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Psoriasis

Psoriasis

Psoriasis is a long-term (chronic) skin problem that causes skin cells to grow too quickly, resulting in thick, white, silvery, or red patches of skin.

Normally, skin cells grow gradually and flake off about every 4 weeks. New skin cells grow to replace the outer layers of the skin as they shed.

But in psoriasis new skin cells move rapidly to the surface of the skin in days rather than weeks. They build up and form thick patches called plaques. The patches range in size from small to large. They most often appear on the knees, elbows, scalp, hands, feet, or lower back. Psoriasis is most common in adults. But children and teens can get it too.

Having psoriasis can be embarrassing, and many people, especially teens, avoid swimming and other situations where patches can show. But there are many types of treatment that can help keep psoriasis under control.

Experts believe that psoriasis occurs when the immune system overreacts, causing inflammation and flaking of skin. In some cases, psoriasis runs in families.

People with psoriasis often notice times when their skin gets worse. Things that can cause these flare-ups include a cold and dry climate, infections, stress, dry skin, and taking certain medicines.

Psoriasis isn't contagious. It can't be spread by touch from person to person.

syptoms of psoriasis

Symptoms of psoriasis appear in different ways. Psoriasis can be mild, with small areas of rash. When psoriasis is moderate or severe, the skin gets inflamed with raised red areas topped with loose, silvery, scaling skin. If psoriasis is severe, the skin becomes itchy and tender. And sometimes large patches form and may be uncomfortable. The patches can join together and cover large areas of skin, such as the entire back.

In some people, psoriasis causes joints to become swollen, tender, and painful. This is called psoriatic arthritis. This arthritis can also affect the fingernails and toenails, causing the nails to pit, change color, and separate from the nail bed. Dead skin may build up under the nails.

Symptoms often disappear (go into remission), even without treatment, and then return (flare up).

A doctor can usually diagnose psoriasis by looking at the patches on your skin, scalp, or nails. Special tests aren't usually needed.

In some cases, psoriasis can be hard to treat. You may need to try different combinations of treatments to find what works for you. Treatment for psoriasis may continue for a lifetime.

Skin care at home can help control psoriasis. Follow these tips to care for psoriasis:

  • Use creams or lotions, baths, or soaks to keep your skin moist.
  • Try short exposure to sunlight or ultraviolet (UV) light.
  • Use creams or lotions, baths, or soaks to keep your skin moist.
  • Follow instructions for skin products and prescribed medicines. It may take a period of trial and error until you know which skin products or methods work best for you. For mild symptoms of psoriasis, some over-the-counter medicines, such as aloe vera, may be soothing.

Things to avoid include:

  • Skin injury: An injury to the skin can cause psoriasis patches to form anywhere on the body, including the site of the injury. This includes injuries to your nails or nearby skin while trimming your nails.
  • Stress and anxiety : Stress can cause psoriasis to appear suddenly (flare) or can make symptoms worse.
  • Infection: Infections such as strep throat can cause psoriasis to appear suddenly, especially in children.
  • Certain medicines: Some medicines, such as nonsteroidal anti-inflammatory drugs (NSAIDs), beta-blockers, and lithium, have been found to make psoriasis symptoms worse. Talk with your doctor. You may be able to take a different medicine.
  • Overexposure to sunlight: Short periods of sun exposure reduce psoriasis in most people, but too much sun can damage the skin and cause skin cancer. And sunburns can trigger flares of psoriasis.
  • Alcohol: Alcohol use can cause symptoms to flare up.
  • Smoking: Smoking can make psoriasis worse. If you smoke, try to quit.

Psoriasis - What Happens

Psoriasis is usually a long-term problem. Symptoms tend to come and go in a cycle of flares, when symptoms get worse, and remission, when symptoms improve and go away for awhile. In other cases psoriasis may persist for long periods of time without getting better or worse.

Several things can make symptoms worse, depending on the type of psoriasis. These factors, or triggers, include:

  • Cold.
  • Dry climates.
  • Stress.
  • Infection.
  • Skin injury.
  • Certain medicines.

