Medical advances are coming at a fast and furious pace. One of the areas where researchers are making headway is in psoriasis research. Psoriasis has a storied past, and is still a disease that impacts patients in a very negative way. We take a look at the past, present and future of psoriasis research and what patients can expect.
Psoriasis has been with us long before Medicine was formalized into a proper discipline separated from ideas about divinity. Hippocrates, the father of medicine, had made observations about psoriasis nearly 2500 years ago in Ancient Greece.1 In a time when psoriasis was commonly confused with contagious illnesses like leprosy,2 effective treatments were sorely lacking.
Misunderstanding of psoriasis as a contagious disease was widespread throughout history, primarily due to the visible skin markings.3 Sadly, this ignorance is hardly “historical,” as this misunderstanding persists today. When psoriasis wasn’t associated with contagion, it was often attributed to allergies, malnutrition, or even poor hygiene. It was only in the 1960s that we also began to seriously investigate the idea that psoriasis may be an autoimmune problem. To say that times were terrible for psoriasis patients is a serious understatement.
Today, there is still no cure for psoriasis. Sadly, psoriasis still has a substantial impact on a patient’s quality of life. Even mild psoriasis can have damaging psychological effects for many. Psoriasis is also associated with obesity, type 2 diabetes, cardiovascular diseases, and a form of arthritis called psoriatic arthritis. Among the public, ignorance about the diseases is still widespread, and patients are still subject to various types of discrimination.4 There is still much work to do.
This said, patients today fare much better than in the past. Psoriasis has been with us for thousands of years, but it’s only in the last fifty years that our understanding of the disease and the options we have for managing it have expanded. Some of the recent game changers in psoriasis treatment include:
- Understanding the genetic factors that are involved in psoriasis
- Improved management using topical medications like corticosteroids
- The development of biological therapies
- Improvement of biologics – Interleukin inhibitors in particular
Today, patients can expect higher clearance and greater efficacy of treatments. Biologic medication remains expensive but is often covered for moderate to severe patients. Even in the last decade, dermatologists now expect 90% or even complete clearance, where 70% clearance would have been considered a success in the past. Dermatology has made great strides in psoriasis treatment.
It’s difficult to predict the future, especially today when knowledge is expanding at a pace that’s never seen before. However, we can make reasonable speculations about the direction we’re headed towards.
- Increased efficacy and less unwanted side-effects of topical medication, and general management and maintenance of psoriasis
- A more thorough understanding of the parts of the immune system at play in psoriasis and ways to turn these parts off without affecting the necessary components (currently the interleukin cytokines are being looked at)5
- Individualized medicine, with the potential to turn off the mechanism causing psoriasis – we’re presently looking at how this may be realized6
Psoriasis is a challenging disease, one that has a severe impact on the quality of life.7 It’s been misunderstood and mistreated in many ways in the past. Today, psoriasis patients fare much better and have access to a variety of safer and more effective treatments, and can look forward to much better results. It’s an exciting time for researchers and dermatologists as well, as we’re unlocking more and more knowledge about psoriasis.
2Which is somewhat ironic, as there is speculation that the genetics that may predispose to psoriasis (excessive innate immunity) may have been selected for by the presence of contagions like leprosy.