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Causes
Symptoms
Exams and Tests
Diagnosis
Treatment
Managing Psoriasis
Self-Care for Psoriasis Patients
Caring for those with Psoriasis
Causes of Psoriasis
Psoriasis is a skin disorder driven by the immune system that involves 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 about one-third of the 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. (Genes govern every bodily function and determine the inherited traits passed from parent to child.) People with psoriasis may notice that there are times when their skin worsens, then improves. Conditions that may cause flare-ups include infections, stress, and changes in climate that dry the skin. Also, certain medicines, including lithium which may be used for manic-depressive illness or other conditions and beta blockers, which are prescribed for high blood pressure or other heart conditions, may trigger an outbreak or worsen the disease.
Source: National Institutes of Health
Symptoms of Psoriasis
In its typical form, psoriasis results in patches of thick, red (inflamed) skin covered with silvery scales. These patches, which are sometimes referred to as plaques, usually itch or feel sore. They most often occur on the elbows, knees, other parts of the legs, scalp, lower back, face, palms, and soles of the feet, but they can occur on skin anywhere on the body.
The disease may also affect the fingernails, the toenails, and the soft tissues of the genitals and inside the mouth. While it is not unusual for the skin around affected joints to crack, approximately 1 million people with psoriasis experience joint inflammation that produces symptoms of arthritis. This condition is called psoriatic arthritis.
Source: National Institutes of Health
Exams and Tests For Psoriasis
It may be necessary to submit a skin sample for microscopic testing in order to identify psoriasis.
In addition, depending on your particular treatment, it may be necessary to submit blood tests to monitor for adverse events related to medication treatment.
Psoriasis Diagnosis
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, guttate psoriasis, pustular psoriasis, inverse psoriasis, erythrodermic psoriasis, and psoriatic arthritis.
Source: National Institutes of Health
Psoriasis Treatment
Doctors generally treat psoriasis in steps based on the severity of the disease, size of the areas involved, type of psoriasis, and the patient's response to initial treatments. This is sometimes called the "1-2-3" approach. In step 1, medicines are applied to the skin (topical treatment). Step 2 uses light treatments (phototherapy). Step 3 involves taking medicines by mouth or injection that treat the whole immune system (called systemic therapy).
Over time, affected skin can become resistant to treatment, especially when topical corticosteroids are used. Also, a treatment that works very well in one person may have little effect in another. Thus, doctors often use a trial-and-error approach to find a treatment that works, and they may switch treatments periodically (for example, every 12 to 24 months) if a treatment does not work or if adverse reactions occur.
Treatments applied directly to the skin may help improve the symptoms of psoriasis. Some patients respond well to ointment or cream forms of corticosteroids, vitamin D3, retinoids, coal tar, or anthralin. Bath solutions and moisturizers may be soothing, but they are seldom strong enough to improve the condition of the skin and reverse the symptoms of psoriasis. Therefore, they usually are combined with stronger remedies. Natural ultraviolet light from the sun and controlled delivery of artificial ultraviolet light are also used in treating psoriasis.
For more severe forms of psoriasis, doctors sometimes prescribe medicines that are taken internally by pill or injection and affect the immune system. This is called systemic treatment. Recently, there has been more focus and use of certain biologic injectable medications (alefacept, efalizumab, and etanercept) in people with more severe cases of psoriasis. These medications are made from proteins produced by living cells instead of chemicals and interfere with specific immune system processes involved in the inflammatory processes of psoriasis.
There are many approaches for treating psoriasis. Combining various topical, light, and systemic treatments often permits lower doses of each and can result in increased effectiveness. Therefore, doctors are paying more attention to combination therapy.
Source: National Institutes of Health
Managing Psoriasis
People with psoriasis can help reduce the frequency of skin flare-ups by avoiding known triggers to their condition. Infection, stress, injury to the skin including sunburn, and changes in climate that dry the skin can all trigger or aggravate the symptoms of psoriasis. In addition, certain medications such as lithium, indomethacin, propranolol, and certain antimalarial medications may also contribute to worsening of symptoms. By being aware of these triggers and planning to avoid or minimize your exposure to them can help keep your psoriasis under control.
Source: Adapted from National Institutes of Health
Self-Care For Psoriasis Patients
People with psoriasis can take control of their condition by avoiding triggers and coping with stress early on in treatment. Psoriasis can have a major impact on a person’s emotional health and can contribute to stress and social anxiety surrounding their appearance. Effective treatment and the utilization of a support network can help you minimize the impact psoriasis has on your attitude and daily life.
Self-management activities such as avoiding known triggers of psoriasis, early treatment of flare ups, and emotional support can help people with psoriasis function better, stay productive and avoid additional health care costs.
Source: Adapted from National Institutes of Health
Caring For Those With Psoriasis
Friends and family members can help a patient with psoriasis manage their disease by learning about the condition and understanding how it affects the patient's life. Friends and family can provide emotional and physical assistance. Their support, as well as support from other people who have the same disease, can make it easier to cope.
Source: Adapted from National Institutes of Health
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