Pathophysiology
The major biological abnormalities in psoriasis are:
- Excessive production of skin cells (hyperproliferation), which leads to thickening of the epidermis and scaling
- Abnormal development of skin cells
- Inflammation
- Stimulation of growth of skin blood vessels.
Cell-mediated immune mechanisms appear to drive these processes. A growing understanding of this area has led to the use of biological agents, including adalimumab, etanercept, infliximab and ustekinumab for the treatment of moderate to severe psoriasis.