Conclusion

Psoriasis is a complex multifactorial immunemediated inflammatory condition of hyperproliferation. There appears to be a genetic susceptibility to the condition which is then triggered by one or more of a number of factors, which are often difficult to determine. There are a number of different clinical variants. The treatments for psoriasis are either topical or systemic. Topical treatments have very variable effects partly due to concordance with treatment issues, but also due to the fact that individuals do seem to respond in an individual manner to topical therapies. For those who do not respond to topical therapies provided in primary care, referral to specialist services is likely to be the next option. Systemic therapies are generally more effective; however, the older ones have significant side effects which can limit their usability. A new generation of biological therapies are now available to those with severe disease who have not responded to other systemic therapies. Health care professionals who work with patients with psoriasis must be aware of the potentially enormous impact that it has on mental health and quality of life issues. Readers are directed to Psychological and social aspects of skin care for further detail on this topic.