Causes and Risk Factors of Plaque Psoriasis

Family History:

Having a close relative, such as a parent or sibling, with psoriasis significantly increases the risk of developing the condition. Studies suggest that individuals with one affected parent have a 10-25% chance of developing psoriasis, while those with two affected parents have an even higher risk.

Environmental Triggers:

Certain environmental factors can trigger the onset of plaque psoriasis or exacerbate existing symptoms. These include:

• • • Infections: Bacterial and viral infections, particularly streptococcal throat infections, are known to trigger psoriasis in some individuals. Streptococcal infection is especially linked to guttate psoriasis, but it can also trigger plaque psoriasis.
    • Skin Injuries: Physical trauma to the skin, such as cuts, scrapes, or burns, can trigger the formation of new psoriatic plaques at the site of injury. This response is known as the Koebner phenomenon.
    • Medications: Certain medications, including beta-blockers (used to treat high blood pressure), lithium (used in psychiatric disorders), and antimalarials, have been associated with triggering or worsening psoriasis.
    • Cold Weather: Cold, dry weather can exacerbate psoriasis by causing the skin to become dry and cracked, leading to more severe symptoms.

Stress:

Stress is a well-documented trigger for psoriasis flare-ups. High levels of stress can weaken the immune system and increase inflammation, leading to the onset or worsening of psoriasis symptoms. Conversely, the visible symptoms of psoriasis can cause psychological stress, creating a cycle that can be difficult to break. Managing stress through relaxation techniques, exercise, and counseling can help reduce the frequency and severity of flare-ups.

Lifestyle Factors:

Certain lifestyle factors can increase the risk of developing plaque psoriasis or exacerbate existing symptoms:

• • • Smoking: Smoking has been strongly linked to the development and severity of psoriasis. It is believed that the toxins in tobacco smoke contribute to inflammation and may trigger the immune system, leading to psoriasis. Smoking is particularly associated with pustular and palmoplantar psoriasis, as well as more severe forms of the disease.
    • Obesity: Obesity is a significant risk factor for psoriasis. Excess body weight can lead to increased inflammation, which may trigger or worsen psoriasis. Additionally, psoriasis plaques often develop in skin folds, where friction and sweat can aggravate the condition. Weight loss has been shown to improve psoriasis symptoms and reduce the risk of comorbidities such as cardiovascular disease.
    • Alcohol Consumption: Heavy alcohol consumption is associated with an increased risk of psoriasis. Alcohol can disrupt the immune system, leading to inflammation and potentially triggering psoriasis flare-ups. It can also interact with certain psoriasis medications, making them less effective or increasing the risk of side effects.

Hormonal Changes:

Hormonal changes, such as those that occur during puberty, pregnancy, or menopause, can influence the course of psoriasis. For example, some women experience an improvement in their symptoms during pregnancy, only to have a flare-up after giving birth. Conversely, menopause can sometimes lead to worsening symptoms due to hormonal fluctuations.

Comorbid Conditions:

Individuals with certain comorbid conditions, such as metabolic syndrome, diabetes, cardiovascular disease, and inflammatory bowel disease, have a higher risk of developing psoriasis. The shared inflammatory pathways between these conditions and psoriasis may contribute to this increased risk.

Age:

While plaque psoriasis can develop at any age, it is most commonly diagnosed in two age groups: between 15-35 years (early-onset) and between 50-60 years (late-onset). Early-onset psoriasis is often more severe and has a stronger genetic component than late-onset psoriasis.