Psoriasis

Anyone can get psoriasis, but it occurs more often in adults. In many cases, there is a family history of psoriasis. Certain genes have been linked to the disease. Men and women get psoriasis at about the same rate.

Individuals with psoriasis may experience significant physical discomfort and some disability. Itching and pain can interfere with basic functions, such as self-care, walking, and sleep. Plaques on hands and feet can prevent individuals from working at certain occupations, playing some sports, and caring for family members or a home. The frequency of medical care is costly and can interfere with an employment or school schedule. People with moderate to severe psoriasis may feel self-conscious about their appearance. Psychological distress can lead to depression and social isolation.

Psoriasis is a skin disorder driven by the immune system, especially involving a type of white blood cell called a T cell. Normally, T cells help protect the body against infection and disease. In the case of psoriasis, T cells are put into action by mistake and become so active that they trigger other immune responses, which lead to inflammation and to rapid turnover of skin cells.

In many cases, there is a family history of psoriasis. Researchers have studied a large number of families affected by psoriasis and identified genes linked to the disease.

People with psoriasis may notice that there are times when their skin worsens, called flares, then improves. Conditions that may cause flares include infections, stress, and changes in climate that dry the skin. Also, certain medicines may trigger an outbreak or worsen the disease. Sometimes people who have psoriasis notice that lesions will appear where the skin has experienced trauma. The trauma could be from a cut, scratch, sunburn, or infection.

Occasionally, doctors may find it difficult to diagnose psoriasis, because it often looks like other skin diseases. It may be necessary to confirm a diagnosis by examining a small skin sample under a microscope.

There are several forms of psoriasis. Some of these include:

• Plaque psoriasis – Skin lesions are red at the base and covered by silvery scales.
• Guttate psoriasis – Small, drop-shaped lesions appear on the trunk, limbs, and scalp. Guttate psoriasis is most often triggered by upper respiratory infections (for example, a sore throat caused by streptococcal bacteria).
• Pustular psoriasis – Blisters of noninfectious pus appear on the skin. Attacks of pustular psoriasis may be triggered by medications, infections, stress, or exposure to certain chemicals.
• Inverse psoriasis – Smooth, red patches occur in the folds of the skin near the genitals, under the breasts, or in the armpits. The symptoms may be worsened by friction and sweating.
• Erythrodermic psoriasis – Widespread reddening and scaling of the skin may be a reaction to severe sunburn or to taking corticosteroids (cortisone) or other medications. It can also be caused by a prolonged period of increased activity of psoriasis that is poorly controlled. Erythrodermic psoriasis can be very serious and requires immediate medical attention.

Doctors generally treat psoriasis in steps based on the severity of the disease, size of the areas involved, type of psoriasis, where the psoriasis is located, and the patient’s response to initial treatments. Treatment can include:1

• Topical Treatment – medicines applied to the skin
• Phototherapy – light treatment
• Systemic Therapy – medicines by mouth or injection