Infact, indipendently of the type of psoriasis (vulgaris, guttate, plaque, pustular, inverse, erythrodermic, arthritis.), no pharmacological therapy (keratolytics, lubricants, coal-tar, ichtamol, topical corticosteroids, narrow band UV treatment, topical vitamin D3 derivatives, PUVA, systemic cyclosporine, systemic metotrexate, systemic retinoids, hydroxyurea, fumaric acid esters, capsaicin, alefacept.) assures patients of a lasting recovery. These factors (streptococcal infections, drug use, alcohol, smoking, skin traumas (Koebner), psychological stress, climate, metabolic problems, hormones, oxidative stress, imbalanced diet etcetera) are significantly involved also in the more or less frequent relapses of psoriasis. In these cases, the onset of psoriasis requires the action of so called provocative factors, triggering the hereditary elements. When one parent or both parents have psoriasis, about 8% and 41% respectively of offspring develop psoriasis. The disease is rare in Blacks, Indians and Yellow race, whereas in Eskimos it is not found at all. The incidence of psoriasis in Europe and USA ranges between 1.5-2.5% and 0.7-2.0% respectively. There are at least two features that are thought to play some role: genetic predisposition and psoriasis triggers. Psoriasis is a complex, recurrent, inflammatory disease of unknown causation, involving immune attacks in skin with chronic inflammation and exuberant overgrowth of the outer layers of the skin.
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