A condition in which skin cells build up and form dander and dry itchy patches. Psoriasis is thought to be an issue with the immune system. Psoriasis triggers include infections, stress, and cold.
The most common symptom is a rash on the skin, but sometimes the rash affects the nails or joints.
The treatment aims to remove scales and prevent skin cells from growing so fast. Topical ointments, light therapy, and medications can provide relief.
What is Psoriasis?
Psoriasis is a chronic, non-contagious skin disease that produces patches of thickened, scaly skin. Dry flakes of silvery-white skin scales are the result of an excessively rapid overgrowth of skin cells. Psoriasis is a faulty inflammatory response. Skin cell proliferation is triggered by inflammatory chemicals produced by specialized white blood cells known as T-lymphocytes. Psoriasis typically affects the skin of the elbows, knees, and scalp.
The spectrum of this disease ranges from mild with limited involvement of small areas of skin to severe psoriasis with large, thick patches to inflamed red skin affecting the entire surface of the body.
Psoriasis is considered an incurable, chronic inflammatory skin condition. It has a variable course, improving and worsening eventually. It is not uncommon for psoriasis to go away on its own for years and remain in remission. Many people notice that their symptoms get worse during the colder winter months.
Psoriasis affects all races and both sexes. Although psoriasis can be seen in people of any age, from babies to the elderly, most often patients are first diagnosed in early adulthood. The self-esteem and quality of life of patients with psoriasis are often reduced due to the appearance of their skin. Recently, it has become clear that people with psoriasis are more likely to suffer from diabetes, high blood lipids, cardiovascular disease, and various other inflammatory diseases. This may reflect a lack of control over inflammation. Caring for psoriasis takes medical teamwork.
Types of Psoriasis:
There are five types of psoriasis:
The most common kind of psoriasis is plaque psoriasis. The American Academy of Dermatology (AAD) estimates that about 80% of people with this disease have plaque psoriasis. It causes red and inflamed spots that span the areas of the skin. These plaques are often covered with silvery whitish scales or plaques. These plaques are generally found on the elbows, knees, and scalp.
Guttate psoriasis is common in childhood. Guttate psoriasis type of psoriasis causes small pink spots. The most common sites for guttate psoriasis are the torso, arms, and legs. These patches are rarely thick or raised like plaque psoriasis.
Pustular psoriasis is more commonly found in adults. It causes white blisters filled with pus and large areas of red, inflamed skin. Pustular psoriasis is usually localized to smaller areas of the body, such as the hands or feet, but it can be widespread.
Reverse psoriasis causes bright areas of red, shiny, and inflamed skin. Patches of reverse psoriasis develop in the armpits or breasts, in the groin, or around skin folds on the genitals.
Erythrodermic psoriasis type of psoriasis is a severe and very rare type of psoriasis. This shape often covers large sections of the body at once. The skin looks almost burnt from the sun. The developing scales often break off in large sections or leaves. It is not common for a person with this type of psoriasis to have a fever or become very ill. This type can be life-threatening, so people should seek immediate medical attention.
Psoriasis Signs & Symptoms:
The signs and symptoms of psoriasis can vary from one to one. Common signs and symptoms include:
- Red spots of skin covered with thick, silvery scales
- Small scale removal spots (mostly seen in children)
- Dry, cracked skin that can cause bleed or itch
- Itching, burning, or pain
- Thickened, pitted, or ridged nails
- Swollen and stiff joints
Psoriasis plaques can range from a few dandruff-like scaly patches to major rashes that cover enormous areas. The most commonly affected areas are the lower back, elbows, knees, legs, soles, scalp, face, and palms.
Most types of psoriasis go through cycles, flaring up for a few weeks or months, then go away for a while or even go into remission.
- While the cause of psoriasis is still unclear, scientists believe it is an autoimmune disease.
- Autoimmune disorders affect the immune system, which produces T cells to protect the body from infectious agents.
- In people with psoriasis, triggers can cause their genes to tell the immune system to target the wrong cells. T cells respond to a trigger as if they were fighting an infection or healing a wound. They produce chemicals that cause inflammation.
- In psoriasis, this autoimmune activity results in excess growth of skin cells. Usually, it takes about 21-28 days for skin cells to replace themselves. However, in people with psoriasis, they take about 2 to 6 days.
- The triggers will be different for each individual with psoriasis, but common triggers include:
- stress and anxiety
- Skin Injuries
- Hormonal changes
- Medications that can trigger a flare-up of psoriasis include:
- Some people associate psoriasis with allergies, diet, and weather conditions, but no evidence has yet supported these theories.
- Importantly, psoriasis is not contagious. Knowledge can help people with dementia cope with the more difficult aspects of socialization.
Two tests or exams may be needed to diagnose psoriasis.
- The best physician can make a diagnosis with a simple physical exam. The symptoms of psoriasis are generally obvious and easily distinguished from other conditions that can cause similar symptoms.
- During this exam, be sure to show your doctor any areas of concern. Also, tell your doctor if any family members have the disease.
- If the symptoms are not clear or your doctor wants to confirm the suspected diagnosis, they may take a small sample of skin. This is known as a biopsy.
- The skin will be sent to a lab and examined under a microscope. The exam can diagnose the type of psoriasis you have. It can also rule out other possible diseases or infections.
- Most biopsies are done in your physician’s office on the day of your appointment. Your doctor will probably inject you with a local numbing medicine to make the biopsy less painful. They will later send the biopsy to a lab for analysis.
When the results come back, your doctor may request an appointment to discuss the results and treatment options with you.
There are many treatments. Some reduce the growth of new skin cells and some relieve itching and dry skin. Your doctor will select a treatment plan that is right for you based on the size of your rash, its location on your body, your age, your general health, and other things. Common treatments include:
- Steroid creams
- Moisturizers for dry skin
- Coal tar
- cream or ointment
- Retinoid creams
Treatments for moderate to severe psoriasis include:
- Light therapy: A Physician shines ultraviolet light on the skin to slow the growth of skin cells. PUVA is a treatment that combines a medicine known as psoralen with a special form of ultraviolet light.
- Methotrexate: This medicine can cause bone marrow and liver disease as well as lung problems, so it is only for severe cases. Doctors closely monitor patients. You will need to have lab tests, possibly a chest x-ray, and possibly a liver biopsy.
- Retinoids: Retinoids pills, creams, foams, lotions, and gels are a class of drugs related to vitamin A. Retinoids can cause serious side effects, including birth defects, so they are not recommended for women who are pregnant or who plan to have children.
- Cyclosporine: This drug is designed to suppress the immune system, can be taken for severe cases that do not respond to other treatments. It can damage the kidneys and increase blood pressure, so your doctor will closely monitor your health while you are taking it.
- Biologic treatments: These work by blocking the body’s immune system to better control the inflammation of psoriasis. Biologic drugs include adalimumab (Humira), brodalumab (Siliq), certolizumab pegol (Cimzia), etanercept (Enbrel), guselkumab (Tremfya), infliximab (Remicade), ixekizumab (Taltz), risankizumab-rzaIa (SKUKRIZA), tildrakizumab (Ilumya), and ustekinumab (Stelara).
- An enzyme inhibitor: The drug apremilast (Otezla) is a new type of medicine for long-term inflammatory diseases like psoriasis and psoriatic arthritis. It is a pill that blocks a specific enzyme, which helps slow down other reactions that lead to inflammation.
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