What is Psoriasis?
It is a common skin condition that at sometime and to a varying extent, affects well over a million-and-a-half people in the United Kingdom and Ireland and approximately eighty million people Worldwide.
Psoriasis is in simple terms only a vast acceleration of the usual replacement processes of the skin. Normally a skin cell matures in twenty one to forty days during its passage to the surface where a constant invisible shedding of dead cells, as scales takes place. Psoriatic cells, however, are believed to turn over in two to three days and in such chaotic profusion that even live cells reach the surface and accumulate with the dead ones in visible layers. It appears as raised red patches of skin covered with silvery scales. It can occur on any part of the body, although knees, elbows and the scalp are usual sites. There is often accompanying irritation.
It cannot be caught from other people, nor can it be transferred from one part of the body to another.
Basic causes are as yet unknown. Hereditary factors are thought to play an important part and much Research is being carried out into this aspect. It does however appear as if a genetic tendency is triggered off by such things as injury, throat infection, certain drugs and both physical and emotional stress.
Psoriasis affects both sexes equally. It may appear for the first time at any age, although it is more likely to appear between 11 and 45. Psoriasis is known as a waxing and waning condition, and there may therefore be considerable variations in its intensity. There are also many
clinical forms with skin involvement varying from a few psoriatic patches to, at its worst and very rarely, a widespread and serious eruption. Most sufferers, however, have only small patches which either get better spontaneously or need very little treatment.
The more severe forms that produce general involvement may demand intensive medical and nursing care. Widespread ignorance as to the nature of psoriasis and the real or imagined reactions and attitudes of non-sufferers may also lead to a withdrawal from society and to feelings of isolation, depression and defensive shyness.
Psoriasis can cause as little as a single dimple on one of your finger or toe nails, or affect as much as the majority of your skin surface, your joints, and your eyes. 2% of people (1 in 50) have psoriasis to some degree.
The most commonly affected areas are the back of the elbows and the front of the knees. It often affects the scalp, too, and can, indeed, affect any part of the body. The standard appearance is of red areas where the skin is thickened and crusty, often with silvery flakes, which come off easily. This appears as patches, which are known as plaques.
Types of psoriasis:
* Plaque psoriasis. The patches most commonly seen are called plaques. They especially affect the back of the elbows and the front of the knees and the back.
* Guttate psoriasis is many small patches of psoriasis, all over the body, and often happens after a throat infection.
* Flexural psoriasis causes red, shiny areas in skin folds e.g. under breasts, between buttocks etc.
* Pustular psoriasis. Smaller, circular patches, filled with pus, appear on the palms of the hands and soles of the feet. This can sometimes cause a fever, and may need treatment with an antibiotic.
* Scalp psoriasis. Scaling and flakes of the scalp, often particularly affecting the hair margins.
A serious, but rare, complication of psoriasis is erythroderma, where large areas of the skin become hot, red, and dry. This is one of the few emergencies involving skin conditions. If you suffer from this your doctor will admit you to hospital.
Sometimes parts of the body other than the skin can be affected: – The joints can be affected by a form of arthritis (Psoriatic arthropathy). This can affect any joint, but often it is only one joint, that becomes inflamed, at a time. One or more of your finger or toe nails may develop little pits as on a thimble, or may become generally more opaque and thickened (nail dystrophy). The eyes may become inflamed (uveitis). Though the rash is sometimes quite obvious, it is not infectious and cannot be caught by contact.
At the moment a permanent cure has not been found. Scientists know much about the cellular changes that occur and have identified many of the triggers. Many cases are controlled or improved by treatment of the visible effects rather than the unknown basic causes. These urgently need to be identified.
A great variety of treatments exist, and work continues to find more cosmetically acceptable ones. However, at least one-third of psoriatics lose the condition naturally for long periods of time or even entirely. Education about the condition has also been shown to be very beneficial.
Side Effects of common Psoriasis Treatments
The following warning on the potential risks of two popular steriod-based eczema drugs Elidel and Protopic can be found on the website of the U.S FDA at: