JapaneseWhat is Psoriasis?
Psoriasis is one of the diseases categorized in the inflammatory keratosis. Psoriasis causes skin cells to produce faster than usual and the extra skin cells form thick silvery scales. It is a chronic condition that often comes and goes.
Thick silvery, scaly erythema repeats remission and exacerbation chronically.
Although there is a higher awareness of the disease in the US, there are only 0.02％～0.1％ of people who are diagnosed with psoriasis in Japan. Psoriasis is not well known in Japan, yet it has been seen daily in dermatological clinics.
Cause of Psoriasis and Goal of Treatment
Psoriasis is a chronic disease. The original cause has not yet been found, but it is thought to be from genetic institution, stress, eating habits, smoking, and other environmental effects. Recently, the mechanism of psoriasis has become understood: the inflammatory cytokines are involved in the main role. (Figure 1)
However, the initial cause of Psoriasis has not yet been revealed. Even though there has been progress in the development of valuable treatment for Psoriasis aiming to cure (or recover from) Psoriasis is difficult to achieve. Thus, most patients with Psoriasis need to live with the disease permanently. Our goal is to control and treat Psoriasis by lowering the side effects so that it has less effect on patient’s daily lives (remission).
【Figure 1】Pathology of immunology in psoriasis and action point of each biological formulation
Psoriasis Treatment
Some choices for treatment with Psoriasis include steroid ointment, Vitamin D3 ointment, ultraviolet light therapy, retinoid (Vitamin A derivative), immunosuppressive drugs, and injections using biological formulation. In our division, we suggest the best treatment for each individual case based on what will have lower side effects considering the symptoms, type of disease, lifestyle, and risk of complications.
Development in Treatment of Psoriasis
As we mentioned earlier, the development in Psoriasis treatment has progressed remarkably in the last few years. Especially the biological formation which has been able to be used since 2010, we achieved leading the remission of severe Psoriasis. (Figure 2)
Before
After
【Figure 2】Effect of biological formulation treatment
Currently, these products are available to buy; Anti-TNF-α antibody formulations such as Remicade® (from 2010) and Humira®（from 2010）, Anti-IL-12/23P40 antibody such as Stelara®（from 2011）, Anti-IL-17a antibody such as Consentyx®（from 2015）and Taltz®（from 2016）, Anti-Il-17ra antibody Lumicef®（from 2016）. Each individual medicine has both effect and inequalities between different diseases. Each medication is different in dosage regimen and dosing interval. We expect that new medications to treat Psoriasis will increase dramatically in the near future due to new inventions.