Psoriasis
What is psoriasis?
Psoriasis is a lifelong chronic skin disease that produces a significant impact on general health, and on social and emotional life. Psoriasis speeds up the growth cycle of skin cells causing raised, thick red skin with silvery scales in patches or plaques which itch, sting and burn. Psoriasis typically develops on the elbow and knees, but psoriasis can also occur on the scalp, hands, feet, trunk and groin. Psoriasis can also lead to joint pain and psoriatic arthritis in some patients.
Psoriasis is an autoimmune disease caused by an overactive immune system. An overactive immune system causes an inflammatory response against your body. Inflammation is the primary driver of psoriasis.
Psoriasis affects all genders, all races and ethnicities. It usually develops between ages 15 and 35, though about 10% of patients develop the disease before age 10. There are several different types of psoriasis, but plaque psoriasis is the most common.
What causes psoriasis?
Genetics and immune system dysfunction are the primary causes. About 10% of people inherit genes that can predispose them to psoriasis, but only about 2-3% of these people actually develop the disease.
Instead, people with a genetic predisposition must be triggered by some external factor that over-stimulates the immune system. Anything that can affect the immune system can activate psoriasis. Triggers are individual and may include stress, skin injury, dry skin, Strep throat infection, respiratory infections and certain medications. Other possible triggers include allergies, diet and climate.
Drugs that have been shown to trigger psoriasis include:
- Lithium – a treatment for bipolar disorder aggravates psoriasis in about 50% of patients who take it.
- Inderal (propranolol) – a blood pressure medication makes psoriasis worse in 25 -30% of patients.
- Quinidine – a heart medication
- Indomethacin – an NSAID used to treat arthritis.
Conditions related to psoriasis include:
- Psoriatic arthritis – about 30% of psoriasis patients develop psoriatic arthritis
- Cancer – people with psoriasis and psoriatic arthritis are at risk for lymphoma and nonmelanoma skin cancer
- Heart disease – people with severe psoriasis are 58% more likely to have a heart attack and 43% more likely to have a stroke
- Crohn’s disease
- Depression – psoriasis causes significant emotional distress including low self-esteem
- Diabetes and metabolic syndrome – people with severe psoriasis are 30% more likely to have type 2 diabetes and 40% have been found to have metabolic syndrome
- Obesity
- Osteoporosis
- Liver and kidney disease
What are the symptoms of plaque psoriasis?
Plaque psoriasis looks like raised, red patches of skin with a slivery sheen made of dead skin cells that are painful, itchy and can crack and bleed. Plaques are typically found on the scalp, knees, elbows and lower back. It can also affect the nails, causing pits and oily appearing spots on the nailbed. Scratching can cause the plaques to thicken. Other forms of psoriasis can cause smooth, red, sore and painful skin on the eyelids, armpits, skin folds, genitals and buttocks.
How is psoriasis diagnosed?
Diagnosis is usually based on clinical symptoms and history. However, psoriasis can be difficult to diagnose because it can look like other skin diseases. Dr. Higgins will examine your skin, discuss your family history (about 33% of people have a family member with psoriasis) and medical history (looking for comorbid diseases and trigger drugs) and may take a biopsy to examine the tissue under the microscope. Tissue that is thickened and inflamed suggests plaque psoriasis.
How is psoriasis treated?
Treatment options depend on the severity of the disease and may include topical and oral medications, light therapy and injectable drugs.
While there is no cure, we can help you manage your condition so you can live a full and active life with psoriasis. Contact our office to schedule an appointment with Dr. Heather Higgins.
