Psoriasis is a long-term skin problem that causes itchy or painful patches of thick, red skin with silvery scales. The spots appear on the elbows, knees, scalp, back, face, palms and feet, but they can appear on other parts of your body. Psoriasis can sometimes be confused with just a skin condition, but it is actually a chronic disease of the immune system. A problem with your immune system causes psoriasis. Normal skin cells gradually grow and slough off about every four weeks, and new skin cells then grow to replace the outer layers of skin as they shed. This chronic condition causes skin cells to grow and mature too quickly and faster than the body can eliminate them, causing buildup. (WEBMD 2014)Psoriasis is a chronic disease that can be controlled with treatment. It can go away for a long time and then come back. With proper treatment, it does not affect your overall health. Psoriasis can last a long time, even throughout life. Symptoms come and go. Most types of psoriasis progress in 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, symptoms may return or worsen. Symptom flare-ups can be caused by external factors from the environment, called 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) Although there are many theories about the possible cause of such a disease, no one really knows why the disease occurs, or what could be the possible way to completely cure it. Psoriasis is a non-contagious inflammatory skin disease. It cannot be transmitted from person to person contact... middle of paper ...... protocol (Tight Control of Psoriatic Arthritis): a randomized controlled trial to compare intensive management with care standard in the early treatment of psoriasis arthritis. The method is a randomized controlled group trial of 206 patients with early RP. It will last a period of 48 weeks. Patients assigned to the intensive group will follow a strict treatment protocol. The primary objective of the trial is to compare intensive management to standard care in terms of the proportion of patients achieving an ACR 20 response at 48 weeks after randomization, to determine whether intensive management has superior clinical effectiveness . The TICOPA trial will provide direct evidence on whether the use of early, intensive treatment of PsA in routine clinical care leads to improvement in patients' disease activity and reduction in radiological joint damage . (TICOPA 2014)