Is psoriasis a multifactorial condition?
yes. Psoriasis is a genetic condition caused by a cluster of genes (and not just by a single gene). It is triggered by environmental factors which may be external, such as changes in season or clothes rubbing on the skin, and internal, such as infectious diseases, emotional stress and certain types of medication.
Alongside these genetic and environmental factors, which confer an increased tendency to develop the condition, skin specific immune reactions can also appear, resulting in inflammation.
Psoriatic plaques result from epidermal cells being replaced more quickly than usual. In psoriatic skin, this process takes approximately a week, compared to one month in normal skin.
Psoriasis can appear at any age, but the first eruptions are most likely to occur between the ages of 10 and 30. It is a lifelong, unpredictable condition, with successive cycles of remission and relapse.
Although psoriasis is rarely life-threatening, it has a significant impact on quality of life. Since it is a chronic disease which is related to an unfavourable appearance it often leads to low self-esteem, impairment on well-being and, over time, depression.
People with psoriasis often experience difficulties in interpersonal communication, particularly when their lesions are visible. This is particularly the case for psoriasis on the face, scalp and hands.
The first eruptions of psoriasis, and the recurrent episodes, are often related to psychological trauma causing strong emotion (e.g. bereavement, relationship breakdown) or physical injuries (e.g. an accident, an operation).
Stress increases the likelihood of new eruptions, meaning that people with psoriasis can quickly find themselves trapped in a vicious circle.
The severity of the condition may be assessed primarily according to its impact on quality of life. Additional factors that determine the severity of psoriasis include susceptibility to treatment and the size of the area covered by lesions. In other words, a certain patient with psoriasis may suffer greater psychological distress than another whose lesions are more extensive or can be treated more easily.