Severe Psoriasis: What's Happening Inside Your Skin?
Featured in HEALTHCENTRAL
“Some medications, like beta blocks and lithium, can also trigger psoriasis, according to Divya Shokeen, M.D., a board-certified dermatologist based in Manhattan Beach, CA. These are "messenger molecules that immune cells use to talk to each other," says Dr. Shokeen. For some people with psoriasis, these cytokines can cause serious damage and discomfort. Cytokines are not created equal, and only a few-namely, IL-23, IL-17, and TNF-a-contribute to psoriasis. "IL-23 and IL-17 are now understood as the core drivers of plaque psoriasis," says Dr. Shokeen. "These have a closer connection to the severity, extent of lesions, and response to biologics." High levels of IL-23 stimulate the production of IL-17, which is a major cause of skin thickening, redness, and rapid cell turnover. Meanwhile, TNF-a is elevated in people with psoriasis, too, but plays a more general role in the body, fueling a wide variety of inflammatory conditions.”
