Psoriasis Vulgaris is the most common form (vulgaris means common) of Psoriasis. Psoriasis Vulgaris is a chronic, immune-mediated inflammatory skin disease which manifests as elevations or plaques of the skin that do not contain pus. The plaques are red or pink in colour and are covered by white or silvery scales. They may be thick or thin, large or small. Plaques appear most often on the elbows and knees and on the scalp. Psoriasis Vulgaris is associated with systemic disorders, including Crohn’s and IDDM. It is rarely life threatening but it does cause considerable psychological stress for patients.
Psoriasis Vulgaris presents with inflammatory infiltrate of leukocytes predominantly into the dermis and involves a cell mediated immune response. However the auto-antigen to which the immune response is directed has not been identified.
Population studies have shown that Psoriasis Vulgaris has a genetic component with relatives of patients at far higher risk of developing the disease than the general population. The risk of Psoriasis Vulgaris is up to three fold higher in monozygotic twins than in dizygotic twins.
The gene found by association studies to be most closely linked to Psoriasis Vulgaris and probably accounting for 35 – 50% of the heritable risk is HLA-C*06. Approximately 87% of Psoriasis Vulgaris patients carry this gene. Other non HLA genes which have shown association are functional polymorphisms in genes for factors that control inflammation such as TNFα.
Genetic testing, especially for HLA-Cw6 is a useful aid to diagnosis, although most diagnosis is done quite easily on the basis of the skin presentation.
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