Psoriasis can present at any age. However, the disease onset appears to follow a bimodal distribution, peaking around 20-30 years of age and again around 50-60 years of age.
Psoriasis is a common skin disease characterized clinically by formation of erythematous and scaly plaques at different sites affecting mainly the extensor prominences, scalp, the lumbosacral area and the sites of trauma. It is a lifelong disease with spontaneous remissions and exacerbations.
The exact etiology is unknown, but it is considered to be an autoimmune disease mediated by T lymphocytes. It is considered the most prevalent T-cell-mediated inflammatory disease in human beings, in which, keratinocytes in focal skin regions are stimulated to proliferate with activation of the immune system mediated by primed T-lymphocytes.
There is an association of HLA antigens seen in many psoriatic patients, particularly in various racial and ethnic groups. Familial occurrence suggests its genetic predisposition .
The pathophysiology of psoriasis involves infiltration of the skin by activated T cells which stimulate the proliferation of keratinocytes. This dysregulation in keratinocyte turnover results in the formation of thick plaques. Other associated features include epidermal hyperplasia and parakeratosis. There are several treatment options available for mild psoriasis, including topical corticosteroids, vitamin D analogs, calcineurin inhibitors, keratolytics, and targeted phototherapy.
More severe disease might require systemic therapy, including phototherapy, acitretin, methotrexate, cyclosporine, or biologic therapy. Psoriasis is accompanied by comorbidities such as obesity, diabetes, and metaboloic syndrome. Although the pathogenesis is still unknown, systemic inflammation caused by adipokines released from visceral adipose tissue is thought to play a role .
Adipokines are various bioactive polypeptides produced and released by adipose tissue. Adipokines are thought to play an important role in the pathogenesis of obesity-related diseases such as insulin resistance, hypertension, inflammation, and metabolic disorders.
Vaspin (visceral adipose tissue-derived serine protease inhibitor also called Serpin A12), It belongs to the serpin group of proteins and is a serine protease inhibitor produced from visceral adipose tissue.Vaspin consists of 415 amino acids and weighing 47-kDa .
Vaspin is an adipokine with recently described anti-inflammatory properties. It has been reported to be expressed in various tissues, such as skin, liver, stomach and pancreas, in addition to adipose tissue in humans . The main source of vaspin in human skin was found to be keratinocytes. Vaspin in the skin is associated with the differentiation of keratinocytes and suppresses the expression of inflammatory mediators.
