Psoriasis
Causes: Psoriasis is a very common condition. The disorder may affect people of any age, but it most commonly begins between ages 15 and 35. It can appear suddenly or slowly. In many cases, psoriasis goes away and then flares up again repeatedly over time. The condition is not contagious.
Psoriasis seems to be an inherited disorder. That means it is passed down through families. Skin cells grow deep in the skin and normally rise to the surface about once a month. In persons with psoriasis, this process is too fast and dead skin cells build up on the skin's surface.
Psoriasis may affect any or all parts of the skin. There are five main types of psoriasis.
- Erythrodermic -- The skin redness is very intense and covers a large area.
- Guttate -- Small, pink-red spots appear on the skin.
- Inverse -- Skin redness and irritation occurs in the armpits, groin, and in between overlapping skin.
- Plaque -- Thick, red patches of skin are covered by flaky, silver-white scales. This is the most common type of psoriasis.
- Pustular -- White blisters are surrounded by red, irritated skin.
- Bacteria or viral infections, including strep throat and upper respiratory infections
- Dry air or dry skin
- Injury to the skin, including cuts, burns, and insect bites
- Some medicines, including anti-malaria drugs, beta-blockers, and lithium
- Stress
- Too little sunlight
- Too much sunlight (sunburn)
- Too much alcohol
- AIDS
- R/A
- Cancer chemotherapy
The skin patches or dots may be:
- Pink-red in color (like the color of salmon)
- Dry and covered with silver, flaky skin (scales)
- Raised and thick
Treatment: The goal of treatment is to control your symptoms and prevent secondary infections.
Psoriasis that covers all or most of the body is an emergency that requires a hospital stay. You may receive painkillers, medicines to make you sleepy (sedatives), and fluids through a needle in your vein, and antibiotic, to fight any infection.
Mild cases of psoriasis are usually treated at home. Your doctor may recommend any of the following:
- Cortisone (anti-itch) cream
- Creams or ointments
- Dandruff shampoos (over-the-counter or prescription)
- Moisturizers
- Prescription medicines containing vitamin D or vitamin A (retinoid)
If you have an infection, your doctor will prescribe antibiotics.
Sunlight may help your symptoms go away. Be careful not to get sunburn. Some people may choose to have phototherapy. Phototherapy is a medical procedure in which your skin is carefully exposed to ultraviolet light. Phototherapy may be given alone or after you take a drug that makes the skin sensitive to light.
Persons with very severe psoriasis may receive medicines to suppress the body's immune response. These medicines include methotrexate or cyclosporine. (Persons who have psoriatic arthritis may also receive these drugs.)
Newer drugs called biologics specifically target the body's immune response, which is thought to play a role in psoriasis. These drugs are used when other treatments do not work. Biologics approved for the treatment of psoriasis include:
- Adalimumab (Humira)-- only approved for psoriatic arthritis
- Efalimab (Raptiva)
- Etanercept (Enbrel)
- Alefacept (Amevive
- Infliximab (Remicade)
Prognosis: Psoriasis is a life-long condition that can be controlled with treatment. It may go away for a long time and then return. With appropriate treatment, it usually does not affect your general physical health.
Possible Complications
- Pain
- Severe itching
- Secondary skin infections
- Side effects from medicines used to treat psoriasis
Doctors recommend daily baths or showers for persons with psoriasis. Avoid scrubbing too hard, because this can irritate the skin and trigger an attack