Psoriasis is a chronic skin disorder, easily identified by its symptoms of white, scaly skin and red lesions, though not so easily cured or understood. In psoriasis, skin cells mature faster than the body can shed them, causing a buildup. Although there are many theories as to what the cause of such a disease might be – genetics, stress, or other triggers – no one is quite sure why the disease occurs, or what could be a possible way to fully cure it. In this essay we will explore the symptoms, types, and effects of this condition, and also some of the known treatments.
Psoriasis can occur in anyone, but there are many groups that are at a higher risk. As mentioned above, genetics plays a role. One out of three cases of the disease have had it in their family. Age is also a risk factor. The disease appears most often in adolescence or after the age of sixty. Also, Caucasians are more susceptible to it, whereas African Americans have the lowest overall incidence of it.
The symptoms of psoriasis differ from type to type, although inflamed, scaly lesions are present in all five types. The most common form of the disease, plaque psoriasis, is identified by small bumps that begin to grow and become scaly. These lesions flake easily, but removing these patches can cause the tender skin below to bleed. In the Guttate type, small, individual, red drops form. This type does not have as much scaling as plaque psoriasis. The drops usually clear up on their own, but may also reappear as a different form of psoriasis, usually plaque. Inverse psoriasis usually occurs in places where the skin folds, such as the genitals, breasts, armpits or the backs of knees. This type will appear red, yet it will be smooth and dry. Also, no scaling will occur. Pustular psoriasis is a type that’s significantly more rare. It is also more painful. In this type, blisters filled with non-infectious pus appear within a few hours and then dry up and peel within another two days. Severe medical risks exist for those who have this particular form of psoriasis, due to its side effects; exhaustion, anemia, weight loss, fever, chills, rapid pulse rate, severe itching and muscle weakness. Even less common than pustular psoriasis is erythrodermic psoriasis. This type is easily noticeable; the entire body is often covered with a fiery redness. This type also poses severe health risks. It damages the body’s ability to control temperature. Hospitalization is sometimes required.
Psoriasis often occurs on the elbows, knees or trunk. The scalp is also a common place; 50% of patients with any sort of psoriasis have it on their scalp.
There is no known cause for psoriasis, as of yet, but many potential “triggers” have been identified. Injury to skin is one of the biggest triggers. This has been named the “Koebner response.” Any type of skin injury can set it off, even scratches or vaccinations. Certain medicines, such as lithium and antimalarials have been known to trigger an outbreak. Although alcohol abuse doesn’t cause the disease, it can greatly aggravate it, causing it to flare up.
Psoriasis is not diagnosed by any blood test. It is done simply by observation. Sometimes, a biopsy may be look at underneath a microscope, but thats about all.
The severity of psoriasis dictates the type of treatment that should be used. While corticosteroids might work for some, ultraviolet radiation might be necessary for others. Corticosteroids are the most widely used and possibly most affective treatment available. Creams and ointments treat psoriasis on elbows, knees, scalp, face, ears, and skin folds, but overuse can turn the skin hard and impervious to further use. The best plan is to use the corticosteroid (which indeed are steroids, and simply strengthen the skin) aggressively for less than two weeks, and then go through an elongated period of no use so the skin does not get permanently damaged.
Tars are also an effective treatment, although most people shy away from them due to their messiness and smell. Purified tars in the form of creams, gels, and ointments are now available, making them much more accessible. Some research has shown that using tars will increase the effects of UV radiation, but it is likely that the treatment will vary greatly from case to case.
Anthralin is deemed the most effective of the topical treatments, but again its messiness and staining make it less desirable to use. As with the corticosteroids, if Anthralin is used too often the affected skin will become resistant. A rotating cycle of treatment is recommended, as is the use of many of the possible creams and ointments.
Some studies have proven that Ultraviolet radiation can improve the symptoms of psoriasis. UVB, or short UV rays, are used in place of real sunlight. Topical treatments are generally paired with the UVB therapy, which UVA therapy is typically accompanied by oral medications. Many people will find that amount of sunlight they receive has little or no impact on the state of their psoriasis, but in the cases where the light therapy has worked, it seems to reduce the appearance of the lesions greatly. Obviously, the risk of the UV light therapy is the possible threat of skin cancer.
Systemic drugs may work in some cases where topical creams have not made an improvement in the psoriasis. Although the drugs seem to have good effects on widespread psoriasis, the side effects can be more dangerous than the disease itself, and nearly all oral medications require regular blood testing or liver biopsies.
Some herbal or holistic remedies have been found to improve symptoms, but they are generally not researched for common use.
In conclusion, psoriasis, although not usually deadly, is a very serious disease. It can leave permanent scaring on the skin. Almost worse than physical scaring is the emotional effect of the disease. People with psoriasis can suffer from very low self confidence, as well as depression and anger.