Psoriasis is a chronic inflammatory skin disease which manifests itself in the most common form with red and scaly plaques generally distributed symmetrically on the elbows, knees and scalp but all areas of the skin, as well as the nails, can be affected . Psoriasis can occur at any age, but generally begins before the age of 40. It has a chronic relapsing pattern with phases of exacerbation alternating with phases of remission of variable duration. The disease results from an abnormal activation of the immune system which results in skin inflammation, proliferation of keratinocytes and formation of new vessels in the dermis. In less severe cases, topical treatments exist which consist of emollients, keratolytics, dithranol, tars, corticosteroids, vitamin D3 derivatives, retinoids and phototherapy. In the most serious cases, in addition to ciclosporin and methotrexate, the use of new generation drugs called "biological" is able to interfere with the pathophysiological mechanism of the disease. It is now certain that this autoimmune disease is associated with numerous comorbidities, which aggravate the patient's clinical picture and which are often underestimated by doctors. It is therefore important for the institutions to change their approach so that they consider the disease globally also for the purposes of effective financial management, as well as an improvement in the symptoms of the disease and a benefit to the patient's life.
La psoriasi è una malattia infiammatoria cronica della cute che si manifesta nella forma più comune con placche arrossate e squamose in genere distribuite in maniera simmetrica ai gomiti, ginocchia e al cuoio capelluto ma tutte le zone della cute, così come le unghie, possono essere colpite. La psoriasi può insorgere a tutte le età, ma in genere esordisce prima dei 40 anni. Ha un andamento cronico recidivante con fasi di esacerbazione alternate a fasi di remissione di durata variabile. La malattia deriva da un abnorme attivazione del sistema immunitario che si traduce in una infiammazione cutanea, proliferazione dei cheratinociti e formazione di nuovi vasi nel derma. Nei casi meno gravi esistono trattamenti topici che consistono in emollienti, cheratolitici, ditranolo, catrami, corticosteroidi, derivati della vitamina D3, retinoidi e fototerapia. Nei casi più gravi oltre la ciclosporina e il metotrexate, l’uso di farmaci di nuova generazione detti “biologici” è in grado di interferire con il meccanismo fisiopatologico della malattia. Si è ormai certi che a questa malattia autoimmune si associno numerose comorbidità, che aggravano il quadro clinico del paziente e che spesso vengono sottovalutate dai medici. È importante quindi un cambio di approccio da parte delle Istituzioni, affinché considerino la malattia globalmente anche ai fini di un’efficace gestione finanziaria, oltre che di un miglioramento della sintomatologia della malattia e un beneficio apportato alla vita del paziente.
"Psoriasi: diagnosi, trattamento e valutazione degli aspetti socioeconomici e psicosociali della patologia"
DEVITO, MARIANNA
2022/2023
Abstract
Psoriasis is a chronic inflammatory skin disease which manifests itself in the most common form with red and scaly plaques generally distributed symmetrically on the elbows, knees and scalp but all areas of the skin, as well as the nails, can be affected . Psoriasis can occur at any age, but generally begins before the age of 40. It has a chronic relapsing pattern with phases of exacerbation alternating with phases of remission of variable duration. The disease results from an abnormal activation of the immune system which results in skin inflammation, proliferation of keratinocytes and formation of new vessels in the dermis. In less severe cases, topical treatments exist which consist of emollients, keratolytics, dithranol, tars, corticosteroids, vitamin D3 derivatives, retinoids and phototherapy. In the most serious cases, in addition to ciclosporin and methotrexate, the use of new generation drugs called "biological" is able to interfere with the pathophysiological mechanism of the disease. It is now certain that this autoimmune disease is associated with numerous comorbidities, which aggravate the patient's clinical picture and which are often underestimated by doctors. It is therefore important for the institutions to change their approach so that they consider the disease globally also for the purposes of effective financial management, as well as an improvement in the symptoms of the disease and a benefit to the patient's life.È consentito all'utente scaricare e condividere i documenti disponibili a testo pieno in UNITESI UNIPV nel rispetto della licenza Creative Commons del tipo CC BY NC ND.
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https://hdl.handle.net/20.500.14239/17135