A perspective of psoriasis as an aberration in skin modified to expression by the inflammatory/repair system.

Evidence has been presented which shows that psoriasis is a disease with inherent aberrations in the skin. The consistently observed aberration in skin is excess proliferation of cellular constituents, particularly the epidermis. This occurs independent of overt inflammatory/repair processes. Evidence is presented to suggest that regulatory factors are present in this disease and affect disease expression on a bodywide basis, and therefore would appear to be circulating. Further, without inflammatory/repair processes possibly unique to patients with psoriasis, clinical lesions of psoriasis are not present and the multitude of abnormalities reported to be present in the inflammatory/repair system are secondary. Finally, the thesis is proposed that in psoriasis, the increased cell turnover status of skin is proinflammatory; the body attempts to regulate this, usually without total success; and the chronic attempts to regulate the disease are frequently broached by exogenous factors.