Psoriasis has a certain chance of heredity, and is now considered to be one of the typical complex diseases and a polygenic hereditary disease, i.e. the disease may develop on the basis of heredity, but may also be affected by a variety of factors such as psychological factors, skin trauma, and internal and external environmental factors. Specifically, the causes of psoriasis vary, and even multiple triggering factors exist simultaneously in the same psoriasis patient.
The existence of a genetic factor in psoriasis is now recognized, which is confirmed by three studies.
First, a considerable number of patients are found to have psoriasis patients in their family members, i.e., genetic genealogy investigation. Domestic and international surveys report that patients with a family history of the disease are about 10% to 30%. In our long-term follow-up survey, there were 279 patients with a family history of psoriasis among 943 patients. The percentage was 29.5%. There were 32 patients with three consecutive generations of disease, among which 8 out of 25 patients with three generations of blood relations in one family had disease, but such cases are rare after all.
Second, a study was conducted to investigate the incidence of psoriasis in twins.
Third, studies on leukocyte blood groups have also proved the existence of a genetic factor for psoriasis.
Since the study of twin pairs and the study of leukocyte blood groups involve deeper theoretical expertise, they are not presented here. The results of these studies also support the existence of a familial predisposition to psoriasis.
It is well established that psoriasis has a genetic component, but the way in which it is inherited, whether the genetic material (genes) is single or multiple, where the genes are located and what its composition is, are among the many questions that have not been thoroughly studied. These problems are the hot spots of modern scientists’ research, and people expect to solve the problem of prevention and treatment of this disease completely through such research, but it is very difficult.
For patients and families, the main concern is whether the disease itself will continue to be inherited to the next generation. We say that the presence of genetic factors does not mean that the offspring must get psoriasis, and as mentioned above, the majority of patients do not have psoriasis in their families. Here we need to explain two issues, one, if you already suffer from psoriasis and there is no psoriasis patient in the family, you do not have to care too much about the existence of genetic factors, because how genetic factors work is an extremely complex issue, it is difficult to understand without a certain degree of professional knowledge. Secondly, if you have psoriasis, there is no need to worry too much about the offspring inheriting the disease, because the family with psoriasis in the offspring is after all a minority. Even if there are patients in the offspring, not every member has the disease, and the number of members with the disease is, after all, a minority. Besides, this is an objective existence, and worrying and fearing about it won’t solve the problem because there is no way for science to predict it yet. Besides, the fact that many psoriasis patients have never found psoriasis patients in their grandparents shows that healthy looking people do not necessarily have the genetic factors of the disease, and there is no guarantee that future generations will not have psoriasis patients, but of course the chances are less after all.
It is also important to note that there is a misconception that children born with psoriasis during the disease will be passed on to their offspring, and that children born after the disease has been cured will not be hereditary. This is a misconception. The hereditary factors carried by the patient will not be changed by whether the disease is cured or not. On the contrary, many drugs used to treat psoriasis have teratogenic effects, and if pregnancy occurs immediately after the lesions have subsided due to treatment with such drugs, there is a risk of producing a malformed fetus, which is not desirable.
Here are some cases for patients to share.
1. Can a couple who both have psoriasis get pregnant?
Answer: This question is a bit complicated. First of all, we need to understand that although genetic factors are important in the development of psoriasis and may play a small part in the development of psoriasis, which means that children born to psoriasis patients may have a higher risk of psoriasis than children born to non-psoriasis patients, it does not mean that children born to psoriasis patients will definitely develop psoriasis. At present, although a lot of results have been achieved in research on the genetic factors of psoriasis, the specific contribution of genetic factors in the development of psoriasis has not yet been fully explained, and scientists in various countries are working intensively on it. China has been in the forefront of the world counterparts in the research of psoriasis genetics, but there is still a long way to go before the genetic mechanism of psoriasis is completely revealed.
Theoretically, if both husband and wife suffer from psoriasis, their children will have a higher chance of developing psoriasis than children born to normal couples. Some individual studies have found that if a single parent suffers from psoriasis, the chances of their children developing psoriasis is about 16%, while if both parents suffer from psoriasis, the chances of their children developing psoriasis is about 50%, however, the results of this study have been questioned by many parties because environmental factors also play an important role in the development of psoriasis, and both couples are in the same or similar environment may also have an impact on the development of psoriasis in their children, and even the children and their parents These factors may also contribute to the development of psoriasis.
So, is it possible for a couple to become pregnant when both of them have psoriasis? This question should be decided by the couple; our laws do not provide for it, and psoriasis itself is not a category of disease that cannot be conceived under the law. Although the possibility of psoriasis occurring in the children of a couple who both have psoriasis is theoretically higher, pregnancy is not prohibited.
2.Is psoriasis not hereditary once it is cured?
Answer: Mr. Zhang, an employee of a company, accompanied his newly married wife with psoriasis to the clinic one day. As his wife’s skin lesions were not much, Mr. Zhang hoped that we could cure his wife’s disease quickly and they were going to have a child so that the disease would not be inherited to their future child. After hearing this, as a doctor, I had to put down my pen and tell the couple what heredity is all about.
The underlying cause of genetic disease, no matter which type, is that the genetic material is faulty, and this faulty genetic material, along with other normal genetic information, is passed from parent to offspring in different ways, and whether or not the disease develops in the offspring is influenced by a variety of factors. In the process of genetic material transmission, it is possible that the faulty genetic information is not passed on, or is partially passed on, and the onset of disease in the offspring depends on the strength of the faulty genetic material, and if the strength of the genetic material is low, a large amount of similar or synergistic genetic material is required to have a certain effect. The accumulation of a certain amount of genetic material in time, but the subsequent development of the disease requires the involvement of some acquired factors, which are most evident in the so-called complex diseases or polygenic diseases. Psoriasis is one of these diseases and belongs to the category of complex diseases, or diseases with polygenic inheritance patterns.
The occurrence of psoriasis is not only the cumulative effect of multiple genes, but is also influenced by environmental factors. Therefore, according to the characteristics of heredity, information about the disease is likely to be passed on to the next generation, and it can be said that psoriasis is inherited, and the disease often shows a family history. However, acquired factors also play an important role, and many people, even with a family history, will remain psoriasis-free for the rest of their lives. Psoriasis vulgaris is not a barrier to pregnancy or childbirth. Moreover, during pregnancy, most of the rashes of psoriasis vulgaris can be reduced or even subside, due to the increase in the level of corticosteroids in the body.
Mr. Zhang’s notion that if the disease is cured, it will no longer be inherited is wrong. The existence of genetic material cannot be changed by our common treatment methods. Whether the disease is treated or not, the chance of its inheritance to our offspring still exists and is not subject to our will.
Psoriasis is a skin disease and there are no barriers to marriage. Psoriasis is a polygenic hereditary disease, as polygenic hereditary diseases occur not only due to the role of genes but also due to environmental factors. According to the available studies, it is confirmed that many people can go their whole lives without psoriasis if they have normal immune function, even with a family history. Interestingly, a large number of studies have shown that the majority of rashes with psoriasis vulgaris tend to diminish or even fade during pregnancy. Of course, a small percentage of patients still have a rash that persists or worsens during pregnancy. For non-severe types of psoriasis, pregnancy is not a problem. It is important to note that some patients who are using medications that affect the fetus due to their condition should decide on the period of pregnancy and childbirth after fully consulting your doctor if there is a teratogenic risk of pregnancy.