Psoriasis and exposome: Unveiling the inner and the external contributors of psoriasis disease

Abstract

The term “exposome” encompasses all the environmental elements, both infectious and non-infectious, that an individual encounters throughout life. It refers to the collective exposure to various factors in the environment that can have an impact on human health and finally result in a disease or affect the disease course. The exposome is a term implicated in all skin diseases including psoriasis. Ranging from lifestyle habits such as diet, smoking, obesity, sunlight exposure, pre-existing diseases, and infectious agents’ exposure to patients’ unique features such as skin microbes, oxidative stress parameters, skin chemical environment, and cutaneous immune reactions, skin seems to encounter a variety of different exposures. All these exposures in turn affect and contribute in distinct ways to the pathogenesis pathways implicated in the creation of the psoriatic skin lesions and shape the disease course and progression. Also, the interaction between environmental and genetic factors is a well-established disease contributor. This chapter discusses the link between each aspect of exposome and psoriasis pathways and mechanisms as well as treatment plans taking into consideration environmental factors. Understanding the exposome–psoriasis relationship would lead to implications and targeted interventions to mitigate possible risk factors and give future directions.