May 30, 2019 | It’s that time of year, when most people trade the coats and long pants they wore all winter for shorts and swimsuits. Not everyone, however, enjoys wearing summer outfits due to a nagging skin disease known as psoriasis. According to the National Institutes of Health, as many as 7.5 million Americans suffer from this autoimmune disease, which affects 125 million people worldwide. Psoriasis causes itchy or sore patches of thick, red skin with silvery scales to appear on the elbows, knees, scalp, back, face, palms and feet, although they can show up on other parts of the body. Psoriasis is a persistent, long-lasting, or chronic disease. People with this common disorder may have periods when their symptoms improve or go into remission alternating with times when the illness worsens. Psoriasis usually occurs in adults and sometimes runs in families, with about one in three people having a close relative who also has the condition.

May 30, 2019 | Psoriasis is driven by the immune system, especially involving a type of white blood cell called a T cell. Normally, T cells travel throughout the body to detect and fight off foreign substances, such as viruses or bacteria. If you have psoriasis, however, the T cells attack healthy skin cells by mistake as if to heal a wound or to fight infection. 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. These changes result in an increased production of both healthy skin cells and more T cells and other white blood cells. What results is an ongoing cycle in which new skin cells move to the outermost layer of skin too quickly, in days rather than weeks. Dead skin and white blood cells can’t slough off quickly enough and build up in scaly patches on the skin’s surface. This usually doesn’t stop unless treatment interrupts the cycle.

May 30, 2019 | The symptoms of psoriasis can vary from person to person but typically they include red patches of skin with silvery scales, itching or soreness and thickened or ridged nails. There are several types of psoriasis, the most common being plaque psoriasis, which can occur anywhere on the body, including inside the mouth. Psoriasis on the scalp appears as itchy areas with silvery-white scales while guttate psoriasis primarily affects people younger than 30 and is usually triggered by a bacterial infection such as strep throat. It’s marked by water-drop-shaped sores on the trunk, arms, legs and scalp. Inverse psoriasis affects the skin in the armpits, groin, under the breasts and around the genitals, causing smooth patches of red, inflamed skin. Most types of psoriasis go through cycles, flaring for a few weeks or months, then subsiding for a time or even going into complete remission. In most cases, however, the disease eventually returns.

May 30, 2019 | Between 10 and 30 percent of the people who develop psoriasis get a related form of arthritis called psoriatic arthritis, which causes inflammation of the joints. Psoriatic arthritis is a lifelong condition that causes deterioration, pain and stiffness in the joints. It can also lead to inflammatory eye conditions such as conjunctivitis. The symptoms range from mild to severe and although the disease usually isn’t as crippling as other forms of arthritis, it can cause stiffness and progressive joint damage that in the most serious cases may lead to permanent deformity. Medication can help prevent joint deformities and disability if used early. Nonsteroidal anti-inflammatory drugs or salicylates may be prescribed to reduce pain and inflammation of the joints. Particularly painful joints may be injected with steroid medications and in rare cases, surgery to repair or replace damaged joints is needed. Without treatment, permanent joint degeneration can occur.

May 30, 2019 | The treatment of psoriasis usually comes in one of three forms. Topical creams and ointments can effectively treat mild to moderate psoriasis. When the disease is more severe, creams are likely to be combined with oral medications or phototherapy, which involves the use natural or artificial ultraviolet light. The simplest form of phototherapy involves exposing the skin to controlled amounts of sunlight. Other forms of light therapy include the use of artificial ultraviolet light either alone or in combination with medications. Because of severe side effects, some oral medications are used for brief periods and may be alternated with other forms of treatment. Although doctors choose treatments based on the type and severity of psoriasis and the areas of skin affected, the traditional approach is to start with the mildest treatments and then progress to stronger ones to find the most effective way to slow cell turnover with the fewest side effects.