Psoriasis
Psoriasis is a non-contagious skin disease that affects about two percent of the world’s population. It is classified as an autoimmune disease because a skin renewal malfunction results in rapid new skin cell growth resulting in dead skin buildup and inflammation. People affected by Psoriasis may have the condition for life or may experience flare ups at certain times due to specific triggers. The following sections describe Psoriasis, the types, the causes and how the condition is diagnosed and treated.
What is Psoriasis?
Part of the natural process of skin renewal involves cell death on the outer layer of the skin while new skin cells develop below the outer layer over a twenty eight day period. These dead cells may scale and usually fall off with daily skin washing.With Psoriasis, the new cells develop every three to four days instead of twenty eight days, meaning that more dead cells develop on the outer skin layer forming psoriatic plaque deposits while excess new cells also multiply beneath. These excess new cells and increased white T-cells cause inflammation of the skin.
Symptoms of Psoriasis include thick, red, itchy, and sore patches of flaky skin covering certain parts of the body. Depending on the type of Psoriasis and body parts affected, the symptoms can range from mild to severe.
Types of Psoriasis
Psoriasis may be classified according to pustular and non-pustular categories. There are five main types of Psoriasis as follows:
- Plaque – pink/red flaky plaque skin patches on elbows and knees mainly (non-pustular)
- Pustular – pus-filled pustule spots develop on the skin
- Flexural – plaque present in thin skin folds of groin and armpits
- Guttate – tiny round inflamed patches appear all over the body
- Erythrodermic – red skin inflammation all over the body (non-pustular)
Other forms include Pustulosis palmaris et plantaris affecting the palms and soles; Acrodermatitis continua resulting in pustules on the fingers and toes; Impetigo herpetiformis is a pustular type occurring in pregnancy and Napkin Psoriasis affects the nappy area; Seborrheic Psoriasis accompanies Soborrheic Dermatitis; Nail Psoriasis affects the finger and toe nails; and Psoriatic arthritis inflames the skin connective tissue of joints. Both Pustular and Erythrodermic Psoriasis can be life threatening because the infected and inflamed skin causes protein and fluid loss resulting in severe illness.
Causes of Psoriasis
Psoriasis is a skin disease of the autoimmune system that can be hereditary. In non-hereditary cases where the condition does not run in families, the contributing autoimmune function is not always clearly understood. Some types affect older people more, such as Flexural and Psoriasis Arthritis. Certain chemicals and medications can trigger the condition, as can health conditions like throat infections (Guttate), hypertension and stress. Bruises, burns and cuts on the skin can also cause Psoriasis. Lifestyle factors like excess alcohol and tobacco intake can also play a role.
Diagnosing Psoriasis
Usually a physician examines symptoms for diagnosis. Health condition, medications and family history form part of discussion towards diagnosis. Skin scraping and biopsy may be done to determine the type of skin condition. Depending on the type identified, such as Pustular or Erythrodermic, admission to hospital for treatment may be required.
Treatments for Psoriasis
There is to date no cure for Psoriasis, but the following treatments exist:
- Self-help remedies and management –
- Oral or injected systemic medicines –
- Topical treatments –
- Phototherapy –
- Herbal Oregon-grape treatments to the skin are used as an alternative natural therapy.
- Soaking in the Dead Sea is viewed by some as an alternate therapy for Psoriasis.
- Ichthyotherapy is a process where marine organisms are used to feed on the Psoriasis plaque to aid with skin healing.
Part of treating Psoriasis involves managing the condition that can severely affect mental health. Cognitive Behavior Therapy is used to help patients deal with the psychological effects of managing the condition. Some emollients, like aqueous cream and petroleum jelly can be bought without prescription to soothe the affected skin.
These medicines, such as ciclosporin and methotrexate, are usually prescribed by a dermatologist to reduce the skin’s renewal process.
Medicated ointments and creams that either contain tar (Coal Tar), steroids (corticosteroid), or vitamin D (calcitriol or tacalcitol), may be prescribed for application to the inflamed skin.
Light therapy may be used in combination with other treatments or as a stand-alone treatment option in severe cases. Artificial Ultraviolet B (UVB) rays are applied to the skin two to three times a week according to the treatment plan. Some light therapies include a combination of UVA with psoralen tablets (Photochemotherapy).