odos priežiūra - March 23, 2023

Psoriasis - what is it and how to help the patient

Psoriasis causes symptoms such as scaly, dry or itchy skin. Psoriasis cannot be completely cured, but if the provoking factors are identified, medication and lifestyle changes can be used to control the disease and improve the quality of life.

What is psoriasis?

Psoriasis is a chronic autoimmune condition that causes a rapid buildup of skin cells. This accumulation of cells causes flaking on the surface of the skin. Inflammation and redness around the scales are quite common. Typical psoriasis scales are whitish-silver in color and form thick red patches. However, on darker skin tones, they can also appear as purple, dark brown with gray scales. Sometimes they crack and bleed.

Psoriasis is the result of an accelerated skin production process. Normally, skin cells grow deep within the skin and slowly rise to the surface. And eventually they fall. The normal life cycle of a skin cell is 1 month. For people with psoriasis, this production process can take just a few days. For this reason, skin cells do not have time to fall off. This rapid overproduction results in a build-up of skin cells.

The scales usually form on joints such as elbows and knees. However, they can appear anywhere on the body, including: hands, feet, neck, scalp and face. Less common types of psoriasis affect the nails, mouth, and areas around the genitals.

According to one study published in 2021, approximately 7.5 million Americans age 20 and older have psoriasis. It is usually associated with some diseases like type 2 diabetes, inflammatory bowel disease, heart disease, psoriatic arthritis, anxiety, depression.

Types of psoriasis

There are five types of psoriasis.

Plaque psoriasis. Plaque psoriasis is the most common type of psoriasis . The American Academy of Dermatology (AAD) estimates that approximately 80 to 90 percent of people with the condition have plaque psoriasis. This results in red, inflamed patches on fair skin tones and purplish or grayish or darker brown spots, making it more difficult to diagnose in people of color. These spots are often covered with whitish-silver plaques. These plaques are usually found on the elbows, knees and scalp.

Scaly psoriasis. Psoriasis usually occurs in childhood. This type of psoriasis causes small pink or purple spots. The most common areas of this psoriasis are the trunk, arms and legs. These patches are rarely thick or raised like in plaque psoriasis.

Pustular psoriasis. Pustular psoriasis is more common in adults. It causes white, pus-filled blisters and large areas of red or purple (depending on skin tone) - inflammation of the skin. It may appear as a more intense purple on darker skin tones. Pustular psoriasis is usually localized to smaller areas of the body, such as the hands or feet, but it can be widespread.

Inverse psoriasis. Inverse psoriasis causes bright patches of red, shiny, inflamed skin. Inverse psoriasis patches appear under the armpits or breasts, in the groin, or around genital skin folds.

Erythrodermic psoriasis . According to the National Psoriasis Foundation, erythrodermic psoriasis is a severe and very rare type of psoriasis. This form often involves large parts of the body at once. The skin almost looks sunburnt. Skin scales often fall off in large chunks or sheets. Fever is common. This type can be life-threatening, so it's important to see a doctor right away.

What are the symptoms?

Psoriasis symptoms vary from person to person and depend on the type of psoriasis. Areas of psoriasis can be as small as a few flakes on the scalp or elbow, or cover most of the body.

The most common symptoms of psoriasis include: raised, inflamed patches of skin that appear red on fair skin and brown or purple on dark skin, whitish-silver scales or plaques on red patches or gray patches on purple and brown patches, dry skin that may cracking and bleeding, pain, itching and burning sensation, thick nails, painful, swollen joints. Not everyone will experience all of these symptoms. Some people will experience completely different symptoms if they have the less common form of psoriasis.

Most people with psoriasis go through "cycles" of symptoms. The condition may cause severe symptoms for a few days or weeks, and then the symptoms may disappear and be almost unnoticeable. Then, after a few weeks or when a common psoriasis trigger worsens, the condition may flare up again. Sometimes the symptoms of psoriasis disappear completely. When there are no symptoms, this condition is called "remission." This does not mean that psoriasis will not recur.

Is psoriasis contagious?

Psoriasis is not contagious. You cannot pass the skin condition from one person to another. If you touch a psoriatic lesion on another person, the disease will not develop. It is important to be aware of this condition because many people believe that psoriasis is contagious.

What causes psoriasis?

It is not clear what causes psoriasis. But thanks to decades of research, it's believed to be genetics and the immune system. Psoriasis is an autoimmune condition. Autoimmune conditions are the result of an attack on the body. In psoriasis, white blood cells known as T cells mistakenly attack skin cells. Normally in the body, white blood cells are used to attack and destroy invading bacteria and strengthen the defense against infections. This mistaken autoimmune attack causes the skin cell production process to go into overdrive. Accelerated skin cell production causes new skin cells to appear too quickly. They are pushed to the surface of the skin, where they accumulate. This results in the formation of plaques that are commonly associated with psoriasis. Attacks on skin cells also cause red, inflamed areas of skin to appear.

Some people inherit genes that make them more likely to develop psoriasis. Based on 2019 According to published research, if you have a close family member with a skin condition, you are at a higher risk of developing psoriasis.

How is psoriasis diagnosed?

Two tests or examinations may be needed to diagnose psoriasis.

Medical examination. The symptoms of psoriasis are usually distinct and easily distinguished from other conditions that can cause similar symptoms.
Biopsy. If the symptoms are unclear or the doctor wants to confirm a suspected diagnosis, he may take a small skin sample. This is known as a biopsy. The test can diagnose the type of psoriasis. It can also rule out other possible disorders or infections.

