August is Psoriasis Month
What is psoriasis?
Per www.psoriasis.org “Psoriasis is a chronic, autoimmune disease that appears on the skin. It occurs when the immune system sends out faulty signals that speed up the growth cycle of skin cells. Psoriasis is not contagious.
There are five types of psoriasis: plaque, guttate, inverse, pustular and erythrodermic. The most common form, plaque psoriasis, appears as raised, red patches or lesions covered with a silvery white buildup of dead skin cells, called scale. Psoriasis can occur on any part of the body and is associated with other serious health conditions, such as diabetes, heart disease and depression.
According to current studies, as many as 7.5 million Americans have psoriasis.”
So you have been diagnosed with one of the above types of psoriasis, now what?
Causes of psoriasis and triggers
The exact cause of any type psoriasis is still unknown. However, it is understood that the immune system and genetics are key factors in its development. Most researchers agree that the immune system is somehow mistakenly triggered, which causes a cascade of metabolic events, including acceleration of skin cell growth. A normal skin cell matures and falls off the body in 28 to 30 days, in young in tact and healthy skin. A skin cell in a patient with psoriasis takes only 3 to 4 days to mature and instead of shedding off (desquamating), the cells pile up on the surface of the skin, forming psoriasis lesions.
Many scientists believe that at least 10 percent of the general population inherits one or more of the genes that create a predisposition to psoriasis. However, only 2 percent to 3 percent of the population develops the disease. Research has shown that for a person to develop psoriasis, the individual must have a combination of the genes that cause psoriasis and be exposed to specific external factors known as “triggers.”
Triggers are not universal. What can trigger one person’s psoriasis to become active, may not affect another. Known and established psoriasis triggers include:
Stress can cause psoriasis to flare for the first time or aggravate existing psoriasis. Relaxation and stress reduction may help prevent stress from impacting psoriasis.
Injury to skin
Psoriasis can appear in areas of the skin that have been injured or traumatized. This is called the Koebner [KEB-ner] phenomenon. Vaccinations, sunburns and scratches can all trigger a Koebner response. The Koebner response can be treated if it is caught early enough.
Certain medications are associated with triggering psoriasis, including:
- Lithium: Used to treat manic depression and other psychiatric disorders. Lithium aggravates psoriasis in about half of those with psoriasis who take it.
- Antimalarials: Plaquenil, Quinacrine, chloroquine and hydroxychloroquine may cause a flare of psoriasis, usually 2 to 3 weeks after the drug is taken. Hydroxychloroquine has the lowest incidence of side effects.
- Inderal: This high blood pressure medication worsens psoriasis in about 25 percent to 30 percent of patients with psoriasis who take it. It is not known if all high blood pressure (beta blocker) medications worsen psoriasis, but they may have that potential.
- Quinidine: This heart medication has been reported to worsen some cases of psoriasis.
- Indomethacin: This is a nonsteroidal anti-inflammatory drug used to treat arthritis. It has worsened some cases of psoriasis. Other anti-inflammatories usually can be substituted. Indomethacin’s negative effects are usually minimal when it is taken properly. Its side effects are usually outweighed by its benefits in psoriatic arthritis.
Although scientifically unproven, some people with psoriasis suspect that allergies, diet and weather trigger their psoriasis. Strep infection is known to trigger guttate psoriasis.
*Other health conditions associated with psoriasis
Individuals with psoriasis are at an elevated risk to develop other chronic and serious health conditions also known as “comorbid diseases” or “comorbidities.” These include heart disease, inflammatory bowel disease and diabetes. People with more severe cases of psoriasis have an increased incidence of psoriatic arthritis, cardiovascular disease, hypertension, diabetes, cancer, depression, obesity, and other immune-related conditions such as Crohn’s disease
An October 2006 study confirmed the increased risk of cardiovascular disease for psoriasis patients, especially those with severe psoriasis in their 40s and 50s. Psoriasis patients should examine their modifiable risk factors—for example, quit smoking, reduce stress, decrease your sodium intake and maintain a normal weight.
Psoriasis can cause considerable emotional distress for patients, including decreased self-esteem, and an increased incidence of mood disorders, such as depression. One study estimates that approximately one-fourth of psoriasis patients suffer from depression.
A number of studies have found an increased risk of certain types of cancer in psoriasis patients, such as a form of skin cancer known as squamous cell carcinoma and lymphoma. In some instances, these cancers have been associated with specific psoriasis treatments which suppress the immune system. Patients should follow recommended regular health screenings for cancer and avoid high risk behaviors.
Treating moderate to severe psoriasis usually involves a combination of treatment strategies. Besides topical treatments, your doctor may prescribe phototherapy (also known as light therapy) and/or systemic medications, including biologic drugs.
The National Psoriasis Foundation Medical Board urges psoriasis patients to work with their doctors to outline an appropriate preventative program based on individual medical histories and known risk factors to ensure they are continually monitoring for the potential onset of any health issues related to psoriasis.
*sourced from http://www.psoriasis.org