aetiology of psoriasis
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The aetiology of psoriasis seems to be multifactorial:
- genetic:
- about 30% of patients having one first degree relative with psoriasis themselves develop the disease; for patients having two infected first degree relatives, the figure is about 60%
- there are strong HLA associations (HLA CW6)
- note - environmental factors are important - monozygous twin studies
show a concordance rate of only 40 to 65%
- note - environmental factors are important - monozygous twin studies
show a concordance rate of only 40 to 65%
- infection:
- Streptococcal pharyngitis (1) - may cause guttate psoriasis, usually in children and young adults, and within 10-14 days; this pattern is associated with HLA-Cw6 in about 75% of cases
- AIDS/HIV (1)
- skin lesions identical to psoriasis may arise in patients with Reiter's
syndrome
- stress, e.g. moving house; examinations
- trauma:
- Koebner phenomenon - skin disease occuring in scars or sites of trauma
- well recognised in psoriasis (1)
- Koebner phenomenon - skin disease occuring in scars or sites of trauma
- well recognised in psoriasis (1)
- drugs:
- alcohol
- beta blockers
- non-steroidal anti-inflammatory drugs
- antimalarials, e.g. chloroquine
- mepacrine
- Lithium (1)
- Some treatment methods of psoriasis (e.g., anthralin and phototherapy) -
if treated with high initial doses (1)
- Smoking and alcohol (2)
Reference:
- 1. Schön M.P, Boehncke W.H. Psoriasis. NEJM 2005;352:1899-1912
- 2. Guillen S, Khachemaoune A. Photo quiz - Large, Silvery Plaques. AFP 2007;75(8)
Last edited 08/2019
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