Psoriasis provocateurs

Avoid disease provocateurs, also known as triggers, which can start a new psoriasis attack. These triggers are not the same for everyone. They can also change over time. The most common triggers of psoriasis are:

Stress; Unusually high stress can trigger a flare-up. Learning to reduce and manage stress can reduce and possibly prevent flare-ups.
Alcohol; Controlling your alcohol intake if you have this disorder, as it can cause psoriasis flare-ups, can make your daily life easier. If you drink too much, psoriasis outbreaks may be more frequent. Considering cutting down on alcohol or quitting smoking isn't just good for the skin. That's why it's a good idea to have a plan to deal with your drinking problems if you need help.
injuries; An accident, cut, or scratch can trigger a flare-up. Injections, vaccines and sunburns can also trigger a new outbreak.
Medicines; Some drugs, such as lithium preparations, antimalarial drugs, antihypertensive drugs are considered to cause psoriasis.
Infection; Psoriasis is caused, at least in part, by the immune system mistakenly attacking healthy skin cells. If a person has an infection, the immune system can mistakenly mount an immune response against itself, in addition to the necessary protection against infection. This can start another psoriasis flare-up.

As mentioned, psoriasis cannot be cured. The "treatment" aims to reduce inflammation and dandruff, slow down the growth of skin cells, and remove plaque. Psoriasis treatment is divided into three categories:

Local treatment . Creams and ointments applied directly to the skin can help reduce mild to moderate psoriasis. Topical corticosteroids, topical retinoids, vitamin D analogs, salicylic acid, and moisturizer are used for the topical treatment of psoriasis.
Systemic drugs . People with moderate to severe psoriasis and those who have not responded well to other treatments may need oral or injectable medications. Many of these drugs can have severe side effects, so doctors usually prescribe them for a short period of time. These include biologics, oral retinoids, and more.
Light therapy . This psoriasis treatment uses ultraviolet (UV) or natural light. Sunlight destroys overactive white blood cells that attack healthy skin cells and cause rapid cell growth. Both UVA and UVB light can help reduce the symptoms of mild to moderate psoriasis.

Most people with moderate to severe psoriasis will benefit from a combination of treatments. This type of therapy uses more than one type of treatment to reduce symptoms. Some people may use the same treatment throughout their lives. Others may need to change treatments from time to time if their skin stops responding to treatment.

Recommendations for people with psoriasis

Several lifestyle changes can help ease psoriasis symptoms and reduce flare-ups:

Lose any excess weight . It is not clear how weight interacts with psoriasis, but losing excess weight may also help the treatment work. If you are overweight, trying to reach an average weight can reduce the severity of your condition.
Eat heart-healthy food . Reducing your intake of saturated fat, found in animal products such as meat and dairy products, may be helpful in treating psoriasis. It's also important to eat more lean proteins that contain omega-3 fatty acids, such as salmon, sardines and shrimp. Plant sources of omega-3s, including walnuts, flaxseeds, and soybeans, are also helpful sources, especially if you're looking for plant-based products.
Avoid foods that provoke psoriasis . Psoriasis causes inflammation. Certain foods can also cause inflammation. Avoiding these foods may help improve your symptoms. Foods to avoid would be red meat, refined sugar, highly processed foods, dairy products.
Consume less or give up alcohol altogether . Alcohol consumption may increase the risk of an exacerbation. Reducing or stopping smoking can help reduce your risk.
Consider taking vitamins .

How to help someone with psoriasis

People with psoriasis may experience emotional stress, especially when the disease is widespread and covers large areas of the body. The support and encouragement of loved ones can make a world of difference to a sufferer. So let's look at six specific ways to help people with psoriasis.

Learn about the disease . Psoriasis is often misunderstood. If you don't know much about the condition, you may make inaccurate assumptions or comments. Misguided advice and insensitive comments are frustrating for people with psoriasis and can make the condition worse. The more you understand, the easier it will be to offer practical support and help sufferers cope with a flare-up.
Don't look at their skin . Psoriasis flare-ups vary from person to person, and the severity of the disease can range from mild to severe. Some people with psoriasis have symptoms only in areas of the body that are easily hidden from view. Therefore, the disease cannot have an obvious social or emotional impact on them. Others have more severe cases, and psoriasis may cover more of their body. To support someone with this condition, make a conscious effort not to look at their skin.
Encourage outdoor activities . Sunlight in limited doses can calm psoriasis symptoms. For that matter, spending time outdoors can help people with this condition. Instead of sitting indoors, encourage outdoor activities on a sunny day. Offer to go for a walk or bike ride together. In addition to providing a healthy dose of natural vitamin D, outdoor activity can take your mind off your illness, boost your immune system, and boost your energy levels.
Get involved in treatment. You can't force another person to seek help for psoriasis, but you can encourage treatment. Encourage the person to talk to their doctor before experimenting with natural remedies or herbal supplements. Involvement in treatment also includes offering to accompany them to the doctor. Your visit can be a source of emotional support and an opportunity to learn about psoriasis treatments, side effects, and possible complications.
Reduce stressors . Stress is a known trigger for psoriasis flare-ups. We all face daily stressors. However, if possible, look for ways to reduce stress in the person's life. You can encourage stress-relieving activities such as yoga, meditation, and deep breathing.
Listen to their concerns . Sometimes people with psoriasis just need to talk.