Psoriasis

It is not entirely clear what causes psoriasis, but after decades of research, doctors have identified two key factors: genetics and the immune system.

IMMUNE SYSTEM: Psoriasis is an autoimmune condition – the result of the body attacking itself. In the case of psoriasis, white blood cells known as T cells mistakenly attack the skin cells, causing the skin cell production process to go into overdrive. The sped-up skin cell production causes new skin cells to develop too quickly. They are pushed to the skin’s surface, where they pile up.

This results in the “plaques” – raised red patches covered with a whitish buildup of dead skins cells called scales – that are most commonly associated with psoriasis. The attacks on the skin cells also cause red, inflamed areas of skin to develop. Once T-cells start to attack skin cells, this usually continues for the rest of a person’s life. There is one exception. Some children who get a type of psoriasis called guttate (gut-tate) psoriasis never have it again.

GENETICS: Psoriasis runs in families: If a parent, grandparent, brother, or sister has psoriasis, you have a higher risk of getting it. However, the percentage of people who have psoriasis and a genetic predisposition is only 2-3%, according to the National Psoriasis Foundation (NPF).

Triggers

External “triggers” may start a new bout of psoriasis. The most common triggers for psoriasis include:

STRESS: Unusually high stress may trigger a flare-up. If you learn to reduce and manage your stress, you can reduce and possibly prevent flare-ups.

ALCOHOL: Heavy alcohol use can trigger psoriasis flare-ups. If you excessively use alcohol, psoriasis outbreaks may be more frequent.

INJURY: An accident, cut, or scrape may trigger a flare-up. Shots, vaccines, and sunburns can also trigger a new outbreak.

MEDICATIONS: Some medications are considered psoriasis triggers. These medications include:

• lithium
• antimalarial medications
• high blood pressure medication

INFECTION: Psoriasis is caused, at least in part, by the immune system mistakenly attacking healthy skin cells. If you’re sick or battling an infection, your immune system will go into overdrive to fight the infection. This might start another psoriasis flare-up. Strep-throat is a common trigger.

Psoriasis symptoms differ from person to person and depend on the type of psoriasis. Areas of psoriasis can be as small as a few flakes on the scalp or elbow, or cover the majority of the body.

SKIN

Dandruff-like scaling is the most common symptom of psoriasis. The areas of inflamed skin become covered with thick, silvery scales that itch and burn. When you scrape off the scales, the skin begins to bleed. Almost all parts of the body can be affected, but usually these areas (plaques) are found on the elbows, knees, back and scalp. 

Other body parts where you can find plaques include:

• face, mouth and forehead
• arms and legs
• hands, feet and nails
• stomach and breasts
• genital area
• eyebrows and eyelids
• ears and ear canals.

Different people can get different symptoms. Some may have only a few areas covered with skin lesions, others may have major eruptions and experience severe itching or soreness. 

Most people with psoriasis go through “cycles” of symptoms. The condition may cause severe symptoms for a few days or weeks, and then the symptoms may clear up and be almost unnoticeable. Then, in a few weeks or if made worse by a common psoriasis trigger, the condition may flare up again. Sometimes, symptoms of psoriasis disappear completely.

When you have no active signs of the condition, you may be in “remission.” That doesn’t mean psoriasis won’t come back, but for now you’re symptom-free.

JOINTS

Psoriasis can also affect the joints, when it is called psoriatic arthritis. You can have psoriatic arthritis without having plaques, but it is very uncommon. When you have arthritis, your joints become swollen, reddened and hot and it can be very painful. Inflammation can also affect the tendons and ligaments in addition to the inflammation of the joints. It is important to get medical help if you think you have psoriatic arthritis.

Comorbidity: If you have psoriasis, the risk of suffering from other autoimmune diseases, such as gluten intolerance, inflammatory bowel disease and alopecia areata, is higher.

Psoriasis is not contagious. Unlike chickenpox or a cold, you cannot catch psoriasis from someone. There is also no cure, but there are some lifestyle changes may help ease symptoms of psoriasis and reduce flare-ups:

• Lose weight

If you’re overweight, losing weight may reduce the condition’s severity. Losing weight may also make treatments more effective.

• Eat a heart-healthy diet

Reduce your intake of saturated fats. These are found in animal products like meats and dairy. Increase your intake of lean proteins that contain omega-3 fatty acids, such as salmon, sardines, and shrimp. Plant sources of omega-3s include walnuts, flax seeds, and soybeans.

• Avoid trigger foods

Psoriasis causes inflammation. Certain foods cause inflammation too. Avoiding those foods might improve symptoms. These foods include: red meat, refined sugar, processed foods, dairy products.

• Drink less alcohol

Alcohol consumption can increase your risks of a flare-up. Cut back or quit entirely. If you have a problem with your alcohol use, your doctor can help you form a treatment plan.

• Take vitamins

Some doctors prefer a vitamin-rich diet to vitamins in pill form. However, even the healthiest eater may need help getting adequate nutrients. Ask your doctor if you should be taking any vitamins as a supplement to your diet.

It can be difficult to distinguish eczema and psoriasis. Sometimes, tests are required to diagnose psoriasis. 

There is no treatment to cure the disease completely. But there are many treatments that can relieve the symptoms, such as steroid creams, systemic medications, light therapy and immune system suppressing medication. You should consult a doctor to get more detailed information and advice.

It is important to treat psoriatic arthritis as soon as possible, because if it is left untreated, arthritis can adversely affect your mobility. The treatment aims to curb the disease and relieve pain.

Psoriasis can sometimes affect your mood and quality of life. 

Cognitive-behavioral therapy, CBT, can help you learn to manage your psoriasis and lead a good life.

If you think you may have psoriasis, you should consult a doctor to get the right treatment.

APPOTEK can help you with psoriasis. During the initial consultation, a nurse or a physician will evaluate your symptoms and make a diagnosis. Then they may prescribe treatment or refer you for further examination. A physical examination may be required for psoriasis.