Disease of the Week - Psoriasis

Disease of the Week – Psoriasis

Tue, Oct 27, 2009

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So this week I thought I’d talk about a skin disease, since I haven’t talked about any so far. So let’s talk about psoriasis, which is a common skin condition that causes skin redness and irritation. I’ve heard of a lot of people that have psoriasis (only saw it once, one of my friends had it), and my wife suggested that I write about it.

Typically, people with psoriasis have thick, red skin with flaky, white patches called scales. These red, irritated areas commonly appear as patches on the elbows, knees, and the trunk of the body. It’s also seen on the scalp, which was the case in my friend. So like I said, psoriasis is typically a red area of skin that thickens and on top is a lot of white, scaly skin. You’ll also see lesions on the genitals in males. You’ll see nail changes (where it will become thick, with yellow/brown spots, and most commonly with pits in the nail surface). One of the more debilitating secondary symptoms is psoriatic arthritis where there is joint pain and aching.

Psoriasis is a common autoimmune disease that can affect anyone of any age, but mainly those 15 to 35 years of age. It is something characterized by flare ups that can go away, and this can repeat again and again over time. Like many autoimmune diseases, it appears to be an inheritable disease that’s not contagious. Since the body’s immune system essentially confuses our healthy skin cells for dangerous antigens, the body ends up attacking it which causes that thickened layer of inflamed skin. This forces the body to create more skin cells to replace those being attacked that are dead on the surface. Compared to a normal person, skin typically is replaced continuously over the course of a month. In psoriasis, this replacement occurs faster than normal, which causes that thickened skin.

There are five main types of psoriasis.

Erythrodermic – The skin redness is very intense and covers a large area.
Guttate – Small, pink-red spots appear on the skin.
Inverse – Skin redness and irritation occurs in the armpits, groin, and in between overlapping skin.
Plaque – Thick, red patches of skin are covered by flaky, white scales. This is the most common type of psoriasis.
Pustular – White blisters are surrounded by red, irritated skin.

As far as your doctor diagnosing this disorder, it’s typically done just by inspecting the skin. However, with the various types a biopsy of the skin may be in order to rule out other skin problems, like cancers. If you have that joint pain with psoriasis, X-rays may also be used. There’s no true prevention for the disease, but if you do acquire it, avoiding the things that can cause flare ups is in order. These include excess or not enough sunlight, alcohol, stress, lack of moisture, etc.

Typically, severe psoriasis is treated with immunosuppressive drugs, but this can tend to be as dangerous as psoriasis itself, since these drugs end up stopping your immune system from fighting common infections. Also, this prevents the body from keeping cancerous cells in check and allows them to multiple. One of my professors at school who is a pathologist actually prescribed someone to take high levels of vitamin D instead of taking the immunosuppressive drugs. If I remember correctly, he may be close to publishing a journal article on therapeutic levels of vitamin D used for severe psoriasis. So that is something to keep in mind.

Some of those severe cases may only be treated with those immunosuppressive drugs, but if it’s mild then there are a lot of options out there. Anti-itch creams, dandruff shampoos, vitamin D and A, moisturizers, oatmeal baths, etc.

So this is a disease that may not be 100% treatable at the moment, but it is something that is manageable. So if you feel like you’ve been suffering from this, go to your physician to see if they can help you out.

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