Psoriasis (skin)

Main

Psoriasis is a chronic autoimmune skin condition that causes rapid buildup of skin cells. The overactive immune system attacks healthy skin cells, leading to inflammation and fast cell growth. This results in thick, scaly patches on the skin's surface. These patches, called plaques, often appear on elbows, knees, scalp, and lower back. For example, someone might have red, itchy patches on their elbows that crack when they bend their arms.

Psoriasis has a strong genetic component, with multiple genes contributing to its development. However, having these genes doesn't guarantee developing psoriasis. Other factors can trigger or worsen the condition, including stress, skin injuries, certain medications, infections (especially strep throat), cold weather, and lifestyle factors like smoking or excessive alcohol consumption.

Psoriasis can present in various forms, each with distinct characteristics:

1. Plaque psoriasis: The most common type, affecting about 80-90% of people with psoriasis. It causes dry, raised, red skin patches covered with silvery scales.

2. Guttate psoriasis: Characterized by small, drop-shaped lesions on the trunk, arms, legs, and scalp. It often starts in childhood or young adulthood.

3. Inverse psoriasis: Causes smooth, red patches in skin folds, such as under the breasts or in the groin area. The patches may appear shiny and lack scales.

4. Pustular psoriasis: Characterized by white pustules surrounded by red skin. It can occur on small areas of the body or cover most of the body in severe cases.

5. Erythrodermic psoriasis: A rare and severe form that causes widespread redness and shedding of scales across much of the body surface. It can be life-threatening and requires immediate medical attention.

Each type of psoriasis may require different treatment approaches, and some people may experience more than one type simultaneously or at different times in their lives.

Terms

• Autoimmune condition: A disorder where the immune system attacks healthy cells. Example: In psoriasis, the body attacks its own skin cells.

• Chronic disease: A long-lasting health condition that persists for months or years. Example: Psoriasis is a chronic disease requiring ongoing management.

• Immune system: The body's defense mechanism against infections and diseases. Example: In psoriasis, the immune system mistakenly attacks skin cells.

• Inflammation: The body's response to injury or irritation, causing redness, swelling, and heat. Example: Psoriasis plaques show signs of skin inflammation.

• Plaque: A thick, raised area of inflamed skin in psoriasis. Example: Red patches with silver scales on the knees.

• Scales: Dry, flaky dead skin cells on psoriasis plaques. Example: White flakes on red skin patches.

• Trigger: Something that causes psoriasis symptoms to worsen. Example: Stress causing a psoriasis flare-up.

Analogy

Psoriasis is like an overenthusiastic gardener. Normally, skin cells grow and shed every month, like a well-tended garden. But with psoriasis, it's as if the gardener is planting new flowers daily without removing the old ones. This leads to a buildup, like a garden overgrown with layers of plants. For instance, imagine a flowerbed where new flowers keep growing on top of the old ones, creating a thick, messy pile.

Misconception

Many people think psoriasis is contagious or caused by poor hygiene. This isn't true. Psoriasis is an internal condition and can't spread through touch. People often avoid those with visible psoriasis, thinking they might "catch" it. For example, a child with psoriasis might be excluded from swimming lessons because other parents fear their kids will get infected, causing unnecessary isolation.

History

1. 1808-1813: Psoriasis first described as a distinct skin condition by Robert Willan

2. 1950: Introduction of steroid creams for treatment

3. 1960-1970: Discovery of rapid skin cell turnover in psoriasis through new research techniques

4. 1970: Development of light therapy for psoriasis

5. 1990: First biologic drugs for psoriasis treatment

6. 2000-now: Advanced therapies and personalized treatments for better psoriasis management

How to use it

1. Topical treatments: Apply prescribed medications directly to your skin. For example, use a corticosteroid cream like clobetasol propionate on psoriasis patches twice daily as directed by your doctor. After applying the medication, wait 30 minutes before moisturizing to allow the treatment to absorb properly. This can help reduce inflammation and slow skin cell growth.

2. Light therapy: If recommended by your doctor, undergo phototherapy sessions. This might involve exposing your skin to controlled amounts of UVB light three times a week at a clinic. Always protect unaffected skin and eyes during treatment. Light therapy can help slow skin cell growth and reduce inflammation.

3. Systemic medications: For severe psoriasis, your doctor might prescribe oral or injectable medications. For instance, you might take methotrexate tablets weekly or use a biologic drug like adalimumab via injection every two weeks. These medications work throughout your body to target the overactive immune response in psoriasis. Keep track of your dosing schedule and any side effects to discuss with your doctor.

Facts

• Psoriasis affects about 2-3% of people worldwide.

• Up to 30% of people with psoriasis develop psoriatic arthritis.

• People with psoriasis have a higher risk of heart disease and depression.

• Smoking and being overweight can make psoriasis worse.

• Psoriasis usually starts between ages 15 and 35, but can occur at any age.