Psoriasis is a long-term skin problem that causes itchy or painful patches of thick, red skin with silvery scales. The patches occur on the elbows, knees, scalp, back, face, palms, and feet, but can appear on other parts of the body. Psoriasis can sometimes be confused with a simple skin disease, but it is actually a chronic disease of the immune system. A problem with the immune system causes psoriasis. Normal skin cells gradually grow and shed about every four weeks, then new skin cells grow to replace the outer layers of skin as they shed. This chronic condition causes skin cells to grow too quickly and mature faster than the body can shed them, causing buildup. (WEBMD 2014) Psoriasis is a lifelong condition that can be controlled with treatment. It may go away for a long time and then return. With proper treatment it does not affect overall health. Psoriasis can last a long time or a lifetime. Symptoms come and go. Most types of psoriasis go through cycles. A patient with psoriasis may experience weeks or even months without symptoms, appearing to go into complete remission. Because psoriasis is a chronic disease, however, symptoms may return or worsen. Flare-ups of symptoms can be caused by external factors in the environment, known as triggers. Triggers affect everyone differently. Scientists believe that psoriasis is the result of several factors, including genetics, environmental factors, and the immune system. (MEDLINE 2014) While there are many theories about what the cause of this disease might be, no one is entirely sure why it occurs or what a possible way to cure it completely might be. Psoriasis is a non-contagious inflammatory skin disease. Cannot be transmitted from person to person....... middle of paper ......rotocol (Tight Control of Psoriatic Arthritis): a randomized controlled trial to compare intensive management with standard therapy in early psoriasis arthritis. The method is a randomized, controlled group study of 206 patients with early PsA. It will last for a period of 48 weeks. Patients assigned to the intensive group will follow a rigorous treatment protocol. The primary objective of the study is to compare intensive management with standard therapy in terms of the proportion of patients achieving an ACR 20 response at 48 weeks after randomization, in order to determine whether intensive management has superior clinical efficacy. The TICOPA study will provide direct evidence on whether the use of early, intensive treatment of psoriatic arthritis in routine clinical care leads to improved disease activity in patients and a reduction in radiological joint damage. (TICOPA 2014)