Polygenic score
Influential genes: USP8,TRAF3IP2,RUNX3,DXO,SP140
The FLG gene, when it has a loss-of-function mutation, is a significant risk factor for atopic dermatitis, a common chronic inflammatory skin disorder
Psoriasis is an inflammatory skin disease characterized by itchy erythematous plaques. The course of the disease is chronic with acute flare-ups and periods of remission. The world prevalence is around 2-3% but it reached 11% in some Northern European countries.
There are several risk factors identified and the most significant one is genetics - there is a positive family history of psoriasis in 40% of cases. Other risk factors include smoking, obesity, alcohol, some medications (lithium, beta-blockers, antimalarial drugs), and infections. The diagnosis is based on the history and physical findings. The treatment includes many approaches like different creams, injections, light therapy, etc. There aren’t any definite preventive measures, but the symptoms can be improved and the number of flare-ups can be reduced.
Psoriasis is found worldwide but the prevalence varies among different countries and ethnicities. The worldwide prevalence is estimated to be 2-3% but it is reaching 8-11% in some Northern European countries.
There are multiple risk factors for psoriasis. The most important one is a family history of psoriasis and in addition to genetics various behavioral and medical conditions are linked to it. These are for example smoking, obesity, and alcohol use. Also, multiple drugs are associated with the worsening of this condition, the most commonly implicated drugs are beta-blockers, lithium, and antimalarial drugs. Infections (bacterial and viral) may be also associated with an aggravation of psoriasis.
There is a strong genetic linkage, around 40% of affected individuals have a positive family history of the disease. The genes that are linked to its development are MHC (major histocompatibility complex) and HLA (Human leukocyte antigen) genes, as well as IL23 genes.
The course of the disease is usually chronic with acute flare-ups and periods of remission.
Psoriasis has different forms and can have a different presentation depending on the affected area. The clinical subtypes of psoriasis include chronic plaque psoriasis, guttate psoriasis, pustular psoriasis, and erythrodermic psoriasis.
The most common form is chronic plaque psoriasis. It is characterized by symmetrically distributed itchy erythematous plaques. The scalp, extensor elbows, knees, and intergluteal cleft are commonly affected. It can be either a localized disease or a widespread one involving most of the body's surface.
Some special sites like nails, palms, and intertriginous areas (areas in which skin touches skin, e.g. the armpits) can be involved as well.
Psoriatic arthritis is common in patients with psoriasis, which typically presents as joint pain, joint stiffness, and back pain.
The diagnosis is based on the history and physical examination. If the findings are inconclusive, a skin biopsy can be performed.
The treatment options include creams and ointments (topical therapy, often containing steroids), light therapy (phototherapy), and oral or injected medication. The therapy choice depends on the severity of the disease and various combinations of these options can be used.
The prevention of psoriasis is not possible, however, there are some things you can do to relieve symptoms or help reduce the number of psoriasis flare-ups. These include taking daily baths, keeping the skin moisturized, avoiding triggers, and getting a small amount of sunlight each day.
Psoriasis is a chronic condition with no known cure. However, with appropriate treatment and management techniques, symptoms can usually be well controlled and allow patients to live normal lives. It doesn’t significantly influence mortality, but affects the quality of the affected persons life.
Atopic dermatitis is a chronic pruritic inflammatory skin disease. It occurs most frequently in children but can also affect adults. It has a chronic relapsing course over months to years. The majority of the patients are free of eczema by adolescence but in some cases it can persist.
The prevalence is estimated to be 15-20% in children and 3% in adults, but there is some variation among countries and ethnicities.[2]
The most important risk factor for developing atopic dermatitis is a family history of atopy (allergic rhinitis, asthma, or atopic dermatitis), and it is positive in 70% of affected individuals. There are several genes identified that are responsible for the development of eczema, for example, FLG gene involvement results in a defective epidermal barrier. Various environmental factors are linked to atopic dermatitis, these include climate, air pollution, some nonpathogenic microorganisms, water hardness and others.
The skin will be dry, itchy with red-brownish patches or small red bumps covered with fluid. Chronic scratching leads to skin thickening and fissures. Anybody part can be affected but there are also some regional variants: atopic hand eczema, eyelid eczema, atopic cheilitis (affecting lips), etc.
The skin is also really sensitive to various environmental stimuli like different allergens, irritants, pollution, humidity, microorganisms, and stress. It is also predisposed to various bacterial and viral skin infections.
The diagnosis is based on the history and physical examination of a patient. If the diagnosis is inconclusive, a skin biopsy can be performed. The blood lab results can also show increased IgE levels and eosinophilia.
The treatment consists of some emollients (moisturizers) to prevent the dryness of the skin. Various topical medications like corticosteroids, tacrolimus, and antihistamines can be used to reduce the inflammation.
The prevention mainly consists of keeping your skin moisturized, and avoiding triggers (sweat, detergents, soaps, stress, obesity, etc)
Seborrheic dermatitis is a chronic relapsing inflammatory skin disease. It occurs mostly in infants and adults, with a prevalence of 3% (clinically significant cases only).[3]
There are various risk factors identified. Age is one of them because seborrheic dermatitis is really common in newborns and infants. Immunosuppression (organ transplantation, cancer) also plays a big role. HIV patients have a much higher prevalence of seborrheic dermatitis (35%) and it’s even higher (85%) in AIDS. Other risk factors include various neurological and psychiatric diseases (Parkinson’s syndrome, epilepsy, eating disorders, depression), psoriasis, rosacea, and stress.
The severity varies but usually, it’s a mild form characterized by well-demarcated red plaques with greasy-looking yellowish scales. These lesions usually appear in areas that are rich in sebaceous glands such as the scalp, the external ear, the center of the face, the upper part of the trunk, and the intertriginous areas. When there is only a mild involvement of the scalp it can present as dandruff (diffuse, fine desquamation without inflammation).
The diagnosis is based on the history and physical examination. If the diagnosis is inconclusive, a skin biopsy can be performed.
The goal of therapy is to clear all the visible signs, reduce symptoms and prevent relapses. The available treatment options include topical antifungal agents, topical anti-inflammatory agents, and several topical agents with nonspecific antimicrobial, anti-inflammatory, or keratolytic properties. For the patients with moderate to severe presentation oral antifungals can be prescribed. In case of scalp involvement antifungal shampoos (Ketoconazole 2%) are used.
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