Psoriasis is a chronic, immune-mediated inflammatory skin disease causing thickened, scaly plaques — typically on the elbows, knees, scalp and trunk. The immune system mistakenly activates T-cells that trigger excessive production of skin cells, completing the normal 28-day skin cell cycle in 3-5 days. The resulting buildup causes the characteristic scaling, redness and inflammation. It affects 125 million people globally and has a significant impact on quality of life, mental health and — through systemic inflammation — cardiovascular health.

Is psoriasis contagious?

No — psoriasis is NOT contagious and cannot be transmitted through touch, sharing items, swimming pools or any other contact. It is an autoimmune condition driven by the person's own immune system dysregulation. Persistent public misconception that psoriasis is infectious causes profound stigma — people with psoriasis frequently experience social exclusion, discrimination in employment, and reduced quality of relationships. WHO's 2014 WHA67.9 resolution explicitly called for tackling psoriasis stigma.

What triggers psoriasis?

Common triggers that provoke flares in people with psoriasis: infections (streptococcal throat infection — classically triggers guttate psoriasis); medications (lithium, beta-blockers, antimalarials, NSAIDs withdrawal of systemic corticosteroids); physical trauma (Koebner phenomenon — plaques at injury sites); stress (psychological stress triggers immune activation); alcohol; smoking; and obesity (adipose tissue releases pro-inflammatory cytokines). Identifying and avoiding individual triggers is an important part of management.

What types of psoriasis exist?

Plaque psoriasis (90%): classic raised, scaly plaques. Guttate psoriasis: small, drop-shaped plaques — often triggered by streptococcal infection in children and young adults. Inverse psoriasis: smooth, red plaques in skin folds. Pustular psoriasis: pus-filled blisters — can be localised or generalised (a medical emergency). Erythrodermic psoriasis: widespread skin redness and shedding — medical emergency requiring hospitalisation. Nail psoriasis: pitting, oil spots, onycholysis — present in 50% of psoriasis patients, 80% of psoriatic arthritis.

What are biologic treatments?

Biologic therapies — genetically engineered protein drugs targeting specific immune pathways — have transformed moderate-severe psoriasis treatment. TNF inhibitors (adalimumab, etanercept, infliximab) were first-generation. IL-17 inhibitors (secukinumab, ixekizumab, bimekizumab) are more effective. IL-23 inhibitors (guselkumab, risankizumab, tildrakizumab) are the most effective, achieving near-complete skin clearance (PASI 90+) in the majority of patients with 8-12 weekly injections. Small molecule options: apremilast (PDE4 inhibitor) and JAK inhibitors (deucravacitinib).

What is psoriatic arthritis?

Psoriatic arthritis affects approximately 30% of psoriasis patients — causing inflammatory arthritis in peripheral joints (hands and feet, with characteristic dactylitis — "sausage digits"), enthesitis (inflammation at tendon insertion sites — Achilles, plantar fascia), spine and sacroiliac joints, and nail changes. It can be seronegative (rheumatoid factor-negative). If untreated, it causes joint erosion and disability. Biologic therapies (TNF, IL-17, IL-23 inhibitors, JAK inhibitors) treat both skin and joint disease simultaneously.

How does psoriasis affect mental health?

Psoriasis has profound psychological impact: clinical depression affects approximately 30% of patients (double the general population rate); anxiety affects approximately 35%; and approximately 10% have reported suicidal ideation. The visible nature of plaques, stigma, chronic pain, sleep disruption and the burden of daily treatment all contribute. Treating psoriasis effectively improves mental health outcomes significantly. Screening for depression is an essential part of psoriasis management.

What is the cardiovascular risk in psoriasis?

Psoriasis — particularly severe, widespread disease — is an independent cardiovascular risk factor. Systemic inflammation from psoriasis promotes atherosclerosis, raising the risk of myocardial infarction by 25-50% and stroke by 30-40% in severe psoriasis. This risk is comparable to other chronic inflammatory conditions like rheumatoid arthritis. Aggressive treatment of psoriasis with systemic agents may reduce cardiovascular events. Cardiovascular risk assessment and management is an essential component of psoriasis care.

What non-biologic treatments exist?

Topical treatments (mild-moderate disease): potent corticosteroids (first-line), calcipotriol (vitamin D analogue), coal tar, salicylic acid. Phototherapy: narrowband UVB is highly effective and widely used. Systemic non-biologics (for moderate-severe): methotrexate (first-line, cheap); ciclosporin (rapid effect); acitretin (retinoid — for pustular psoriasis). Small molecules: apremilast (oral PDE4 inhibitor); deucravacitinib (TYK2 inhibitor). Biologics are reserved for inadequate response to conventional systemic therapy.

How does GMJ News cover psoriasis?

