Psoriasis. For some sufferers, it is irritating, embarrassing, depressing and difficult to deal with. However, it is a very common skin condition, that affects almost 7.5 million Americans in some form. Psoriasis is a chronic, autoimmune disease that appears on the skin. It can affect most any age, but onset is usually starts between the ages 15-35. Although it looks as if it is contagious, it isn’t. It is usually a genetic factor passed down in families.
With plaque psoriasis, the most common form, particular immune cells are activated, producing too much of a protein called tumor necrosis factor (TNF). This protein causes skin cells to grow too quickly. The cells build up and form raised, red patches with a silvery scale, known as plaques. Normally, skin cells, which grow deep in the skin, rise to the surface about once a month, but with psoriasis, this process happens about every two weeks.
There are five types of psoriasis. All types can occur on any part of the body and are associated with other serious health conditions, such as diabetes, heart disease, eye inflammation, arthritis and depression. The five types are:
1. Plaque Psoriasis (psoriasis vulgaris) is the most common form of the disease. About 80 percent of psoriasis patients have this type. It is characterized by raised, inflamed, red lesions covered by a silvery white scale. It is typically found on the elbows, knees, scalp and lower back.
2. Guttate [GUH-tate] psoriasis often starts in childhood or young adulthood. The word “guttate” is a Latin word meaning “drop.” This form of psoriasis appears as small, red, individual spots on the skin, usually on the trunk and limbs. Normally, these spots are not as thick as plaque lesions.
Guttate psoriasis often comes on quite suddenly. A variety of conditions can bring on an attack of guttate psoriasis, including upper respiratory infections, streptococcal throat infections, tonsillitis, stress, injury to the skin and the administration of certain drugs.
3. Inverse psoriasis is found in the armpits, groin, under the breasts and most other skin folds. This type of psoriasis appears as bright-red lesions that are smooth and shiny. Inverse psoriasis is subject to irritation from rubbing and sweating because of its location in tender areas. It can be more troublesome in overweight people or those with deep skin folds.
4. Pustular psoriasis is characterized by white blisters of non-infectious pus (containing white blood cells) surrounded by red skin. Pustular psoriasis, seen mostly in adults, can be either localized to certain areas of the body, or to the extreme covering most of the body. It begins with reddening of the skin followed by formation of pustules and scaling.
Pustular psoriasis may be triggered by internal medications, irritating topical agents, overexposure to UV light, pregnancy, systemic steroids, infections, stress and sudden withdrawal of systemic medications or potent topical steroids.
5. Erythrodermic [eh-REETH-ro-der-mik] psoriasis is a particularly inflammatory form of psoriasis that affects most of the body surface. Periodic, widespread, fiery redness of the skin and the shedding of scales in sheets, rather than smaller flakes, characterize it. Severe itching and pain, heart rate increase, and fluctuating body temperature often accompany the reddening and shedding of the skin.
Psoriasis is not curable; however, it is controllable with medication, and there are many new therapies, including biologic drugs, that will give a patient longer periods of clear skin.
For mild psoriasis affecting less than 10 percent of the total skin surface, topical creams, lotions and sprays may prove be very effective. Occasionally, a small local injection of steroids directly into a resistant patch of psoriasis plaque may be needed.
For moderate to severe psoriasis involving much larger areas of the body (20 percent or more of the total skin surface) topical products might not be effective. Treatment might require ultra-violet light treatments or systemic medications. Internal medications usually have greater risks.
Other types of medications that have proven to help relieve irritation and reduce redness and inflammation are:
• Topical corticosteroids (steroids, such as hydrocortisone) are very useful and usually the first line of treatment for limited or small areas of psoriasis. These come in many preparations, including sprays, liquid, creams, gels, ointments and mousses.
• Calcitrol , a vitamin D analogue cream.
• Moisturizers, especially with therapeutic concentrations of salicylic acid, lactic acid, urea and glycolic acid. These moisturizers are available as prescription and OTC (over the counter) forms. They help to moisten and lessen the appearance of thickened psoriasis scales.
• Bath salts or bathing in high-salt-concentration waters like the Dead Sea in the Middle East has proven to help some patients. Epsom salt soaks may also be helpful.
• Coal Tar, one of the oldest treatments, is available in multiple preparations, including shampoos, bath solutions and creams.
• Anthralin is available for topical use as a cream, ointment, or paste. This medication is believed to normalize DNA activity in skin cells. Anthralin (Dritho-Scalp) can also remove scales, making the skin smoother. However, anthralin can irritate skin, and it stains virtually anything it touches, including skin, clothing, countertops and bedding.
• Apple Cider Vinegar soothes irritated skin and is a disinfectant. According to the Psoriasis Foundation, some folks with psoriasis have reported success in using it to treat their condition.
Hopefully, this information has shed some light on a very frustrating skin condition. If you suspect you might have psoriasis and have not been diagnosed, see your doctor immediately. The sooner you start treatment, the less aggravation you will have. If you have been diagnosed with Psoriasis, know that you are not alone. The new medications being tested are very promising!
Some information from: National Psoriasis Foundation; MedicineNet.com.