**Treatment**

226 Psoriasis

Yazici A. C., Basterzi, A., Acar, S. T., Ustunsoy, D., Ikizoglu, G., Demirseren, D. & Kanik, A.

Yosipovitch, G., & Samuel, L. (2008). Neuropathic and psychogenic itch. *Dermatologic* 

*ISSN*:1300-2163.

*Therapy, 21*(1), 32-41. ISSN: 1529-8019.

(2006). Alopecia areata and alexithymia. *Turk Psikiyatri Derg, 17*(2), 101-106.

**12** 

*Italy* 

*University of Florence* 

**The Role of Immune Response and the Impact** 

Psoriasis is a chronic immune-mediated skin disease with a intricate pathogenesis and a strong genetic background (Nickoloff et al., 2007a), that affects approximately 1–3% of the worldwide population, with an equal sex distribution (Stern et al., 2004). The main type of psoriasis is chronic plaque psoriasis (Cpp) accounting for approximately 85–90% of all cases. The Cpp is characterized by erythematous scaly plaques, usually on elbows, knees, scalp and buttocks. Plaque size can diverge from minimal to the involvement of the entire skin surface (erythrodermic psoriasis) (C. E. Griffiths et al., 2007; Nestle et al., 2009). Other forms of psoriasis comprise guttate psoriasis, inverse, palmoplantar and generalized pustular

The concept of psoriasis as "the disease of healthy people" has long been surpassed, nowadays we know that during the time course of this disease, as a consequence of dysregulated immunity and ensuing inflammation, certain conditions may appear at somewhat unpredictable time points in a progressive fashion; these so-called comorbidities, although targeting different organs, share common pathogenetic factors. They often become manifest years after the onset of skin manifestations and are often observed in

Psoriatic Arthritis (PsA) is traditionally included among common co-morbidities, even if it should be rather considered a component of the clinical spectrum of psoriatic disease. PsA involves peripheral joints, the axial skeleton, sacroiliac joints, nails and enthuses, and is frequently associated with psoriatic skin lesions. The prevalence of PsA ranges from 5 to

Recently, co-morbidities like cardiovascular disease, obesity and metabolic syndrome have been found to be associated with psoriasis, raising the idea that psoriasis might not be only a

Psoriasis patients suffer also from considerable psychological and financial burdens resulting in a significantly impaired quality of life (Rapp, et al., 1999); likewise traditional systemic psoriasis therapies (methotrexate [MTX], cyclosporin A, retinoids or PUVA therapy) have a potential for long-term toxicity and cannot always provide plenty disease improvement (Pathirana et al., 2009; Smith et al., 2009). Thus, the development of agents efficiently targeting key steps in the pathogenesis of psoriasis and co-morbidities is clearly

40% among psoriatic patients lesions (D. D. Gladman, 2009; Nograles et al., 2009).

skin disorder (Gerdes & Mrowietz, 2009; Kimball et al., 2008a; Menter et al., 2008).

psoriasis (C. E. Griffiths & Barker, 2007; Nestle et al., 2009).

**1. Introduction** 

severe forms of psoriasis.

an important goal.

**of Biological Drugs in Psoriasis Patients** 

Amedeo Amedei and Mario Milco D'Elios
