; 23 (5): 491-502
• 16. Henseler T. Christophers E. Psoriazis of early and late onset: Characterization of two types of Psoriazis vulgaris. Journal of The American Academy of Dermatology , 1985; 13 (3): 450-456.
• 17. Kim N, Thrash B, Menter A. Comorbidities in Psoriazis Patients. Journal of Cutaneous Medicine and Surgery 2010; 29 (1): 10-15.
• 18. Kocsard E. Associated Dermatoses and Triggering Factors in Psoriazis. Australasian Journal of Dermatology 1974; 15 (2): 64-76.
• 19. Kavala M, Türkoğlu Z, Özlü E. Metotreksat ve dermatolojide klinik kullanımları. Göztepe Tıp Dergisi 2014; 29 (2):104-110.
• 20. Kim S. Phytotherapy: emerging therapeutic option in urologic disease. Translational Andrology and Urology 2012; 1 (3): 181-191.
• 21. Landau JL, Moody MN, Kazakevich N, Goldberg LH. Psoriazis and the pregnant woman: what are the key considerations? Skin Therapy Letter 2011; 16 (9): 1-3.
• 22. Lowes MA, Suárez-Fariñas M, Krueger JG. Immunology of Psoriasis. Annual Review Immunology 2014; 32: 227–255
• 23. Meier M, Sheth PB. Clinical spectrum and severity of Psoriazis. Current Problems in Dermatology 2009; 38:1-20.
• 24. Mak RKH, Hundhausen C, Nestle FO. Progress in Understanding the Immunopathogenesis of Psoriazis. Actas Dermosifiliogr 2009; 100 (2): 2-13.
• 25. Mitra A, Wu Y. Topical delivery for the treatment of Psoriazis. Expert Opinion on Drug Delivery 2010; 7 (8): 977-992.
• 26. Menter A, Gottlieb A, Feldman SR, Van Voorhess AS, Leonardi CL, Gordon KB, Lebwohl M, Koo JY, Elmets CA, Korman NJ, Beutner KR, Bhusman R. Guidelines of care for the management of Psoriazis and psoriatic arthritis. Section 1. Overview of Psoriazis and guidelines of care for the treatment of Psoriazis with biologics. Journal of The American Academy of Dermatology 2008; 58 (5): 826-850.
• 27. Machado-Pinto J, Diniz M dos S, Bavoso NC. Psoriazis: New comorbidities. Brazilian Annals of Dermatology 2016; 91 (1): 8-14.
• 28. Patel R V, Lebwohl M. In the clinic Psoriazis. Annals of Internal Medicine 2011; 155 (3).
• 29. Pasić A. Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ. Fitzpatrick’s Dermatology in General Medicine 2008; 7 (2): 2402.
• 30. Papp, Kim A. The long-term efficacy and safety of new biological therapies for psoriasis. Archives of Dermatological Research 2006; 298(1): 7-15.
• 31. Reich K, Domm S, Mrowietz U. Therapie mit Methotrexat in der Dermatologie. JDDG - Journal of the German Society of Dermatology 2012; 10 (5): 363-371.
• 32. Sarac G, Koca TT, Baglan T. A brief summary of clinical types of psoriasis. Northern Clinics of İstanbul 2016;3(1):79–82.
• 33. Silva AJ, Brickelmaier M, Majeau GR, Li Z, Su L, Hsu YM, Hochman PS. Alefacept, an immunomodulatory recombinant LFA-3/IgG1 fusion protein, induces CD16 signaling and CD2/CD16-dependent apoptosis of CD2(+) cells. The Journal of Immunology 2002; 168 (9): 4462-4471.
• 34. Smith CH, Anstey AV, Barker JN, Burden AD, Chalmers RJ, Chandler DA Finlay AY, Griffiths CE, Jackson K, McHugh NJ, McKenna KE, Reynolds NJ, Ormerod AD, 2011. Biologic Agents in Psoriazis: British Association of Dermatologists’ Guidelines for Biologic Intervention for Psoriazis 2009. In: British Association of Dermatologists’ Management Guidelines, 230-262.
• 35. Tüzün Y. Psöriasis Vulgaris. Dermatolog olmayanlar için Dermatoloji Sempozyum Dizisi 2012; 76: 9-36.
• 36. Taşǧin EE, Kalkan G, Ekşioǧlu HM, Vahaboǧlu G. Clinical and epidemiologic characteristics of patients with childhood psoriazis seen in dermatology clinic. Turk Dermatoloji Dergisi 2013; 7 (2): 81-86.
• 37. Van De Kerkhof PCM. The topical treatment of Psoriazis. Clinical and Experimental Dermatology 2005; 30(2):205-208.
• 38. Xing J, Hong-song Q, De-jun S. Clinical observations on 206 cases with lower limb deep venous thrombosis treated by integrated traditional Chinese and Western medicine.Chinese Journal of Integrated Traditional and Western Medicine 1997; 3 (4): 245-256.
• 39. Yorulmaz A, Metin A. Siklosporin. - Turkiye Klinikleri Journal of Dermatology Special Topics 2014; 7 (29): 19.
• 40. Zhu KJ, Zhu CY, Shi G, Fan YM. Association of IL23R polymorphisms with Psoriazis and psoriatic arthritis: A meta-analysis. Inflammation Research 2012; 61 (10):1149-1154.
• 41. Weigle N, McBane. Psoriasis. Am Fam Physician 2013; 87(9): 626-33.
• 42. Langley RGB, Krueger GG, Griffiths CEM. Psoriasis: epidemiology, clinical features, and quality of life Annals of the Rheumatic Diseases 2005.