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Recent insights into the immunopathogenesis of psoriasis provide new therapeutic opportunities
Brian J. Nickoloff, Frank O. Nestle
Brian J. Nickoloff, Frank O. Nestle
Published June 15, 2004
Citation Information: J Clin Invest. 2004;113(12):1664-1675. https://doi.org/10.1172/JCI22147.
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Science in Medicine

Recent insights into the immunopathogenesis of psoriasis provide new therapeutic opportunities

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Abstract

Chronic and excessive inflammation in skin and joints causes significant morbidity in psoriasis patients. As a prevalent T lymphocyte–mediated disorder, psoriasis, as well as the side effects associated with its treatment, affects patients globally. In this review, recent progress is discussed in the areas of genetics, the immunological synapse, the untangling of the cytokine web and signaling pathways, xenotransplantation models, and the growing use of selectively targeted therapies. Since psoriasis is currently incurable, new management strategies are proposed to replace previous serendipitous approaches. Such strategic transition from serendipity to the use of novel selective agents aimed at defined targets in psoriatic lesions is moving rapidly from research benches to the bedsides of patients with this chronic and debilitating disease.

Authors

Brian J. Nickoloff, Frank O. Nestle

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Figure 1

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Clinical and histological appearance of stable chronic psoriatic plaques...
Clinical and histological appearance of stable chronic psoriatic plaques. Note the well-demarcated erythematous plaques covered by white-silvery scale (arrows), widely distributed on the lower back and extremities. Prepsoriatic symptomless skin is clearly demarcated from lesional skin. Psoriasis often develops at skin sites where minor trauma may occur, such as elbows and buttocks. Induction of psoriatic lesions by trauma is referred to as the K_bner phenomenon. Insets: Histological appearance of prepsoriatic (symptomless) skin (upper left panel), with unremarkable epidermis and dermis, and rare mononuclear cells present predominantly in the dermis. By contrast, a chronic psoriatic plaque (lower left panel) reveals markedly thickened skin due primarily to accumulation of scale and elongation of rete ridges. In addition, there is loss of the granular cell layer, increased layers of epidermal keratinocytes, and an influx of lymphocytes, DCs, and macrophages into the dermis, accompanied by the presence of dilated and tortuous blood vessels.

Copyright © 2022 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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