Psoriasis: Is it in the Mind?

Abstract

Psoriasis is a chronic, relapsing, multifactorial cutaneous disease which may severely affect quality of life. The worldwide prevalence is about 2%, but varies according to regions. Studies from Indian subcontinent have reported the prevalence range from 0.44 to 2.8%. It usually presents clinically as erythematous, indurated, scaly plaques over the skin. Nails and joints may also be affected. Various pathogenetic mechanisms have been implicated in Psoriasis. Role of stress, cytokine storm and genetics are fundamental aspects which form the basis of targeted therapies. Since stress and stress-related hormones promote serotonin (5-HT) synthesis, the potential involvement of 5-HT in psoriasis is speculated. Role of brain derived neurotrophic factor (BDNF), vascular changes in psoriasis, Substance P and their interplay has given directions for multiple therapeutic regimens.