Of all the stunning advances medical science has made over the past few decades, perhaps few are more pronounced than the treatment of psoriasis. In the 1950s, common remedies included arsenic, ammoniated mercury, and coal tar. In the ‘60s and ‘70s, heavy advertising promoted a “new healing discovery” called Tegrin, a coal tar product promising relief from “the heartbreak of psoriasis.” Methotrexate, the first breakthrough in systemic treatment, became common in the 1970s.
It’s just in the past two decades that advances in psoriasis therapy have greatly accelerated. Growing understanding of the genetic, immunological, and environmental factors that contribute to the condition’s pathogenesis have led to development of targeted, precision therapies that alleviate patient morbidity and improve quality of life, especially in patients with moderate to severe symptoms. These developments have produced life-changing results for those afflicted with this widely debilitating condition.
Psoriasis is a chronic skin disorder and the most prevalent autoimmune disease in the United States, affecting as many as 7.5 million Americans—and at least 100 million worldwide. A recent study of the disease’s burden estimated the annual direct and indirect costs of psoriasis as high as $25,796 per person, or about $135 billion annually. The disease is characterized by exaggerated and disordered epidermal cell proliferation and keratinization. Despite advances in our understanding of the disease, the precise chain of events that culminates in this aberrant keratinization remains unclear.
Although psoriasis itself does not often affect survival, it is associated with a variety of comorbidities that include psoriatic arthritis, metabolic syndrome, cardiovascular disease, Type 2 diabetes, inflammatory bowel disease, and depression. It also can seriously diminish patients’ quality of life. In fact, patients with psoriasis have a reduction in their quality of life similar to, or worse than, patients with other chronic diseases such as heart disease and diabetes.