ETIOLOGY, CLINICAL STAGING AND EVIDENCE-BASED TREATMENT APPROACHES FOR PSORIASIS

Psoriasis is a chronic immune-mediated inflammatory skin disease with systemic implications. It is no longer interpreted only as a cosmetic disorder or a simple disturbance of keratinization; contemporary dermatology defines it as a complex inflammatory condition in which genetic predisposition, environmental triggers, dysregulated innate and adaptive immunity, and metabolic comorbidity interact. The methodological basis of the article is a narrative synthesis of dermatology textbooks used in Uzbekistan and current international guidance from dermatology organizations and public health institutions. The results show that plaque psoriasis remains the most common clinical phenotype, but scalp, nail, inverse, guttate, pustular and erythrodermic variants require differentiated clinical thinking. Severity assessment should not rely only on the visible area of lesions; special-site involvement, pruritus, pain, quality-of-life impairment and symptoms of psoriatic arthritis must also be considered. Treatment follows a stepwise model: topical therapy for limited disease, phototherapy for more extensive or resistant cases, and systemic or biologic therapy for moderate-to-severe disease or functionally disabling involvement. The article concludes that effective psoriasis management requires early recognition, careful staging, comorbidity screening and patient-centered long-term control rather than short-term suppression of plaques alone.

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