Psoriasis is a chronic skin condition that is the result of a rapid buildup of skin cells that do not turn over like normal cells, resulting in the cells piling up the on surface of the skin. Psoriasis causes red, raised, dry and cracked scaly patches, and even blisters, to form on the skin. In some cases, psoriasis affects the fingernails, causing yellowing and small depressions. Psoriasis can be mild, moderate or severe, and, in most cases, causes itching and burning in affected areas or skin.
Research shows psoriasis is the result of an autoimmune disorder and people who get psoriasis tend to have a blood relative who has psoriasis. Not everyone who inherits the genes for psoriasis will have psoriasis appear. Psoriasis is not contagious. Exposure to a trigger may be the inciting factor for psoriasis to show. Common triggers include stress,infection, injury to the skin, smoking, strep throat, winter weather, sunburn, some medications and alcohol consumption. Although there is no cure, there are several treatments available to effectively relieve symptoms. In the United States, more than seven million men, women and children have psoriasis.
Causes of Psoriasis
Psoriasis is caused by a mistaken activation of a type of white blood cell called a T cell (T lymphocyte cell). Although T cells usually travel through the body to fight off viruses and other foreign substances, in patients with psoriasis, they attack healthy skin cells. This causes an increased production of healthy skin cells, which then build up on the surface of the skin, causing scaling and patches. The symptoms of psoriasis can worsen as a result of certain triggers, including the following:
Types of Psoriasis
There are seven different types of psoriasis, each causing different symptoms. Some types are more common than others. Although patients usually have only one type of psoriasis at any given time, another type can appear once the first has cleared.
Plaque Psoriasis
Plaque psoriasis is the most common type; it affects about 80 percent of psoriasis patients. It causes raised red lesions that are covered with silvery white scales, and usually appears on the elbows, knees, scalp and back.
Guttate Psoriasis
Guttate psoriasis usually begins during childhood or early adulthood. It causes small red spots to appear on the skin of the torso, arms and legs, and is associated with bacterial infections such as strep throat.
Inverse Psoriasis
Inverse psoriasis develops in the armpits or groin, under the breasts, or in other folds of skin. It manifests itself as bright-red lesions that can become irritated from sweat and friction. It is most common in overweight patients.
Pustular Psoriasis
Pustular psoriasis causes white, pus-filled blisters that are surrounded by red areas of skin. It is often triggered by medication, ultraviolet light, pregnancy or infection, and is most common in adults.
Erythrodermic Psoriasis
Erythrodermic psoriasis is the least common type of psoriasis. It often causes redness and scaling on the whole body, and can lead to serious illness if left untreated.
Nail Psoriasis
Nail psoriasis affects the nails, causing them to thicken and yellow, and develop small pits in the nail bed. Patients with nail psoriasis are likely to also have a fungal infection.
Psoriatic Arthritis
Psoriatic arthritis is a combination of psoriasis and arthritis. It can cause swelling, pain and discoloration of the joints, in addition to the skin-related symptoms of psoriasis. Psoriatic arthritis can occur with
Diagnosis of Psoriasis is performed by examination of the skin, nails and scalp by a dermatologist. In some cases, a biopsy may be performed to confirm the diagnosis.
Treatment of Psoriasis
Treatment for psoriasis focuses on clearing the skin of current symptoms. Treatments for the root cause of of psoriasis are intended to interrupt the abnormal cycle that has caused an increased production of skin cells. This can be achieved through injectable medications (biologics), topical treatment, oral medication, light therapies or a combination of the three.
Topical Treatment
Topical treatment for psoriasis usually includes the use of of corticosteroids, vitamin D or topical retinoids. These topical medications target inflammation, skin-cell growth and DNA activity to effectively treat the symptoms of mild-to-moderate psoriasis.
Light Therapy
Light therapy may be used in combination with topical treatments to slow the production of skin cells, and improve the overall appearance of the skin. Light therapy includes exposure to natural sunlight or narrowband ultraviolet-B light.
Systemic Medication
Oral and/or injectable medications may be prescribed for moderate to severe cases of psoriasis, or those that are unresponsive to other types of treatment. Prescription oral medications include apremilast (Otezla), retinoids, methotrexate or cyclosporine.
Biologics are systemic therapy that is usually administered by injection or infusion. The first biologic was FDA approved in 2003 and to date many options exist to treat psoriasis and psoriatic arthritis. A few of the biologics have research showing that they slow, stop or prevent joint damage. It may now be possible to prevent the lifelong disability that psoriatic arthritis can cause.
Patients with psoriasis can help relieve symptoms by keeping the skin clean and moisturized, covering the affected areas while sleeping, and avoiding catalysts such as stress, smoking and alcohol. By adhering to a doctor’s treatment plan and following the recommended home remedies, effective relief from psoriasis is possible.
