| CME ARTICLE |
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| Year : 2009 | Volume
: 54
| Issue : 1 | Page : 7-12 |
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Current concepts in the pathogenesis of psoriasis
Rajeev Patrick Das1, Arun Kumar Jain1, V Ramesh2
1 Institute of Pathology (ICMR), Safdarjang Hospital and Vardhman Mahavir Medical College, New Delhi, India
2 Department of Dermatology and Regional STD Centre, Safdarjang Hospital and Vardhman Mahavir Medical College, New Delhi, India
Correspondence Address:
Arun Kumar Jain
Institute of Pathology (ICMR), PB#4909, Safdarjang Hospital Campus, New Delhi - 110 029
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0019-5154.48977
Clinical trial registration None
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Psoriasis is a multi-factorial skin disease with a complex pathogenesis. Various factors which have been suggested to play a key role in the pathogenesis are T cells, antigen presenting cells (APC's), keratinocytes, Langerhans' cells, macrophages, natural killer cells, an array of Th1 type cytokines, certain growth factors like vascular endothelial growth factor (VEGF), keratinocyte growth factor (KGF), and others. It has been hypothesized that the disease starts with the activation of T cell by an unknown antigen, which leads to secretion of an array of cytokines by activated T cells, inflammatory cells, and keratinocytes. The characteristic lesion of psoriasis is due to the hyper-proliferation of the keratinocyte. Activated Langerhans' cells migrate from skin to lymph nodes presenting the antigen to nodal naοve T cells (cells that have not been activated by antigen previously). The T cells activated by non-antigen-dependent mechanism may, however, become antigen-specific memory cells that react with a cross-reactive auto-antigen such as keratin (molecular mimicry). The genetic background of the disease may be suggested from the fact that concordance rate is 63-73% in monozygotic twins, as compared to 17-20% in dizygotic twins. Several disease susceptibility loci have been suggested as predisposing factors, PSORS1-PSORS9. |
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