Advances in therapy make it possible to achieve complete remission of psoriasis in 50% of cases.

VALENCIA (EP). Psoriasis is a chronic and painful multifactorial disease that manifests itself as plaques, eczema or sores on the skin and for which there is no cure, although in nine out of ten cases complete remission of the disease is achieved. for which early attention and adequate and continuous treatment over time are necessary, as explained by dermatologist and coordinator of the psoriasis group of the Spanish Academy of Dermatology and Venereology (AEDV), doctor Jose Manuel Carrascosain an interview with Europa Press.

“The latest biological treatments provide better and more durable clinical results with very good safety. Therefore, today we can say that we can achieve, even in patients with serious diseases, up to 90 percent of achieving very good results, and “in more than half of the cases” patients achieve what we call “complete remission”, that is, the patient has no clinical manifestations, which does not mean that he is cured,” he assured.

According to Dr. Carrascosa, the prevalence of this disease is 2.3 percent, meaning “there are more than a million people with psoriasis in Spain.” Moreover, there is no cure because it occurs in people who are genetically predisposed to the disease, that is, they have various genes that cause them, after exposure to various triggers, to develop certain changes in the immune pathways that lead to psoriasis.

“Regarding this genetic predisposition, there is also a facial predisposition, but not only when spontaneously or after certain events such as infections, stress, when lesions appear, and therefore there are patients in whom episodes occur from time to time, but for most of them, the time we will see is persistence for years, decades, and sometimes throughout life,” the expert noted, assuring that “most patients have chronic and persistent forms of the disease.”

Regarding the most common manifestations of the disease, Dr. Carrascosa emphasized that “the most common is the formation of plaques, skin infections, sketchy and red, oozing, which can appear anywhere and can include formations from a limited area to a very large one.” In addition, this can be accompanied by the psychological impact that the disease has, as “there are things that the patient stops doing”, so it has a strong impact on their quality of life.

Being a disease of genetic and cutaneous origin, its manifestations can occur at different times in life, although the onset of psoriasis is “more common in younger patients, around the age of 20 to 30 years.” “Whereas for many patients this will be long-term, consistent use throughout their lives, because you have patients who will suffer from psoriasis for decades,” the doctor said.

New oral care products tailored to each patient

Currently, the treatment of psoriasis is varied, because while previously only anti-inflammatory treatments were available, which were effective “in some patients,” now research is directed toward biological treatments that are more specific to each patient, since “they are based on the pathogenesis of the disease.” is aimed at more specific and specific molecular targets,” the specialist explained.

“We have many types of biological therapies, the oldest ones are anti-TNF, anti-L17, anti-L23, and it is true that the newest, the most innovative, the latest, as they provide better and more durable clinical results with very good safety profile,” Dr. Carrascosa said.

However, much remains to be done in the treatment of psoriasis, since, according to the specialist, “some molecules are now being developed that, instead of a puncture, are administered orally, but which are also based on very specific pathogenic mechanisms. “about illness.”

Thus, the expert especially emphasized the importance of certain groups of cells, such as resident memory cells, which are part of the normal immune system and “are responsible for the generation of memory cells, that is, immune cells that remember this aggression and serve in fact to protect themselves.

“In chronic inflammatory diseases, these types of cells are the ones that, when they don’t work properly, remember the psoriasis inflammation because even if you treat the patient and the lesions heal when you stop treatment. So these recent memory cells have become a target for treatment , because it is believed that if we can eliminate these resident memory cells, we can achieve longer remissions, meaning the patient can go longer without lesions or, in some cases, we could even cure the disease,” he said.

Early detection: 30% of patients suffer from psoriatic arthritis.

One of the most common complications of psoriasis is arthropathy or psoriatic arthritis, which occurs in 30 percent of patients. Psoriatic arthropathy appears in people with psoriasis on average five to ten years after the onset of skin lesions, although it can occur before the onset of psoriasis.

“Psoriatic arthropathy consists of inflammation of the elements of the joint structure, which may include enthesopathy, that is, inflammation of the site of attachment of the tendon to the bone, where it usually begins and may be accompanied by arthritis itself, that is, inflammation of the joints, but also tenosinobitis, that is, inflammation of the tendons or dactylitis.” , he explained.

Thus, he warned that psoriatic arthropathy “can affect both peripheral joints, that is, the joints of the hands, feet, elbows, knees, as well as what is known as axial arthropathy, affecting the spine, anywhere and a particularly common one is sarogileitis, which occurs involvement of the sacral bones.

In this context, the dermatologist emphasized the importance of “early interception” of the disease, that is, “early diagnosis and treatment of psoriatic arthritis in patients with psoriasis, with the aim of preventing or minimizing joint damage and other associated symptoms.”

This early interception is possible thanks to tests such as ultrasound or early detection test, which can detect joint pain that does not yet have symptoms of psoriatic arthropathy. “It is important to detect this before joint inflammation or degeneration occurs because it can prevent the development of the disease in patients with prearthropathy and avoid all associated diseases,” he added.

“There are studies that show that patients with psoriasis who receive early biological treatment are less likely to develop psoriatic arthropathy. This is our proposal and our dream,” concluded Dr. Carrascosa.