An immune-mediated disease that affects the skin. There are five types of psoriasis: plaque, guttate, inverse, pustular, and erythrodermic. The most common form, plaque psoriasis, is commonly seen as red and white hues of scaly patches appearing on the top first layer of the epidermis.
The symptoms of psoriasis vary depending on the type a person experiences. Some common symptoms for plaque psoriasis, the most common form of the condition, include the following:
Plaques of Scales: Or crust on the person's scalp.
Disorders of the Fingernails and Toenails: To include discoloration and pitting of a person's nails. The nails might also start to crumble or detach from the person's nail bed.
Plaques of Red Skin: Many times these are covered with loose and silver-colored scales. The lesions might be painful and itchy and sometimes crack and bleed. In severe instances, the plaques of irritated skin grow and merge into each other and cover large areas.
Psoriasis may also be associated with psoriatic arthritis, which leads to swelling and pain of a person's joints. The National Psoriasis Foundation has estimated that between 10-30% of people with psoriasis also experience psoriatic arthritis. Additional forms of psoriasis include:
Pustular Psoriasis: Pustular psoriasis is characterized by scaly and red skin on the palms of a person's hand or their feet with tiny pustules.
Inverse Psoriasis: Inverse psoriasis is characterized by bright red and shiny lesions that appear in skin folds such as in a person's groin area, armpits, or under a person's breasts.
Guttate Psoriasis: Guttate psoriasis many times begins in childhood or young adulthood and is characterized by small red spots, mainly on a person's limbs and torso. Triggers might be strep throat, respiratory infections, stress, tonsillitis, injury to the person's skin, and use of beta-blocker and anti-malarial medications.
Erythrodermic Psoriasis: Erythrodermic psoriasis is characterized by periodic redness of a person's skin and the shedding of scales in sheets. The form of psoriasis is triggered by withdrawal from a systemic psoriasis treatment, infection, severe sunburn, and certain types of medications. It requires immediate medical treatment because it has the potential to lead to severe illness.
People who suffer from psoriasis know that this uncomfortable and at times disfiguring skin disease can be difficult and frustrating to treat. The condition comes and goes in cycles of remissions and flare-ups over a lifetime. While there are medications and other therapies that can help to clear up the patches of red, scaly, thickened skin that are the hallmark of psoriasis, there is no cure.
Causes of Psoriasis
A number of factors, ranging from trauma and emotional stress to streptococcal infection, may cause episodes of psoriasis. Research indicates that some irregularity in a person's immune system is the main cause of psoriasis. Approximately 80% of people experiencing flare-ups reported a recent emotional trauma such as the death of a loved one or a new job. The majority of doctors believe external stressors serve as triggers for an inherited defect in immune function.
A skin injury and certain medications may aggravate psoriasis, to include certain types of blood pressure medications such as beta-blockers, common ibuprofen, and the anti-malarial medication hydroxychloroquine. Psoriasis tends to run in families, yet may skip generations. For example; a grandfather and his grandson might be affected, but the child's mother never develops the disease. While psoriasis may be stressful, the majority of outbreaks are fairly harmless. With proper treatment, the symptoms usually subside within a few months.
Treatment of Psoriasis
Unfortunately, there is no cure for psoriasis at this time. A number of types of treatment are available, to include products applied to a person's skin, oral medications, and phototherapy which may help to control psoriasis. Many people experience psoriasis that is mild and can be treated with skin products. In some instances, psoriasis may be difficult to treat if it is widespread and severe. Most psoriasis returns, even in milder forms.
The goal of treatment is to slow the rapid growth of skin cells that cause psoriasis and to reduce the inflammation associated with it. Treatment is based on the type of psoriasis a person has, its severity, location, the person's overall health and their age. It also depends on how much the person is affected by the condition, either physically because of factors such as joint pain, or emotionally because of frustration or embarrassment from a skin rash that might cover a visible or large area of their body.
Despite the fact that psoriasis is currently incurable, it does respond well to many systemic and topical types of treatments. People with severe psoriasis can obtain relief during flare-ups in around 85-90% of instances. Treatment for mild psoriasis, which is characterized by a few isolated raised patches, starts with skin care. Treatment includes keeping the person's skin moist. Basic treatment many times involves combining treatments and products a person can obtain without a prescription such as:
It is important for people with psoriasis to avoid the things that may trigger a flare-up or make their condition worse. Skin injury, stress, an infection, or alcohol use may all contribute to the flare-up of symptoms. Streptococcal infections, which commonly affect a person's upper respiratory tract, are also associated with guttate psoriasis. Effective treatment of psoriasis helps to improve a person's overall well-being and reduce the physical symptoms associated with psoriasis. A person might try prescription medicines if psoriasis is not relieved by over-the-counter products. Topical medications for treatment of psoriasis include the following:
A type of treatment referred to as, 'occlusion therapy,' might be effective for some people. The therapy involves first applying skin products such as medicated creams, moisturizers, or gels and the wrapping the person's skin with fabric, tape, or plastic. Occlusion helps to keep the area moist while increasing the effectiveness of medicated creams. It is important to communicate with a doctor before attempting occlusion therapy to ensure that it is performed safely.
Treatment using more than one type of topical medicine is often done. Doing so may help to prevent side-effects from some of the stronger medications. For example; a person may use one medicine during the week, but another one on the weekend. Creams, lotions, ointments, and other medications spread on a person's skin work better for some people than others. If one medication does not clear up psoriasis, a doctor will most likely advise another one, or a combination of treatments.