The exact causes of psoriasis remain a mystery. However, there are certain factors which play an important role in triggering the disease. These include genetic disposition and a malfunctioning immune system.

Several other factors can also trigger the onset of psoriasis or cause the disease to flare up. These include:
- severe mechanical stimuli
- infections
- skin wounds
- certain medicines, such as drugs used to lower blood pressure (ACE inhibitors and beta blockers), pain relievers (ibuprofen, ASS and diclofenac), drugs for lowering cholesterol levels, drugs against rheumatism or malaria
- alcohol
- severe stress
- hormone fluctuations
- extreme fluctuations in weight
- obesity
- extraordinary mental or physical strain

The immune system is the main culprit in triggering the disease. During a psoriasis flare-up, the immune cells react in the same way as they would to a skin wound by sparking inflammatory reactions in the skin and accelerating skin renewal processes. This triggers production of abnormally high levels of new skin cells. Normally, the epidermis renews itself over a period of four weeks. In patients suffering from psoriasis, however, the process only lasts some three to four days.

 

The affected skin often itches. Scratching irritates the skin and can cause injury.

 

 

There are several different forms of the disease. The most common, however, is psoriasis vulgaris, which displays the following symptoms, among others:
- sharply defined patches of red, thick skin covered in shiny, silvery-white scales, also known as plaques
- patches of skin ranging from about the size of a coin to roughly palm-sized are affected
- Affected patches of skin are often spread symmetrically over both halves of the body
- dry, sensitive skin
- itchy, burning, sore skin
- bleeding

The nails are also often affected. In addition, comorbid conditions affecting internal organs such as cardiovascular disease or metabolic disorders may occur and have to be treated systemically. Roughly 30% of patients present with psoriasis arthritis. This is an inflammatory disease of the musculoskeletal system which affects tendons, joints, bones and soft tissue.

In addition to physical symptoms, many people with psoriasis suffer from discrimination and stigmatisation as their skin is visibly scaly and inflamed. This often causes them to withdraw, become isolated and fear rejection. In turn, this can trigger depression or other mental illnesses.


 

At present, research has not been able to find a cure for the disease. However, the symptoms of psoriasis respond well to targeted treatment. In some cases, they even clear up altogether.

Various options are available for treatment. The emphasis in the first instance is on what is known as local treatments, UV treatment, classic systemic therapies or immunotherapy.

The chosen form of treatment is selected in view of the type of psoriasis, the patient’s age and gender, the severity of the disease and other individual factors.

The most modern form of treatment is immunotherapy using biopharmaceuticals. Biopharmaceuticals are drugs produced using biotechnological methods which explicitly target the immune system’s abnormal reaction by blocking specific messenger substances known as interleukins which trigger and continue to fuel the inflammation.

The Psoriasis Centre at Universitätsklinikum Erlangen is part of the DZI and specialises in treating and carrying out research into psoriasis. With our experienced team, we offer patients the best possible care whilst working closely together with other departments. Patients may only need to attend the hospital as an outpatient for their treatment, or they might need to spend one or several days as an inpatient.

They are also offered special assistance in understanding and caring for their condition. We do not only focus on immediate patient care, however. In order to investigate the causes and new methods of treating the disease, we also conduct a number of clinical studies. The decision as to whether patients are suitable for participating in a study is taken on an individual case-by-case basis and in consultation with the patient’s doctors from the various specialist areas.

Do you have any questions on the treatment of psoriasis? Please feel free to get in touch with us by phone, e-mail or via our contact form.