Psoriasis

Psoriasis – an autoimmune skin condition. It is a long-term (chronic) disease with no cure, in which the immune system becomes overactive, causing skin cells to multiply too quickly. Normal skin cells completely grow and shed in a month. Psoriasis skin cells, instead of shedding, on average over 7 to 14 days pile up on the surface of the skin.The skin’s appearance can vary from person to person: from patches of dry, cracked, thick red skin with silvery-white scales that itch or bleed with dandruff-like scaling, to major eruptions over much of the body of people with white skin, or to shades of purple with gray scale on people with brown or black skin. The affected skin might heal with temporary changes in color (post inflammatory hyperpigmentation), particularly on brown or black skin. Some people report that psoriasis plaques itch, burn, and sting. Plaques and scales may appear on any part of the body, although they are commonly found on the ears, eyelids, hands, nails, elbows, knees, feet and scalp. The symptoms of psoriasis can sometimes go through cycles, “flaring” for a few weeks or months followed by periods when it subsides or goes into remission. Psoriasis can come on suddenly or slowly. Many times, it disappears and then reactivates.
Many people who are predisposed to psoriasis may be free of symptoms for years until the disease is triggered by some environmental factor. Some common psoriasis “triggers” may include infections such as strep throat or skin infections, weather – especially cold dry conditions, an injury such as a cut or scrape, an insect bite, a severe sunburn, smoking/exposure to secondhand smoke, heavy alcohol consumption, certain medications including lithium, some high blood pressure drugs and anti-malarial drugs, and rapid withdrawal of oral or injected corticosteroids.
Scientists do not fully understand what causes psoriasis, but believe it involves a mix of genetics and environmental factors. Symptoms often start between ages 15 and 25 but it can start at any age, likely a family history of it, more common in adults, and affecting men and women equally of all skin colors. According to the World Psoriasis consortium 2% – 3% of the total population has psoriasis. Psoriasis is not contagious. Triggers vary from person to person and also its severity. There are several “types” of psoriasis, each of which varies in its signs and symptoms associated with a particular involved body part, and the skin’s appearance and the most likely “trigger.”
Having psoriasis carries the risk of getting other serious conditions, when psoriasis inflammation impacts other organs and tissues in the body. People with psoriasis may experience these health conditions, including: (a) psoriatic arthritis/PsA – a chronic form of arthritis that causes pain, swelling, stiffness of the joints and places where tendons and ligaments attach to bones, i.e., Achilles heel pain. The severity of the psoriasis increases the risk of developing this condition with one in three who may develop PsA. Some people can develop PsA before exhibiting skin lesions, but generally psoriatic arthritis typically occurs about seven to ten years after the symptoms appear on the skin. PsA often goes undiagnosed particularly in its milder forms. It is important to diagnosis and treat PsA early to help avoid permanent joint damage; (b) an increased risk of fatty liver disease – when there is too much fat in your liver; (c) cardiovascular disorders, i.e., heart disease, high blood pressure and stroke; (d) increased risk of getting certain cancers; (e) inflammatory bowel disease/Crohn’s disease; (f) osteoporosis; (g) imbalance of lipids in the blood (dyslipidemia) – elevated cholesterol; (h) uveitis -inflammation of the middle of the eye; (i) kidney disease, and; (j) metabolic syndrome occurs in approximately 20–50% of people with psoriasis and is more than twice the risk for those people who do not have psoriasis. This syndrome may possibly cause abdominal obesity, insulin resistance, type 2 diabetes and non-alcoholic liver disease/fatty liver.
The goal of treatment is to control symptoms – stop quick skin cell growth, remove scales and prevent infection. Treatment options include creams/ointments (topical therapy), light therapy (phototherapy), oral or injected medications, or a combination of modalities. Which treatment that is used depends on how severe the psoriasis is and how responsive it has been to previous treatment. There may be a need to try different drugs or a combination of treatments before an approach is found that manages each person’s condition.
If you suspect that you may have psoriasis, see your health care provider. Also seek medical care if your condition becomes severe, painful, increases, causes you concern about its appearance and/or doesn’t improve with treatment. This is a lifelong medical situation that needs regular doctor visits and review of treatment approaches.
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