| Sažetak | Psorijaza je upalna multifaktorijalna bolest kronične prirode koja može biti klinički heterogena. U preko 80 % pacijenata bolest se prezentira kao plak psorijaza, međutim može biti i kapljičasta, eritrodermijska, pustularna i artropatska. Psorijaza je obilježena opsežnom upalom, proliferacijom i poremećenom diferencijacijom epidermisa. Psorijatični plakovi se obično nalaze na vlasištu, donjem dijelu trupa i ekstenzornoj površini ekstremiteta, a obilježava ih dobra ograničenost, simetrična pojava, eritem, infiltracija i ljuskanje. U procjeni težine bolesti najčešće se koriste sustavi bodovanja BSA, PASI i DLQI. Dijagnoza se uobičajeno postavlja detaljnom anamnezom i fizikalnim pregledom, a iznimno i biopsijom. U pacijenata je potrebno utvrditi prisutnost komorbiditeta, a u nekim slučajevima razmišljati i o diferencijalnoj dijagnozi psorijaze. Tradicionalno se patogeneza psorijaze opisuje kroz fazu inicijacije i fazu održavanja bolesti. Već su 80-te i 90-te godine prošlog stoljeća donijele spoznaju o psorijazi kao imunosno posredovanoj bolesti, iz čega je uskoro proizašao razvoj biološke terapije. Biološka terapija psorijaze donijela je značajne pomake u terapiji umjereno teške do teške plak psorijaze. Danas se u terapiji psorijaze koriste lijekovi iz skupina inhibitore TNF-α, inhibitora IL-17, inhibitora IL-23, inhibitora IL-12 i -23 te inhibitora IL-36, dok se aktualno ispituju i novi lijekovi. |
| Sažetak (engleski) | Psoriasis is a chronic inflammatory multifactorial disease that can be clinically heterogeneous. In over 80 % of patients, the disease is presented as plaque psoriasis, but it can also be guttate, erythrodermic, pustular and arthropathic. Psoriasis is characterized by extensive inflammation, proliferation and impaired differentiation of the epidermis. Psoriatic plaques are usually found on the scalp, lower trunk, and extensor surfaces of the extremities. They are characterized by well-defined, symmetrical appearance, erythema, infiltration, and scaling. BSA, PASI and DLQI scoring systems are most often used to assess the severity of the disease. The diagnosis is usually established by a detailed history and physical examination, and exceptionally by a biopsy. In patients, it is necessary to determine the presence of comorbidities and, in some cases, to think about the differential diagnosis of psoriasis. Traditionally, the pathogenesis of psoriasis is described through the initiation and maintenance phases of the disease. Already in the 80s and 90s of the last century, psoriasis was already recognized as an immune-mediated disease, which soon led to the development of biological therapy. Biological therapy for psoriasis has brought significant advances in treating moderately severe to severe plaque psoriasis. Today, drugs from the group of TNF-α inhibitors, IL-17 inhibitors, IL-23 inhibitors, IL-12 and -23 inhibitors, and IL-36 inhibitors are used in psoriasis therapy, while new drugs are currently being tested. |
