Psoriasis

Psoriasis Galeno

The word "psoriasis" was used for the first time in the writings of Roman physician Galeno di Pergamo (133-200 AD); the term was used to describe an itchy rash that resembled seborrhoeic eczema more than the psoriasis we know today.

Arab physicians were the first to distinguish psoriasis from other diseases of the skin in the eighth century, and were also the first to use a form of psychotherapy to treat it.

Hieronymus

 

The most important work on skin diseases was written by Hieronymus Mercurialis (1530 - 1606), Professor of Medicine at the University of Padua and Bologna: De morbis cutaneis et omnibus corporis humani excrementis.

Mercurialis uses the term "lepra grecorum" to describe psoriasis, and "psora" for other skin diseases. 

Robert Willan - psoriasis


Robert Willan was an English dermatologist who published a book called "On Cutaneous Diseases" in 1808, in which he gives a modern description of psoriasis: "I think it is also necessary [...] to express the scaly psora by a distinctive appellation; for this purpose, the term psoriasis".

Psoriasis is traditionally defined as a dermatitis with chronic and relapsing course, which in its most common form manifests as erythematous scaly plaques on the extensor surfaces of the body. Prevalence in Italy is estimated at 2.8% with higher frequency in males; we can therefore estimate that approximately 1,500,000 Italians suffer from this disease.

Dystrophic changes inthe nails are observed in more than a third of patients, and a typical arthropathy (psoriatic arthropathy) is present in a variable percentage of cases: 8-30%

Recent evidence, however, seems to increasingly suggest that we should move away from the idea that psoriasis is a disease that affects the skin exclusively, to the perception that psoriasis is a systemic disease.

A wide range of co-morbidities may in fact be associated with psoriasis:

  • Arthropathy
  • Chronic inflammatory bowel diseases
  • Ocular diseases
  • Metabolic diseases
  • Psychological disorders

    We only treat psoriasis locally, with Calcipotriol+associated steroid - Dovobet gel - for mild forms, UVB TLO1 for medium severity, and for severe forms:

    • Methotrexate 10 -15 mg IM per week
    • Cyclosporine 3 - 3.5 mg per kg per day
    • Acitretin 25-35 mg daily

    When traditional systemic drugs are no longer effective against psoriasis, we will also consider using biological medication: Enbrel, Remicade, Humira, Stellara.

    Share by: