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Ann Rheum Dis 64:ii30-ii36 doi:10.1136/ard.2004.031120
  • Psoriatic arthritis and psoriasis: classification, clinical features, pathophysiology, immunology, genetics

Psoriasis pathophysiology: current concepts of pathogenesis

  1. J G Krueger1,
  2. A Bowcock2
  1. 1Laboratory for Investigative Dermatology, Rockefeller University, New York, USA
  2. 2Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
  1. Correspondence to:
    J Krueger
    Rockefeller University, 1230 York Ave, New York, NY 10021 USA; jgkrockefeller.edu

    Abstract

    Psoriasis vulgaris is a common skin disorder characterised by focal formation of inflamed, raised plaques that constantly shed scales derived from excessive growth of skin epithelial cells. The disease is defined by a series of linked cellular changes in the skin: hyperplasia of epidermal keratinocytes, vascular hyperplasia and ectasia, and infiltration of T lymphocytes, neutrophils, and other types of leucocyte in affected skin. In a relatively short period, psoriasis vulgaris has been conceptualised as a T lymphocyte mediated autoimmune disease and new biological therapies that target T cells have just entered routine clinical practice. Similarly, rapid progress has been made towards dissecting cellular and molecular pathways of inflammation that contribute to disease pathogenesis. This short review presents current pathogenic concepts that have emerged from genetic, genomic, and cellular information obtained in basic studies and from clinical studies of selective immune targeting drugs.