PSORIASIS

What is Psoriasis ?

Psoriasis is a relatively common skin disease affecting 1% to 2% of the population. The main feature of psoriasis is a red scaly area or patch. The patches appear particularly on the knees, elbows and scalp and sometimes on other parts of the trunk, and legs. Psoriasis affects both sexes and all races. It can occur at any stage of life although it starts most frequently in young adults.Psoriasis only rarely affects general health apart from arthritis. Itching is usually mild. Once the problem starts, it usually continues although it may get better or worse over time and even seem to disappear for prolonged periods.

So What is Psoriasis ?

Non-contagious
Usually inherited
Autoimmune disorder
Rarely life threatening

Psoriasis is a disease/disorder , where angry red lesions appear on the skin,multiply, and scale over with silvery patches. Of course, this is an over simplification.Psoriasis -- the word comes from ancient Greece, and means to itch. Red eruptions appear on the surface of the skin and begin to itch. These areas form plaques over the reddened lesions. The plaques resemble multi-layered scales of skin. Psoriasis varies in intensity from a few random spots to a massive outbreak covering the entire body and requiring hospitalization.Psoriasis has a tendency to be genetically inherited. Recently it has been classified as being an autoimmune disorder (the body's immune system turning on itself). This disorder can originate in juveniles or not be evident until adulthood, It has been reported to initiate as early as birth or not occur until very late in life. Once psoriasis begins, there are only remissions and relapses of varying degrees of intensity. There is no known cure, only possible control over the severity.Psoriasis reacts. It has triggers (such as a systemic strep infection) which can cause the body to go from a very mild case to a severe case within days. There are also other factors, such as sunlight, which help decrease the severity.Psoriasis occurs in two percent of the population. It can be a mildly annoying problem or can destroy the self-esteem and life of the victim. Although it is not contagious, it is an ugly disease that can alienate coworkers and acquaintances.

Types of psoriasis

The symptoms of psoriasis can manifest in a variety of forms. Variants include plaque, pustular, guttate and flexural psoriasis. This section describes each type

Plaque psoriasis (psoriasis vulgaris) is the most common form of psoriasis. It affects 80 to 90% of people with psoriasis. Plaque psoriasis typically appears as raised areas of inflamed skin covered with silvery white scaly skin. These areas are called plaques.

Flexural psoriasis (inverse psoriasis) appears as smooth inflamed patches of skin. It occurs in skin folds, particularly around the genitals, the armpits, and under the breasts. It is aggravated by friction and sweat, and is vulnerable to fungal infections.

Guttate psoriasis is characterized by numerous small oval (teardrop-shaped) spots. These numerous spots of psoriasis appear over large areas of the body, such as the trunk, limbs, and scalp.

Pustular psoriasis appears as raised bumps that are filled with non-infectious pus (pustules). The skin under and surrounding pustules is red and tender. Pustular psoriasis can be localised, commonly to the hands and feet generalised with widespread patches occurring randomly on any part of the body.

Nail psoriasis produces a variety of changes in the appearance of finger and toe nails. These changes include discolouring under the nail plate, pitting of the nails, lines going across the nails, thickening of the skin under the nail, and the loosening and crumbling of the nail.

Psoriatic arthritis involves joint and connective tissue inflammation. Psoriatic arthritis can affect any joint but is most common in the joints of the fingers and toes. This can result in a sausage-shaped swelling of the fingers and toes known as dactylitis. Psoriatic arthritis can also affect the hips, knees and spine. About 10-15% of people who have psoriasis also have psoriatic arthritis.

Erythrodermic psoriasis involves the widespread inflammation and exfoliation of the skin over most of the body surface. It may be accompanied by severe itching, swelling and pain. It is often the result of an exacerbation of unstable plaque psoriasis, particularly following the abrupt withdrawal of systemic treatment. This form of psoriasis can be fatal, as the extreme inflammation and exfoliation disrupt the body's ability to regulate temperature and for the skin to perform barrier functions.

Cause

The cause of psoriasis is not fully understood. There are two main theories about the process that occurs in the development of the disease. The first considers psoriasis as primarily a disorder of excessive growth and reproduction of skin cells. The problem is simply seen as a fault of the epidermis and its keratinocytes. An alternate viewpoint sees the disease as being an immune-medicated disorder in which the excessive reproduction of skin cells is secondary to factors produced by the immune system. It is thought that T Cells (which normally help protect the body against infection) become active, migrate to the dermis and trigger the release of cyokines (tumor nercrosis factor-alpha) which cause inflammation and the rapid production of skin cells. It is not known what initiates the activation of the T cells.Psoriasis is a fairly difficult disease. The majority of people's experience of psoriasis is one in which it may worsen or improve for no apparent reason. Studies of the factors associated with psoriasis tend to be based on small (usually hospital based) samples of individuals. These studies tend to suffer from representative issues, and an inability to tease out casual associations in the face of other (possibly unknown) intervening factors. Conflicting findings are often reported. Nevertheless, the first outbreak is sometimes reported following stress (physical and mental), skin injury, and streptococcal infection. Conditions that have been reported as accompanying a worsening of the disease include infections, stress, and changes in season and climate. Excessive alcohol consumption, smoking and obesity may exacerbate psoriasis or make the management of the condition difficult.

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