What is psoriasis?
Psoriasis is a common immune system condition that affects nearly 125 million people around the world. In the skin, inflammation causes skin cells to grow too fast. This most commonly results in thick, scaly patches on the skin known as plaques. Although psoriasis plaques may be unsightly, they are not contagious. Psoriasis can have a negative social and psychological impact. Although psoriasis affects the skin, it is not just a disease of the skin. The inflammation underlying psoriasis can affect many other parts of the body, including the joints.
What causes psoriasis?
Psoriasis is thought to be an immune system problem that causes the skin to grow faster than normal. The immune system attacks the skin and creates inflammation, which stimulates more growth. The causes of this immune system issue are not clear, but there are genetic and environmental factors. Certain things can trigger psoriasis including stress, some bacterial infections, medications, smoking, injury to the skin, and more.
What are the symptoms?
The most common symptoms of psoriasis are the development of plaques on the skin. Plaques are thick areas of skin that can be red and silvery. Common areas for plaques include the knees, elbows, lower back, and scalp. They can be itchy. Less commonly, psoriasis can also appear as multiple scaly and small drop-shaped lesions across the body, known as guttate psoriasis. This kind of psoriasis can occur after an infection like strep throat. Psoriasis can also affect the fingernails and toenails, resulting in discoloration and malformation. Other forms of psoriasis exist that affect areas involving hands and feet, and skin folds, such as the arm pits, groin area, and underneath the breasts.
Arthritis caused by psoriasis is an important and often underappreciated symptom. Most people notice psoriasis on their skin before developing arthritis, but it is possible to develop arthritis before skin lesions. Psoriatic arthritis may appear as a swollen or tender finger or toe, pain and swelling in the heel, or morning joint stiffness that fades during the day.
Psoriasis is a condition that creates inflammation in many areas of the body, not just the skin. This inflammation can be a risk factor for cardiovascular disease, like heart attack and stroke. This should be taken into consideration when seeking treatment for psoriasis.
What are the treatment options for psoriasis?
There are many treatment options for managing psoriasis. However, it is often a life-long disease. Although treating the psoriatic plaques that appear on the skin is important, treating the underlying inflammation is also an important concern. Avoiding items that can trigger psoriasis is important.
Corticosteroids are the primary option for reducing inflammation and itching in the skin. Steroids can be beneficial because they offer more immediate results. However, they should not be used excessively in order to avoid possible side effects in the skin. Longer term topical therapies include Vitamin D and Vitamin A containing creams. Lotions and creams containing salicylic acid or lactic acid can help to soften thick plaques.
Phototherapy uses controlled ultraviolet light to calm down the inflammation in the skin. It is a treatment option that can be useful when combined with other therapies.
Systemic therapies are medications that will affect the entire body, not just the skin. These therapies are most appropriate for more severe cases of psoriasis and those that are affecting the joints. The goal is to adjust the immune system and reduce the inflammatory process throughout the body. Biologic agents like adalimumab (Humira ®) specifically target inflammatory signals in the body. Oral medications like methotrexate and cyclosporine act by different mechanisms to modify the immune system and help alleviate the manifestations of psoriasis. New biologic treatments are constantly being developed to address the problems associated with psoriasis.
Schedule an appointment with Dr. Schuering for evaluation and consideration for what therapies are best for you.