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Introduction
Psoriasis vulgaris is a systemic, chronic, inflammatory disorder that can be transmitted genetically and is provoked by environmental factors. It primarily affects the skin and joints. It is associated with other inflammatory disorders and autoimmune diseases (eg psoriatic arthritis, inflammatory bowel disease, coronary artery disease) and is characterized by recurrent exacerbations and remissions.
Epidemiology
Psoriasis is found in approximately 2% of the population. Its
prevalence ranged from 0.5-11% in adults and 0-1.4% in children.
In the
United States, the prevalence is from 51-79/100,000 cases. In Canada, the
prevalence differs by age ranging from 44-225/10,000 cases.
According
to the 2019 Global Burden of Disease (GBD) report, the prevalence of psoriasis
was approximately 129/100,000 cases in Southeast Asia. The prevalence in China
was consistently below 1% as reported by the Chinese Medical Association from a
survey in 2008 and the GBD in 2019. Several studies in India reported that the
prevalence in the country was around 0.4-2.8% affecting men more than women. A Korean-based study that utilized the Korean National Health Insurance
Database from 2011-2015 mentioned that the prevalence of psoriasis was 450/100,000
cases. In Malaysia, a study claimed that the prevalence was 2-6%.
Pathophysiology
Psoriasis is a complex immune-mediated inflammatory disease involving T lymphocytes, dendritic cells, and cytokines (eg interleukin [IL]-23, IL-17, and tumor necrosis factor [TNF]) causing hyperproliferation and abnormal differentiation of the epidermis, infiltration of inflammatory cells, and vascular dilatation in genetically susceptible patients.