Psoriasis

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Psoriasis is a common skin condition that changes the life cycle of skin cells. Psoriasis causes cells to build up rapidly on the surface of the skin. The extra skin cells form thick, silvery scales and itchy, dry, red patches that are sometimes painful.

Symptoms

Psoriasis signs and symptoms can vary from person to person but may include one or more of the following:

  • Red patches of skin covered with silvery scales
  • Small scaling spots (commonly seen in children)
  • Dry, cracked skin that may bleed
  • Itching, burning or soreness
  • Thickened, pitted or ridged nails
  • Swollen and stiff joints

Psoriasis patches can range from a few spots of dandruff-like scaling to major eruptions that cover large areas.

When to see a doctor

If you suspect that you may have psoriasis, see your doctor for an examination. Also, talk to your doctor if your psoriasis:

  • Progresses beyond the nuisance stage, causing you discomfort and pain
  • Makes performing routine tasks difficult
  • Causes you concern about the appearance of your skin
  • Leads to joint problems, such as pain, swelling or inability to perform daily tasks

Seek medical advice if your signs and symptoms worsen or don’t improve with treatment. You may need a different medication or a combination of treatments to manage the psoriasis.

Psoriasis triggers

Psoriasis typically starts or worsens because of a trigger that you may be able to identify and avoid. Factors that may trigger psoriasis include:

  • Infections, such as strep throat or skin infections
  • Injury to the skin, such as a cut or scrape, bug bite, or a severe sunburn
  • Stress
  • Cold weather
  • Smoking
  • Heavy alcohol consumption
  • Certain medications — including lithium, which is prescribed for bipolar disorder; high blood pressure medications such as beta blockers; antimalarial drugs; and iodides.

Risk factors

Anyone can develop psoriasis, but these factors can increase your risk of developing the disease:

  • Family history
  • Viral and bacterial infections. People with HIV are more likely to develop psoriasis than people with healthy immune systems are. Children and young adults with recurring infections, particularly strep throat, also may be at increased risk.
  • Stress
  • Obesity
  • Smoking

Complications

If you have psoriasis, you’re at greater risk of developing certain diseases. These include:

  • Psoriatic arthritis.
  • Eye conditions. Certain eye disorders — such as conjunctivitis, blepharitis and uveitis — are more common in people with psoriasis.
  • Obesity.
  • Type 2 diabetes.
  • High blood pressure.
  • Cardiovascular disease. For people with psoriasis, the risk of heart attack is almost three times greater than for those without the disease.
  • Metabolic syndrome. This is a cluster of conditions — including high blood pressure, elevated insulin levels and abnormal cholesterol levels — that increases your risk of heart disease. People with psoriasis have a higher risk of metabolic syndrome.
  • Other autoimmune diseases. Celiac disease, sclerosis and the inflammatory bowel disease called Crohn’s disease are more likely to strike people with psoriasis.
  • Parkinson’s disease. This chronic neurological condition is more likely to occur in people with psoriasis.
  • Kidney disease. Moderate to severe psoriasis has been linked to a higher risk of kidney disease.

Tests and diagnosis

In most cases, diagnosis of psoriasis is fairly straightforward.

  • Physical exam and medical history.
  • Skin biopsy.

Treatments and drugs

Psoriasis treatments can be divided into three main types: topical treatments, light therapy and systemic medications.

Topical treatments

Used alone, creams and ointments that you apply to your skin can effectively treat mild to moderate psoriasis. When the disease is more severe, creams are likely to be combined with oral medications or light therapy. Topical psoriasis treatments include:

  • Topical corticosteroids.
  • Vitamin D analogues.
  • Topical retinoids.
  • Calcineurin inhibitors.
  • Salicylic acid.
  • Coal tar.
  • Moisturizers.

Light therapy (phototherapy)

  • Sunlight.
  • UVB phototherapy.
  • Narrow band UVB therapy.
  • Goeckerman therapy.
  • Photochemotherapy or psoralen plus ultraviolet A (PUVA).
  • Excimer laser.

Oral or injected medications

If you have severe psoriasis or it’s resistant to other types of treatment, your doctor may prescribe oral or injected drugs. Because of severe side effects, some of these medications are used for only brief periods and may be alternated with other forms of treatment.

  • Retinoids.
  • Methotrexate.
  • Cyclosporine.
  • Drugs that alter the immune system (biologics).
  • Other medications. .
  • Experimental medications.

Lifestyle and home remedies

Although self-help measures won’t cure psoriasis, they may help improve the appearance and feel of damaged skin. These measures may benefit you:

  • Take daily baths.
  • Use moisturizer.
  • Expose your skin to small amounts of sunlight.
  • Avoid psoriasis triggers, if possible.
  • Avoid drinking alcohol.

Alternative medicine

A number of alternative therapies claim to ease the symptoms of psoriasis, including special diets, creams, dietary supplements and herbs. None have definitively been proved effective. But some alternative therapies are deemed generally safe, and they may be helpful to some people in reducing signs and symptoms, such as itching and scaling.

  • Aloe vera.
  • Fish oil.
  • Oregon grape.

 

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