What Is Psoriasis?

Psoriasis is an inflammatory skin condition. There are five types, each with unique signs and symptoms. Regardless of type, psoriasis often causes discomfort. The skin itches and may crack and bleed. Severe itching and discomfort may make sleeping difficult, and the pain can make everyday tasks difficult. Psoriasis is a chronic or lifelong condition because there is currently no cure. People often experience flares and remissions throughout their life. Controlling the symptoms typically requires lifelong therapy.

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Who Gets Psoriasis?

More than 4.5 million adults in the United States have been diagnosed with psoriasis, and approximately 150,000 new cases are diagnosed each year, with an estimated 20% having moderate to severe psoriasis. Psoriasis occurs in males and females about equally, and recent studies show that there may be an ethnic link. Approximately a third of people who develop psoriasis have one or more family members with the condition. 

About 1 in 10 people develop psoriasis during childhood, and psoriasis can begin in infancy. The earlier psoriasis appears, the more likely it is to be widespread and recurrent. Research shows that the signs of psoriasis usually appear between ages 15 and 35, with about 75% developing psoriasis before age 40. It is possible, however, to develop psoriasis at any age.

Types of Psoriasis

About 80% of those who develop psoriasis have plaque psoriasis, the most common type, appearing as patches of raised, reddish skin covered by a silvery-white scale. The patches, or plaques, frequently form on the elbows, knees, lower back, and scalp; however, they can occur anywhere on the body. 

Other types of psoriasis are guttate psoriasis (small, red spots on the skin), inverse psoriasis (smooth, red lesions form in skin folds), pustular psoriasis (white pustules surrounded by red skin), and erythrodermic psoriasis (widespread redness, severe itching, and pain).

Treatment depends on the severity and type of psoriasis. While some psoriasis is so mild that the person is unaware of the condition, a few develop such severe psoriasis that lesions cover most of the body, requiring hospitalization. These represent the extremes, and most cases fall somewhere in between.

Psoriatic Arthritis

Between 10% to 30% of people who develop psoriasis get a related form of arthritis called “psoriatic arthritis,” which causes inflammation of the joints. Psoriatic arthritis develops in roughly one million people across the United States, and 5% to 10% experience some disability. Psoriatic arthritis usually first appears between 30 and 50 years of age — often months to years after skin lesions first occur. However, not everyone who develops psoriatic arthritis has psoriasis. About 30% of people with psoriatic arthritis never develop the skin condition.

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What Causes Psoriasis?

Psoriasis may be one of the oldest recorded skin conditions. It was probably first described around 35 AD, and some evidence indicates an even earlier date. Still, until recently, little was known about psoriasis. While scientists still do not fully understand what causes psoriasis, research has significantly advanced our understanding. One significant breakthrough was discovering that kidney-transplant recipients with psoriasis experienced clearing when taking cyclosporine. Since cyclosporine is a potent immunosuppressive medication, this indicates that the immune system is involved.

Immune-Mediated

Researchers now believe that psoriasis is an immune-mediated condition. This means the condition is caused by faulty signals in the body’s immune system. Psoriasis is believed to develop when the immune system tells the body to overreact and accelerate the growth of skin cells. Usually, skin cells mature and are shed from the skin’s surface every 28 to 30 days. When psoriasis develops, the skin cells grow in three to six days and move to the skin surface. Rather than being shed, the skin cells pile up, causing visible lesions.

Genes

Researchers have identified genes that cause psoriasis. These genes determine how a person’s immune system reacts. These genes can cause psoriasis or another immune-mediated condition, such as rheumatoid arthritis or type 1 diabetes. Having a close blood relative with psoriasis increases your risk of developing psoriasis or another immune-mediated condition, especially diabetes or Crohn’s disease. Psoriasis research continues to accelerate rapidly and will continue to advance our knowledge of what causes psoriasis.

Family History

Some people who have a family history of psoriasis never develop this condition. Research indicates that a “trigger” must activate the symptoms. Stress, skin injuries, certain medications, a strep infection, and sunburn are some known potential triggers. Anti-malarial drugs can trigger psoriasis, beta-blockers (a medicine that treats high blood pressure and heart conditions), and lithium. Dermatologists have noticed psoriasis suddenly appearing after a person takes one of these medications, gets a strep infection, or experiences another trigger.

Quality of Life

All types of psoriasis, ranging from mild to severe, can affect a person’s quality of life. Our medical providers know that living with this lifelong condition can be physically and emotionally challenging. 

Itching, soreness, and cracked and bleeding skin are common. Nail psoriasis can be painful. Even the simple act of squeezing a tube of toothpaste can hurt. One woman described her psoriasis as “a bad sunburn that won’t go away.”

Several studies have shown that people often feel frustrated. In some cases, psoriasis limits activities and makes it difficult to perform job responsibilities. The National Psoriasis Foundation reports that those with psoriasis lose 56 million work hours yearly. 

Additionally, a survey conducted by the National Psoriasis Foundation in 2002 indicates that 26% of people living with moderate to severe psoriasis have been forced to change or discontinue their normal daily activities.

Studies have also shown that stress, anxiety, loneliness, and low self-esteem are part of daily life for people with psoriasis. One study found that thoughts of suicide are three times higher for psoriatics than in the general population.

Embarrassment is another familiar feeling. Imagine getting your hair cut and noticing that the stylist or barber is visibly uncomfortable. What if you extended your hand to someone, and the person recoiled? How would you feel if you spent most of your life trying to hide your skin?

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Psoriasis Treatment Options

Psoriasis treatments fall into three categories:

  • Topical (applied to the skin) for mild to moderate psoriasis
  • Phototherapy (light, usually ultraviolet, applied to the skin) for moderate to severe psoriasis
  • Systemic (taken orally or by injection or infusion) for moderate, severe, or disabling psoriasis
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Are You Tired of Chronically Inflamed Skin?

If you are seeking a safe and effective treatment for psoriasis, contact our office today to learn more about the options available to give you longer-lasting relief.

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Better skin health starts here. Schedule your appointment today.

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