I have a patient who has psoriasis which need weekly injection of metathrexate to be done by me on the request of her dermatologist. Most of the time the the rashes are suppressed but when she is stressed the scaly rashes returned. Another patient had such bad psoriasis that even bending his joints hurts both because of the psoriatic arthritis as well as the split of the hard psoriatic skin.
Psoriasis is a disorder of the skin which typically consists of red patches covered by silvery-white scales especially around the trunk, elbows, knees and scalp.
There are five types, each with unique signs and symptoms.
1.Plaque psoriasis is the most common type of psoriasis. About 80% of people who develop psoriasis have plaque psoriasis, which appears as patches of raised, reddish skin covered by silvery-white scale. These patches, or plaques, frequently form on the elbows, knees, lower back,and scalp.
2.guttate psoriasis (small, red spots on the skin),
3.pustular psoriasis (white pustules surrounded by red skin),
4.inverse psoriasis (smooth, red lesions form in skin folds)
5.erythrodermic psoriasis (widespread redness, severe itching, and pain).
Psoriasis occurs about equally in males and females.
Recent studies show that there may be an ethnic link.
It seems that psoriasis is most common in Caucasians and slightly less common in African Americans.
Worldwide, psoriasis is most common in Scandinavia and other parts of northern Europe.
It appears to be far less common among Asians and is rare in Native Americans.
There also is a genetic component associated with psoriasis.
About one-third of people who develop psoriasis have at least one family member with the condition.
Research shows that the signs and symptoms of psoriasis usually appear between 15 and 35 years of age.
About 75% develop psoriasis before age 40.
However, it is possible to develop psoriasis at any age.
After age 40, a peak onset period occurs between 50 and 60 years of age.
About 1 in 10 people develop psoriasis during childhood, and psoriasis can begin in infancy. The earlier the psoriasis appears, the more likely it is to be widespread and recurrent.
Its exact cause is unknown but the result is skin which grows about seven times more quickly and thicker than usual.
It is thought to be due, at least in part, to an abnormal immune reaction against some component of the skin.
Genetic factors play a part. About half those affected know of someone else in the family with it.
The rash often seems to start after some sort of trigger.
This may be emotional stress, skin injury (cuts and scratches for example), a streptococcal sore throat, hormones (it often occurs at puberty), or rarely, certain medications.
Psoriasis is not contagious.
Itchy, raised patches of dark pink skin.
White scales on the scalp, knees, elbows and upper body.
Pitting, discoloring and thickening of the fingernails and toenails.
Red, scaly and cracked skin on the palms of the hands or on the soles of the feet.
There may be fluid oozing out of the cracks and movement may become very painful.
The itching and discomfort may keep a person awake at night, and the pain can make everyday tasks difficult.
All types of psoriasis, ranging from mild to severe, can affect a person’s quality of life. Living with this lifelong condition can be physically and emotionally challenging.
Itching, soreness, and cracked and bleeding skin are common. Nail psoriasis can be painful.
Even the simple act of squeezing a tube of toothpaste can hurt.
Several studies have shown that people often feel frustrated.
In some cases, psoriasis limits activities and makes it difficult to perform job responsibilities.
Studies also have shown that stress, anxiety, loneliness, and low self-esteem are part of daily life for people living with psoriasis. One study found that thoughts of suicide are three times higher for psoriatics than the general population.
Embarrassment is another common feeling. Imagine getting your hair cut and noticing that the stylist or barber is visibly uncomfortable. What if you extended your hand to someone and the person recoiled? How would you feel if you spent most of your life trying to hide your skin?
Psoriasis is a chronic, meaning lifelong, condition because there is currently no cure. People often experience flares and remissions throughout their life. Controlling the signs and symptoms typically requires lifelong therapy.
Treatment depends on the severity and type of psoriasis. Some psoriasis is so mild that the person is unaware of the condition. A few develop such severe psoriasis that lesions cover most of the body and hospitalization is required. These represent the extremes. Most cases of psoriasis fall somewhere in between.
Topical medications (such as steroid and tar lotions, ointments, creams, and shampoo)
Phototherapy (either ultraviolet B, or UVB, radiation or psoralen with ultraviolet A, or PUVA, radiation)
Systemic therapy (oral drugs that affect the whole body system, not just the skin e.g. cyclosporins, methotrexate)
Combination are often used. These treatments are often given in the order described -- from least to most potent -- as necessary, although the physician may choose a more powerful therapy or use combination first if the patient's initial condition is severe.
With the emergence of several new therapies, including the biologic agents, more people are experiencing substantial improvements and reporting a greatly improved quality of life.
I have been dealing with my own psoriasis for almost 10 years now. It mostly is located on my finger and toe nails. It is quite tricky to manage but recently I have had some good results by changing my diet. Here is a link to some nail psoriasis diet information that might help your readers.
ReplyDelete