What is Psoriasis?

Psoriasis occurs when the immune system sends out faulty signals that affects the life cycle of skin cells. It speeds up the growth cycle of the skin cells, from weeks normally, to days with the disease, causing them to build rapidly on the surface of the skin. These cells form thick, silvery buildups of dead skin called scale and cause dry, itchy and sometimes painful red patches.

As many as 7.5 million Americans have psoriasis. It is a persistent disease that is usually long-term. There are varying levels of psoriasis. It may be just an annoyance for some, but for others it’s disabling, especially if associated with other serious health conditions such as arthritis, diabetes, heart disease and depression. The patches of skin may range in size from small to large. There may be periods when the symptoms go into remission, alternating with periods of breakouts. It can show on any part of the body, but typically appears on the scalp, hands, elbows, knees, feet or lower back.

Psoriasis is not contagious and may be embarrassing for many people. It cannot be spread by touch from person to person.

Psoriasis types range from plaque, guttate, inverse, pustular, nail, scalp and erythrodermic. Approximately 90% of people with psoriasis have plaque-type psoriasis.

Symptoms

Symptoms vary from person to person, but the most common symptoms of psoriasis are red, raised patches of skin under loose, silvery scales. Crusty plaques on the scalp, tiny areas of bleeding when skin scales are picked or scraped off (Auspitz's sign), itching during flare-ups, nail disorders such as pits in the nails, yellowish discoloration of the toenails or fingernails, separation of the end of the nail from the nail bed, and sometimes skin debris under the nail are other symptoms associates with psoriasis. There may joint tenderness, itching, swelling and pain with psoriatic arthritis.

Less than 10% of those affected by psoriasis suffer from guttate psoriasis, a condition that often follows a strep infection and are flare-ups of multiple raindrop-shaped patches.

Symptoms:

• Bright red areas of raised patches (plaques) on the skin, often covered with loose, silvery scales.
• Tiny areas of bleeding when skin scales are picked or scraped off (Auspitz's sign).
• Mild scaling to thick, crusted plaques on the scalp.
• Itching, especially during sudden flare-ups or when the psoriasis patches are in body folds, such as under the breasts or buttocks.
• Nail disorders.

Other symptoms:

• Similar plaques in the same area on both sides of the body (for example, both knees or both elbows).
• Flare-ups of many raindrop-shaped patches. Called guttate psoriasis. It affects less than 10% of those with psoriasis.
• Joint swelling, tenderness, and pain (psoriatic arthritis).

Treatment

Although there is no cure for psoriasis, light therapy, a topical treatment, or oral medications can offer considerable relief. Small amount of natural sunlight along with a creams, lotions, or ointments to moisturize the skin, can improve symptoms. Most psoriasis returns so the purpose of treatment is to reduce inflammation and slow the rapid growth of skin cells that causes psoriasis. Treatment is based on the severity and type psoriasis, its location, your age and overall health.

Medications applied to the skin:

• Creams, ointments, and lotions, to moisturize the skin.
• Shampoos, oils, and sprays, to treat psoriasis of the scalp.
• Some exposure to sunlight.

It is also important to avoid what can trigger a flare-up of psoriasis or make the condition worse. Stress, skin injury, infection, and use of alcohol can all contribute to symptom flare-ups.

Prescription medicines such as calcipotriene - a vitamin D compound, betamethasone - a topical corticosteroids, tazarotene - a retinoids, or anthralin and tars may be prescribed if the psoriasis is not helped by products you can get without a prescription. Avoid irritating cosmetics or soaps may also help reduce symptoms.

Prescription Medications:

• Vitamin D compounds, such as calcipotriene.
• Topical corticosteroids, such as betamethasone.
• Anthralin and tars.
• Retinoids, such as tazarotene.

The following may help Psoriasis patients:

• Soaking in bath water with oil added and using moisturizers may help. Bath soaks with coal tar or other agents that remove scales and reduce the plaque may also help.
  
• Do not use irritating cosmetics or soaps. 
• Cortisone creams can reduce the itching of mild psoriasis and are available without a prescription.

Causes

Although the precise cause of psoriasis is not known, it is understood that the immune system and genetics play a role in its development. About one-third of psoriasis sufferers have one or more family member with the same condition. Environmental factors such as stress, alcohol consumption, climate and certain medicines can all contribute to symptom flare-ups. Skin injury and immune system infections can also worsen the condition. The immune system is believed to play a roll in the development of psoriasis because increased numbers of white blood cells that are present between the abnormal layers of skin. T lymphocyte, or T cells that normally fight off foreign substances, attack healthy skin cells by mistake. Overactive T cells trigger other immune responses including dilation of blood vessels in the skin around the plaques, and an increase in other white blood cells that can enter the epidermis. This increased production of both healthy skin cells and more T cells, and other white blood cells results in an ongoing cycle that allows new skin cells move to the outermost layer of skin too rapidly.

At least 10 percent of the general population inherits one or more of the genes that create a predisposition to psoriasis, but 2 percent to 3 percent of the population that have a combination of genes that cause psoriasis and are exposed to environmental ‘trigger’ factors, develop the condition.

Tests & Diagnosis

Special tests are usually not needed to diagnosis psoriasis since there are typically bright red areas of raised patches covered with loose, silvery, scaling skin that are visible. A simple doctor’s exam will typically diagnose the condition. If the condition is not visible, a biopsy - or skin sample - can be taken for analysis in a lab.

An X-ray may be taken if psoriatic arthritis is suspected and blood work may help rule out other forms of arthritis.

Other disorders that sometimes look like psoriasis may include ringworm, pityriasis rosea, lichen planus or seborrheic dermatitis.

Prevention

Since there is no way to prevent psoriasis from affecting someone, you can improve symptoms, or at the least help reduce flare-up episodes, by keeping the skin moist, avoiding cold, dry climates, reducing stress and anxiety, reducing alcohol consumption, and avoiding medicines that have been known to make psoriasis symptoms worse. Avoid scratching and picking the area, as well as skin injures. Avoid smoking as it may cause more flare ups.

• Keep your skin moist.
• Avoid cold, dry climates. Cold weather may make symptoms worse.
• Avoid scratching and picking skin, and avoid skin injuries (cuts or scrapes).
• Avoid stress and anxiety.
• Avoid infection. Infections such as strep throat can cause one type of psoriasis (called guttate psoriasis) to appear suddenly, especially in children.
• Try to avoid certain medicines. Some, including beta-blockers and lithium, have been found to make psoriasis symptoms worse. When your doctor prescribes any medicines for you, tell him or her that you have psoriasis.
• Limit alcohol to no more than 2 drinks a day for men or 1 drink a day for women.
• Don't smoke. Smoking may make you more likely to get psoriasis and may make it more severe. Smoking may also make your symptoms last longer.

Helpful Links

Psoriasis

• www.amevive.com
• www.psoriasis.org
• www.psoriasissupport.com
• www.psoriasis.com

Psoriasis Directory - Your one-stop destination for anything you can think about psoriasis. This Psoriasis Directory is designed to help its users find the psoriasis information, articles, source, companies, products and services.

Drug Development

• www.clinicaltrials.gov
• www.centerwatch.com