Psoriasis

Psoriasis is a skin condition that affects over three percent of the population, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). (Read about "Skin") Close to a quarter of a million more people are diagnosed with it every year, according to the National Psoriasis Foundation (NPF). It happens when the skin cells start to grow much faster then normal. When that happens, they pile up at the surface and form raised red lesions.

Types of psoriasis

There are different forms of psoriasis, according to NIAMS. They include:

• Plaque psoriasis is the most common form of psoriasis. It is characterized by lesions that have a reddened base covered by silvery scales. It most often occurs on the elbows, knees, scalp, lower back, face, palms and the soles of the feet.
• Guttate psoriasis is small dot like lesions. It is often set off by bacterial infections. (Read about "Microorganisms") It most often shows up on the torso, limbs and scalp.
• Pustular psoriasis is blisters that can leak.
• Inverse psoriasis most often appears in the folds of the skin near the genitals, under the breasts or in the armpits. The outbreak is usually intensely red and inflamed. It will be sensitive to sweating or friction. (Read about "Sweating")
• Erythrodermic psoriasis is widespread reddening and scaling of the skin that is itchy or painful. It is often preceded by another insult to the skin such as a sunburn or a drug related rash. (Read about "Skin Rash")

Causes

Psoriasis is now believed to be an autoimmune disease. That means the body turns on itself in some way. (Read about "The Immune System")

It is also believed to have a genetic component. (Read about "Genetics") About one third of the people with the condition have relatives with it. NIAMS says that people with psoriasis also report certain things that can trigger outbreaks or make things worse. Triggers can include things such as changes in climate, infections, stress or skin insult. (Read about "Stress") Some drugs used to treat high blood pressure (Read about "High Blood Pressure") or depression (Read about "Depressive Illnesses") may trigger an outbreak as well.

Psoriasis is not contagious. It is not an infection and someone can't "give it" to someone else, according to the American Academy of Family Physicians (AAFP).

Treatments

Treatments for psoriasis will depend on the severity of the outbreak. NIAMS says there are four basic ways to treat it.

• Topical with medicines applied to the skin. Topical medications are considered the first line of defense. NPF says topical medications can help slow down the excessive cell reproduction and also help reduce inflammation. AAFP says improvement can come almost immediately. Topical medications include anti-inflammatory drugs called corticosteroids, synthetic forms of vitamin D, coal tar, salicylic acid and topical retinoids. Moisturizers may also help to make skin feel better, though they won't actually affect the psoriasis.
• Phototherapy with regular planned doses of natural or artificial light. With natural sunlight there is always the concern of too much sun, which can make the problem worse, and also do its own type of damage to the skin. (Read about "Skin Cancer") For this reason, treatment is done under a doctor's supervision. Phototherapy is also often combined with a light-sensitizing medication. The medication can be taken internally. There is also a topical form of the medication which can be applied to the skin before exposure to a therapeutic light source.
• Laser therapy - Lasers can also be used to target selected areas of the skin that are affected by psoriasis. Laser therapy may not be appropriate for severe cases of psoriasis.
• Systemic which involves the taking of drugs internally. Systemic medications may be used if other treatments have not been successful. Systemic medications for psoriasis include retinoids, methotrexate or hydroxyurea. In some cases, biologic drugs that suppress or modify the immune system may be used. Some biologic drugs block the activation of certain immune cells. Others affect chemical messengers in the immune system that can trigger inflammation. Because systemic medications affect the entire body, there can be many side effects, so you need to discuss the advantages and disadvantages carefully with your doctor. (Read about "Medicine Safety")

It's also important to take good care of your skin. When bathing, avoid very hot water and use mild soaps, use gentle moisturizers (Read about "Skin Care") and maintain a healthy weight.

Complications

The average age for getting psoriasis is 28, according to NPF, although the disease can develop at any time. In many cases, the symptoms are mild and people are able to function normally, although because of its appearance, some may suffer low self esteem as a result. Some cases of psoriasis are more serious, however. One of the more serious complications can be psoriatic arthritis. This is a rheumatic disease (Read about "Arthritis and Rheumatic Diseases") that develops in about ten percent of people with psoriasis. It can affect one joint or many. Sometimes, joints on only one side of the body are affected. The pain associated with psoriatic arthritis can range from mild to extremely painful, even disabling.

There is no cure for this form of arthritis; treatment focuses on relieving pain. Medications can include nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids and disease-modifying antirheumatic drugs (DMARDs). In severe cases, drugs to suppress the immune system may be used, as can tumor necrosis factor-alpha (TNF-alpha) inhibitors. You will need to discuss the risks and advantages of all these medications with your doctor.

As with other forms of arthritis, weight control is important, so you don't put added pressure on your weight-bearing joints. The Arthritis Foundation also recommends proper exercise for arthritis treatment. Exercises can develop range of motion, using gentle stretching, for example, to improve joint mobility. Strengthening exercises for muscles can also help stabilize joints. (Read about "Stretching and Health") Always consult your doctor or physical therapist for information on the right type of exercise for your specific problem. (Read about "Rehabilitation")

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