Our recent Psoriasis Awareness Month series told the story of three incredible women – Aimee, Jude and Reena – who have psoriasis, each providing their own experience and routine on how they manage the skin condition.
To round-off the series, we explored psoriasis from a different perspective: delving into the science behind this skin condition and reflecting on the latest research and developments.
To start, we spoke to Consultant, Medical and Surgical Dermatologist, Dr. Adil Sheraz who explains the condition and the affect it has on patients.
“Psoriasis is a chronic inflammatory, and proliferative disorder of the skin, that affects around 2% of the population. The most characteristic lesions consist of chronic, sharply demarcated, dull-red, scaly plaques, particularly on the extensor prominences (elbows and knees) and in the scalp.
“There are many types of psoriasis, and it is now thought of as being a systemic disease rather than just affecting the skin. It’s well known to cause issues with joints (psoriatic arthritis) where in about 10% of patients it will result in swollen, painful and occasionally deformed joints.”
“It is thought that psoriasis can often run in families, although the exact genetics of the condition are not fully understood. In fact, you are 28% more likely to have psoriasis if one of your parents is affected.
Yet, there has not yet been a concrete link between the skin microbiome and psoriasis. It even remains unclear if changes in the microbiome are a cause of psoriasis, or a consequence of it. It is believed that strain-level analysis of the microbiome is required to unpick these questions and determine the microbiome signatures of psoriasis. (Our recent discussion with Tom van den Bogert at BaseClear explores skin microbiome testing and strain versus species-level analysis).
Despite this, a link between the skin microbiome and atopic dermatitis or other innate immune system activations has been established in research. Dagnelie et al. (2019) references recent exploration into microbial dysbiosis and atopic dermatitis, acknowledging the potential for dysbiosis to trigger similar skin inflammation in other inflammatory diseases.
However, the research into immunological response and psoriasis is more developed, as Dr. Sheraz explains, which gives hope for new treatments for the condition.
“There have many advances in understanding the science behind the cascade of events in our immune system that result in the formation of psoriatic plaques and this in turn has led to incredible breakthroughs in treatments. New biologic treatments are continuously emerging.
 Mechanisms of microbial pathogensis and the role of the skin microbiome in psoriasis: A review. 2019. D. Lewis. [https://www.sciencedirect.com/science/article/pii/S0738081X19300112]