Psoriasis

Definition

Psoriasis is a chronic (long-lasting) skin disease of scaling and inflammation.

Causes

Psoriasis is a skin disease driven by the immune system, especially involving a type of white blood cell called a T cell. Normally, T cells help protect the body against infection and disease. In the case of psoriasis, T cells are put into action by mistake and become so active that they trigger other immune responses, which lead to inflammation and to rapid turnover of skin cells.

In many cases, there is a family history of psoriasis. Researchers have studied a large number of families affected by psoriasis and identified genes linked to the disease. Genes govern every bodily function and determine the inherited traits passed from parent to child.

People with psoriasis may notice that there are times when their skin worsens, called flares, then improves. Conditions that may cause flares include infections, stress, and changes in climate that dry the skin. Also, certain medicines, including beta-blockers, which are prescribed for high blood pressure, and lithium may trigger an outbreak or worsen the disease.

The American Academy of Dermatology Association says psoriasis looks more violet or gray on darker skin.

According to the National Psoriasis Foundation approximately 1.3% African Americans are affected by this condition.

Symptoms

Psoriasis signs and symptoms can vary from person to person but may include one or more of the following:

• Red patches of skin covered with silvery scales
• Small scaling spots (commonly seen in children)
• Dry, cracked skin that may bleed
• Itching, burning or soreness
• Thickened, pitted or ridged nails
• Swollen and stiff joints

Psoriasis patches can range from a few spots of dandruff-like scaling to major eruptions that cover large areas. Mild cases of psoriasis may be a nuisance; more-severe cases can be painful, disfiguring and disabling.

Most types of psoriasis go through cycles, flaring for a few weeks or months, then subsiding for a time or even going into complete remission. In most cases, however, the disease eventually returns.

Exams and Tests

Occasionally, doctors may find it difficult to diagnose psoriasis, because it often looks like other skin diseases. It may be necessary to confirm a diagnosis by examining a small skin sample under a microscope.

There are several forms of psoriasis. Some of these include:

• Plaque psoriasis. Skin lesions are red at the base and covered by silvery scales.
• Guttate psoriasis. Small, drop-shaped lesions appear on the trunk, limbs, and scalp. Guttate psoriasis is most often triggered by upper respiratory infections (for example, a sore throat caused by streptococcal bacteria).
• Pustular psoriasis. Blisters of noninfectious pus appear on the skin. Attacks of pustular psoriasis may be triggered by medications, infections, stress, or exposure to certain chemicals.
• Inverse psoriasis. Smooth, red patches occur in the folds of the skin near the genitals, under the breasts, or in the armpits. The symptoms may be worsened by friction and sweating.
• Erythrodermic psoriasis. Widespread reddening and scaling of the skin may be a reaction to severe sunburn or to taking corticosteroids (cortisone) or other medications. It can also be caused by a prolonged period of increased activity of psoriasis that is poorly controlled.

Another condition in which people may experience psoriasis is psoriatic arthritis. This is a form of arthritis that produces the joint inflammation common in arthritis and the lesions common in psoriasis. The joint inflammation and the skin lesions don’t necessarily have to occur at the same time.

Treatments

Doctors often use a trial-and-error approach to find a psoriasis treatment that works. These include:

• Topical Treatments. Ointments or creams applied directly to the skin. These include corticosteroids, vitamin D3, retinoids, coal tar or anthralin.
• Light Therapy. Both natural light from the sun and artificial ultraviolet light can reduce symptoms. Light therapy should be administered by a doctor, since spending time in the sun or a tanning bed can cause skin damage and increase the risk of skin cancer.
• Systemic Treatment. Doctors may prescribe systemic treatment—medicines taken by pill or injection.
• Combination Therapy. Combining different treatments can prove more effective.
• Psychological Support. People with moderate to severe psoriasis may benefit from counseling or a support group.

Possible Complications

Depending on the type and location of the psoriasis and how widespread the disease is, psoriasis can cause complications. These include:

• Thickened skin and bacterial skin infections caused by scratching in an attempt to relieve severe itching
• Fluid and electrolyte imbalance in the case of severe pustular psoriasis
• Low self-esteem
• Depression
• Stress
• Anxiety
• Social isolation

When to Contact a Medical Professional

If you suspect that you may have psoriasis, see your doctor for an examination.

Preventions

There is no known way to prevent psoriasis. Keeping the skin clean and moist and avoiding your specific psoriasis triggers may help reduce the number of flare-ups.

Doctors recommend daily baths or showers for persons with psoriasis. Avoid scrubbing too hard, because this can irritate the skin and trigger an attack.

Natural Remedies

See the signs and seek relief from psoriasis, a common condition affecting the skin and often the nails. According to research or other evidence, the following self-care steps may be helpful:

What You Need To Know:

• Try topical creams Apply a cream containing 0.025 to 0.075% capsaicin four times a day to relieve itching and help heal sores
• Address your stress Learn stress-reduction techniques such as meditation to improve healing of sores
• Give aloe a go Improve skin-healing by applying a 0.5% herbal extract to affected areas three times a day
• Check out fish oil Capsules providing 1.8 to 3.6 grams of the supplement EPA (eicosapentaenoic acid) a day may improve symptoms

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading the full psoriasis article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.