Plaque Psoriasis

What is
plaque
psoriasis?

Plaque psoriasis is a common, chronic, immune mediated condition1 that involves the skin and nails.2 Psoriasis vulgaris, or chronic plaque psoriasis, is the most common form of the disease, making up 85-90% of cases.3 Psoriasis is characterised by the presence of symmetrically distributed, red, well-defined plaques with a silvery surface scale.1 The scale is usually silvery white.1 Although any part of the skin can be affected by psoriasis, it most commonly occurs on extensor surfaces and scalp involvement is common.4 Evidence suggests that there is a strong genetic component (40-50% of patients have a family history of psoriasis).1 The basis for disease development is thought to be a complex interplay of genetic and environmental factors.5 Triggers include stress, trauma, smoking and alcohol.1

What is
the impact of
plaque psoriasis?

Psoriasis vulgaris, or chronic plaque psoriasis, is the most common form of psoriasis disease, making up 85-90% of cases.2 With psoriasis affecting 1.3-2.2% of people in the UK6, this means that at least 1.1% of the population have plaque psoriasis in the UK. In Ireland, 1.6% of the population have psoriasis7, meaning that the prevalence of plaque psoriasis is therefore around 1.4%.

Psoriasis is associated with an increased risk of cardiovascular events, metabolic diseases, including diabetes and psychological disorders, such as depression.5

How to diagnose and treat plaque psoriasis?

The diagnosis of plaque psoriasis is based almost exclusively on the clinical appearance of the lesions. Auspitz’s sign (i.e. multiple fine bleeding points when psoriatic scale is removed) may be seen in scaly plaques.9

Therapeutic options for plaque psoriasis include topical therapy (such as emollients), phototherapy, systemic non-biological therapy and systemic biological therapy.10

  1. Primary Care Dermatology Society (PCDS). Psoriasis: an overview and chronic plaque psoriasis. Available at: http://www.pcds.org.uk/clinical-guidance/psoriasis-an-overview. Accessed May 2019.
  2. WHO Report – Psoriasis. Available at: https://apps.who.int/iris/bitstream/handle/10665/204417/9789241565189_eng.pdf?sequence=1&isAllowed=ylast accessed May 2019
  3. Palfreeman, A. C., McNamee, K. E., & McCann, F. E. (2013). New developments in the management of psoriasis and psoriatic arthritis: a focus on apremilast. Drug design, development and therapy, 7, 201–210. doi:10.2147/DDDT.S32713
  4. DermNetNZ. Psoriasis. Available at: https://www.dermnetnz.org/topics/psoriasis/. Accessed May 2019
  5. FlatzL, Conrad C. Role of T-cell-mediated inflammation in psoriasis: pathogenesis and targeted therapy. Psoriasis Targets Ther2013;1–10.
  6. NICE. CG153. Psoriasis: assessment and management (October 2012). Available at: https://www.nice.org.uk/guidance/Cg153.  Accessed May 2019
  7. Irish Skin Foundation. Report: The Burden of Psoriasis. Available at: https://irishskin.ie/wp-content/uploads/2016/08/Burden_of_Psoriasis_Report_final.pdf.Accessed May 2019.
  8. Menter A et al (2018). Common and not so common co-morbidities of psoriasis. https://scmsjournal.com/wp-content/uploads/2018/07/4-Menter.pdf (last accessed May 2019)
  9. PathiranaD, Ormerod AD, SaiagCet al. European S3-guidelines on the systemic treatment of psoriasis vulgaris. J Eur AcadDermatolVenereol2009;23(Suppl2):5–70
  10. NICE Psoriasis Pathway. Available at: https://pathways.nice.org.uk/pathways/psoriasis#path=view%3A/pathways/psoriasis/topical-therapy-for-psoriasis.xml&content=view-index (last accessed May 2019)
MAT-21386 May 2019

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