A few cases of psoriasis may go away without treatment. But it's usually best to treat psoriasis so that it doesn't get worse. If it becomes severe and widespread, it may be much harder to treat.

Mild, moderate, and severe psoriasis :

The severity of psoriasis is indicated by the amount of redness and scaling, the thickness of the large areas of raised skin patches (plaques), and the percentage of your skin that is affected.

    Mild

  • Plaques cover a small portion of the body, such as the elbows or knees.
  • Moderate

  • Plaques cover several large areas. For example, most of the scalp may be affected.
  • Plaques may cover up to 20% of the skin (about equal to having both arms completely covered).
  • Any joint pain is mild, but not disabling.
  • Plaques tend to be visible to other people.
  • severe

    When severe, psoriasis can be:

  • On the face.
  • Plaques that may cover large areas (20% to 30%) of the body. When determining the percent of coverage, consider that the palm of your hand equals about 1% of your body surface, and the total surface of both arms equals about 20%.
  • Pustular psoriasis with large, fluid-filled plaque and severe scaling.
  • Erythrodermic psoriasis with severe inflammation and shedding (sloughing) of the skin.
  • Psoriatic arthritis, which includes ongoing joint swelling, tenderness, limitation of range of motion, or joint warmth or redness. Severe cases can result in joint destruction.

Psoriasis - What Increases Your Risk

Many doctors believe that psoriasis may be passed down from parents to their children (inherited). This is because certain genes are found in families who are affected by psoriasis.2 About one-third of people who have psoriasis have one or more family members with the condition.

Other factors that can contribute to the development of psoriasis include:

  • Emotional or physical stress: Stress may cause psoriasis to appear suddenly or make symptoms worse (although this has not been proved in studies).
  • Infection: Infections such as strep throat can cause psoriasis to appear suddenly, especially in children.
  • Skin injuries: An injury to the skin can cause psoriasis patches to form anywhere on the body, including the site of the injury. This includes injuries to your nails or nearby skin while trimming your nails.
  • Emotional or physical stress: Stress may cause psoriasis to appear suddenly or make symptoms worse (although this has not been proved in studies).
  • Smoking: Smoking may make you more likely to get psoriasis and make the symptoms more severe.

Psoriasis - Treatment Overview

Currently there is no cure for psoriasis. But many types of treatment are available, including products applied to the skin, phototherapy, and oral medicines, which can help control psoriasis. Most cases are mild and can be treated with skin products. In some cases, psoriasis can be hard to treat if it is severe and widespread. Most psoriasis returns, even mild forms.

The purpose of treatment is to slow the rapid growth of skin cells that causes psoriasis and to reduce inflammation. Treatment is based on the type of psoriasis you have, its location, its severity, and your age and overall health.

Treatment can also depend on how much you are affected by the condition, either physically (because of factors such as joint pain) or emotionally (because of embarrassment or frustration from a skin rash that may cover a large or visible area of the body). For example, you may get more aggressive treatment if your psoriasis is severe or if the patches frequently upset you.

Depending on what type of psoriasis you have, treatment may also include:

  • TOPICAL MEDICATION
  • ORAL MEDICATIONS
  • IMMUNOMODULATORS
  • Phototherapy, which involves exposing your skin to special ultraviolet light.

You may need to try different treatments before you find one that works well for you. It's important to discuss your treatment and progress with your doctor.

Many doctors will recommend that treatments be changed or rotated after a certain period of time to make treatment more effective and to reduce side effects.

People respond differently to psoriasis treatments. A treatment that worked one time may not work again. A treatment that didn't work the first time may work when tried again later.

You may need to try different treatments before you find one that works well for you. It's important to discuss your treatment and progress with your doctor.

Avoid triggers

It's also important to avoid anything that 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. Streptococcal infections, which usually affect the upper respiratory tract, are linked to guttate psoriasis.

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