After more than a century of benign neglect, the epidermal keratinocyte is finally being recognized for its potential to initiate and propagate inflammatory/immunological skin diseases. In psoriasis, the keratinocyte, on activation, actively participates in a multicellular, multimolecular network coordinated by cytokines. This new appreciation and recognition of the central importance of epidermal keratinocytes, with its distinctive immunobiological capabilities apart from surrounding non-epithelial cell types, has occurred by using molecular biological techniques and refined morphological analysis to dissect each compartment (epidermis vs dermis) into their respective cellular constituents. By reassembling gene transcriptional and protein assessments with temporal-spatial interrelationships, and known functional properties of cytokines, chemotactic peptides, growth factors, and adhesion molecules, a coherent, biologically fascinating, mosaic view of the skin can be synthesized. In this review, the ramifications of these new discoveries in psoriasis are explored. The contemporary molecular view of the psoriatic skin microenvironment is dominated by an elevated and specific transcriptional activity on the part of hyperkinetic epidermal keratinocytes. The
Nickoloff BJ. The Cytokine Network in Psoriasis. Arch Dermatol. 1991;127(6):871–884. doi:10.1001/archderm.1991.01680050115015
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