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New Hope for Psoriasis Sufferers

Discovery of three genes linked to skin disease could usher in new treatments

TUESDAY, Nov. 11, 2003 (HealthDayNews) -- In a potential first step toward the development of new treatments for psoriasis, researchers have discovered genes that seem to make people susceptible to the mysterious skin disease.

No one is claiming a cure is near. But the findings, released this week, are raising hopes among doctors and patients alike.

"Psoriasis can be serious and life-altering. The research and medical communities are really stepping up to pay attention to this disease, and it's getting the attention it deserves," says Leslie Holsinger, chairwoman of the National Psoriasis Foundation's board of trustees.

Psoriasis causes red, scaly and itchy skin lesions, most often on the scalp, elbows, knees and lower back. It affects about 2 percent of the population in Western countries, and typically appears between the ages of 15 and 35.

"It's more than a cosmetic disease," Holsinger says. "It's quite painful and can be debilitating."

Up to 30 percent of people with psoriasis may have symptoms of arthritis, and 5 percent to 10 percent may have some functional disability from arthritis of various joints, the American Academy of Dermatology says.

Doctors acknowledge they don't fully understand the disease, but many suspect it is caused when the immune system becomes overactive and attacks the body's skin cells. What's unusual about the disease is that skin cells actually proliferate.

"Your epidermis becomes much thicker than normal, and you get this flaking and scaling," says study co-author Anne Bowcock, a professor of genetics at Washington University School of Medicine in St. Louis.

Gradually, the patches grow larger and scales form. While the top scales flake off easily and often, scales below the surface stick together. When they are removed, the exposed skin bleeds. These small red areas then grow, sometimes becoming quite large, the dermatology academy says.

Researchers have spent years trying to figure out if genes play a role in psoriasis. As part of the new study, scientists at several U.S. universities examined the genetic makeup of 242 families in northern Europe that had at least two infected members.

The new study linked dysfunctions in three genes to psoriasis. The genes appeared to not turn on and off in a normal way. But not everyone with the genes developed the disease, suggesting other genes play a role.

The findings appear in the Nov. 9 online edition of Nature Genetics.

It's also unclear how the genes cause psoriasis. Bowcock speculates the faulty genes may prevent the body from "down-regulating" the immune system, letting it run out of control.

"This is one of the first pieces of the puzzle," Bowcock says. "There's a lot more work to be done."

The new findings may lead to new treatments, which can't come soon enough for those with psoriasis, who often hide their disease or, in many cases, don't even realize what it is.

"Many people don't talk about their psoriasis," says Holsinger, who has the disease herself.

Holsinger, who works as a cancer researcher, often wears long-sleeves in summer to cover her psoriasis, even though she has let others know about her illness. "Many people who have psoriasis are embarrassed by it, and they don't want people to know about it," she adds.

More information

Learn more about psoriasis from the National Psoriasis Foundation and the American Academy of Dermatology.

SOURCES: Anne Bowcock, Ph.D., professor, genetics, medicine and pediatrics, Washington University School of Medicine, St. Louis; Leslie Holsinger, Ph.D., chairwoman, board of trustees, National Psoriasis Foundation, Belmont, Calif.; Nov. 9, 2003, online edition, Nature Genetics
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