Understanding and Living with Psoriasis

At one time described as a variety of leprosy, psoriasis is probably one of the longest known illnesses of humans and the least understood. While its confusion with leprosy may not have been all that surprising, considering its visual appearance on the skin, it was not until 1841 that the condition was finally given its own name by a Viennese dermatologist.

The non-contagious disease, which affects the skin and joints and commonly causes red scaly patches on the skin, are caused by psoriatic plaques, or areas of inflammation and excessive skin production. As the skin rapidly accumulates at these sites, it takes on a silvery-white appearance. It occurs most frequently on the elbows, knees, scalp, and genitals. Psoriasis is surmised to be activated by abnormal activity of the body's immune system. The chronic condition is recurring and varies in its severity. According to the National Institutes of Health, it is estimated that nearly 7.5 million American suffer from psoriasis.

Five types of psoriasis have been identified. The most common form, plaque, is the most preventable form of the disease and is characterized by raised, inflamed, red lesions covered by a silvery white scale. Guttate psoriasis is a form of psoriasis that often starts in childhood or young adulthood. This form resembles small, red, individual spots on the skin which most often appear on the trunk or limbs. Upper respiratory infections, Strep, tonsillitis, and certain drugs have been known to bring on a sudden case of guttate psoriasis.

A particularly inflammatory form of psoriasis, erythrodermic psoriasis is characterized by periodic and widespread redness of the skin. The reddening and shedding of the skin are often accompanied by severe itching and pain. Patients experiencing a erythrodermic flare should see a physician immediately, as the condition can cause protein and fluid loss.

Mostly seen in adults, pustular psoriasis produces white pustules surrounded by red skin. The pus consists of white blood cells. The consition is often localized to specific areas of the body, such as the hands and feet. Pustular posriasis can be triggered by internal medications, overexposure to UV light, pregnancy, systemic steroids, or infections, to name a few.
According to the National Psoriasis Foundation, psoriasis not only has a physical impact on its sufferer, it also has an emotional, psychological, and social impact. This visible disease can change how people view themselves and interact with others. Learning how to recognize and manage your emotions about psoriasis is just as important as treating the physical symptoms.

Stress is a proven trigger for some people who suffer from psoriasis. Psoriasis can erode a person's self esteem and low self esteem can lead to stress, and possibly the worsening of psoriasis. In addition to relaxation and stress reduction, it's important to understand why psoriasis occurs. There are a variety of stress reduction methods which may prove successful in helping to clear an outbreak.

Psoriasis may also appear in areas of the skin that have been injured or traumatized. Called the "Koebner phenomenon," vaccinations, sunburns, and scratches can all trigger this type of response.

Certain medications are also identified as triggers for a psoriasis outbreak. Used to treat psychiatric disorders, lithium aggravates psoriasis in about half of those with psoriasis who take it. Inderal, a high blood pressure medication worsens psoriasis in about a quarter of patients with psoriasis who take it. Indomethacin, used to treat arthritis, has been known to also worsen some cases of psoriasis. Other possible triggers include allergies, diet and weather.

Psoriasis has no known cure, but various therapies can reduce, or nearly stop, their symptoms. No single treatment works for everyone, but something is likely to work in most cases. Finding the right treatment may take some experimentation. Topicals are typically used as the first line of defense. Topicals slow down or normalize excessive cell reproduction and reduce inflammation. Steroids, ultra violet light treatments, or phototherapy, and systemic medications are also commonly used treatments.

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