GMJ News covers WHO psoriasis resolution, biologic therapy trial data, psoriatic arthritis management, cardiovascular comorbidity evidence and stigma advocacy. Psoriasis is a significant dermatological and systemic condition in Georgia — relevant to PHIG's NCD strategy and the Georgian Medical Journal's clinical coverage.

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Psoriasis and Skin Disorders

GMJ News knowledge hub · last reviewed September 2026 · Georgian Medical Journal

Summary Statistics Glossary GMJ news FAQ Documents Organizations Research

Psoriasis — a chronic immune-mediated skin disease causing scaly plaques, joint inflammation and significant psychological burden — affects approximately 125 million people globally (2-3% of the population), making it one of the most prevalent non-communicable diseases and the most common immune-mediated skin condition worldwide (WHO). Beyond the skin, approximately 30% of people with psoriasis develop psoriatic arthritis — a potentially destructive joint disease — and psoriasis is associated with significantly elevated risks of cardiovascular disease, metabolic syndrome and depression. The biologic therapy revolution — IL-17 inhibitors, IL-23 inhibitors and TNF blockers — has transformed treatment outcomes for moderate-severe psoriasis.

Key messages

125 million people worldwide

Psoriasis affects approximately 125 million people globally (2-3% of the population) — the most common immune-mediated skin disease. It causes chronic, relapsing plaques of thickened, scaly skin with significant physical and psychological burden (WHO).

Immune-mediated, not infectious

Psoriasis is driven by dysregulated T-cell immune activation causing excessive skin cell proliferation — completing the normal 28-day skin cycle in 3-5 days. It is NOT infectious and NOT contagious — yet stigma from this misconception persists globally.

Psoriatic arthritis in 30%

Approximately 30% of people with psoriasis develop psoriatic arthritis — a potentially destructive inflammatory joint disease causing pain, stiffness and joint damage, particularly of the hands, feet and spine.

Biologic revolution

The development of biologic therapies — TNF inhibitors (adalimumab, etanercept), IL-17 inhibitors (secukinumab, ixekizumab), IL-23 inhibitors (risankizumab, guselkumab) — has transformed moderate-severe psoriasis treatment, achieving near-complete skin clearance in the majority of patients.

Cardiovascular and metabolic comorbidities

Psoriasis is independently associated with elevated risks of cardiovascular disease (heart attack, stroke), metabolic syndrome, type 2 diabetes, obesity, inflammatory bowel disease and depression — reflecting the systemic inflammatory nature of the condition.

WHO Resolution 2014

In 2014, WHO adopted Resolution WHA67.9 recognising psoriasis as a serious non-communicable disease with significant comorbidities and psychological impact, calling for member states to improve access to care and tackle stigma.

Key statistics

125M

people with psoriasis globally

WHO/IFPA

2-3%

of global population

WHO

30%

develop psoriatic arthritis

WHO/GRAPPA

60%

report condition has major life impact

WHO

>90%

skin clearance with IL-23 inhibitors

PASI 90 data/trials

2014

WHO WHA67.9 resolution on psoriasis

WHA

Psoriasis prevalence (%) by world region — WHO/published studies

Source: WHO. Psoriasis is more prevalent in colder, northern latitudes. Under-recognised in darker-skinned populations.

Glossary of key terms

Plaque psoriasis
WHO/AADThe most common form (90%) — characterised by well-demarcated, raised, erythematous plaques covered with silvery-white scales, typically on elbows, knees, scalp and trunk. Caused by excessive keratinocyte proliferation driven by Th17/IL-17/IL-23 immune axis.

PASI score
WHO/EDFPsoriasis Area and Severity Index — the standard clinical measure of psoriasis severity. Scores body area involvement (0-72), erythema, induration and scaling. PASI 75/90/100 responses (75/90/100% reduction) are standard clinical trial endpoints for biologic therapies.

IL-17 inhibitors
FDA/EMAMonoclonal antibodies targeting interleukin-17 — the key cytokine in psoriasis pathogenesis. Secukinumab (Cosentyx) and ixekizumab (Taltz) achieve PASI 90 responses in 65-80% of patients. More effective than TNF inhibitors for skin clearance.

IL-23 inhibitors
FDA/EMAThe most effective current biologics for psoriasis — targeting the p19 subunit of IL-23. Guselkumab (Tremfya), risankizumab (Skyrizi) and tildrakizumab (Ilumya) achieve PASI 90 in 75-85% and PASI 100 in 40-55% of patients. Given every 8-12 weeks.

Psoriatic arthritis (PsA)
WHO/GRAPPAInflammatory arthritis associated with psoriasis — affecting peripheral joints (hands, feet — dactylitis, enthesitis), spine (axial PsA), and nails. If untreated, causes joint erosion and disability. Biologics (TNF, IL-17, IL-23 inhibitors) treat both skin and joints.

Koebner phenomenon
DermatologyPsoriatic plaques developing at sites of skin trauma (cuts, burns, injections) — a characteristic feature reflecting the hyperreactive skin immune response in psoriasis.