Psoriasis is an
immune-mediated, genetic disease manifesting in the skin and/or the
joints. According to the National Institutes of Health, as many as 7.5
million Americans have psoriasis. In plaque psoriasis, the most common
type, patches of skin called "lesions" become inflamed and are covered
by silvery white scale. Psoriasis can be limited to a few lesions or can
involve moderate to large areas of skin. The severity of psoriasis can
vary from person to person; however, for most people, psoriasis tends to
be mild.
Is psoriasis contagious?
No, psoriasis is not contagious. It is not something you can "catch" or
"pass on." The psoriatic lesions may not look good, but they are not
infections or open wounds. People with psoriasis pose no threat to the
health or safety of others.
What causes psoriasis?
No one knows exactly what causes psoriasis, but it is believed to have a
genetic component. Most researchers agree that the immune system is
somehow mistakenly triggered, which speeds up the growth cycle of skin
cells. A normal skin cell matures and falls off the body's surface in 28
to 30 days. But a psoriatic skin cell takes only three to four days to
mature and move to the surface. Instead of falling off (shedding), the
cells pile up and form the lesions.
How is psoriasis diagnosed?
No special blood tests or diagnostic tools exist to diagnose psoriasis.
The physician or other health care provider usually examines the
affected skin and decides if it is from psoriasis. Less often, the
physician examines a piece of skin (biopsy) under the microscope.
Is there a cure for psoriasis?
There is no cure, but many different treatments, both topical (on the
skin) and systemic (throughout the body), can clear psoriasis for
periods of time. People often need to try out different treatments
before they find one that works for them.
What treatments are the best for me?
The unpredictable nature of psoriasis makes treatment challenging for
many people. A wide range of treatments is available. No single
psoriasis treatment works for everyone, but something will work for most
people. It is hard to predict what will work for a particular
individual; however, it is important to be open-minded and willing to
work with your doctor to find a treatment that will work for you.
Is all psoriasis alike?
No. There are various forms of psoriasis. Plaque psoriasis is the most
common. Other forms are:
- Guttate [GUH-tate], characterized by small dot-like lesions
- Pustular [PUHS-choo-ler], characterized by weeping lesions and
intense scaling
- Inverse, characterized by intense inflammation
- Erythrodermic [eh-REETH-ro-der-mik], characterized by intense
shedding and redness of the skin
Psoriasis can range from mild to moderate to very severe and
disabling.
Can psoriasis affect all parts of the body?
Psoriasis most commonly appears on the scalp, knees, elbows and torso.
But psoriasis can develop anywhere, including the nails, palms, soles,
genitals and face (which is rare). Often the lesions appear
symmetrically, which means in the same place on the right and left sides
of the body.
Can psoriasis occur at any age?
Psoriasis often appears between the ages of 15 and 35, but it can
develop at any age. Approximately 10 percent to 15 percent of those with
psoriasis get it before age 10. Some infants have psoriasis, although
this is considered rare.
Is psoriasis more prevalent in men or women, or in different ethnic
groups?
Psoriasis occurs nearly equally in men and women across all
socioeconomic groups. It is also present in all racial groups, but in
varying rates.
What health complications are associated with psoriasis?
The skin, the largest organ in the body, plays an important role. It
controls body temperature and serves as a barrier to infection. Large
areas of psoriasis can lead to infection, fluid loss and poor blood flow
(circulation).
Is psoriasis linked to other diseases?
Psoriatic arthritis is a specific type of arthritis that has been
diagnosed in approximately 23 percent of people who have psoriasis,
according to the Psoriasis Foundation's 2001 Benchmark Survey. Psoriatic
arthritis is similar to rheumatoid arthritis but generally milder. In
psoriatic arthritis, the joints and the soft tissue around them become
inflamed and stiff. Psoriatic arthritis can affect the fingers and toes
and may involve the, neck, lower back, knees and ankles. In severe
cases, psoriatic arthritis can be disabling and cause irreversible
damage to joints.
If I have psoriasis does that mean I will develop psoriatic
arthritis?
Approximately 10 percent to 30 percent of people with psoriasis will
develop psoriatic arthritis, although it often may go undiagnosed,
particularly in its milder forms. It can develop at any time, but for
most people it appears between the ages of 30 and 50. Having psoriasis
does not guarantee that you will eventually develop psoriatic arthritis.
How severe can my psoriasis become?
Psoriasis can be mild, moderate or severe. Three percent to 10
percent of the body affected by psoriasis is considered to be a moderate
case. More than 10 percent is considered severe. The palm of the hand
equals 1 percent of the skin. However, the severity of psoriasis is also
measured by how psoriasis affects a person's quality of life. Psoriasis
can have a serious impact even if it involves a small area, such as the
palms of the hands or soles of the feet.
What are psoriasis triggers?
Triggers can include emotional stress, injury to the skin, some types
of infection and reactions to certain drugs. Stress can cause psoriasis
to flare for the first time or aggravate existing psoriasis. Psoriasis
can also be triggered in areas of the skin that have been injured or
traumatized. This is known as the "Koebner 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, like antimalarial drugs, lithium and certain beta-blockers,
are also known to cause people's psoriasis to flare. Other triggers may
include weather, diet and allergies. Triggers will vary from person to
person and what may cause one person's psoriasis to flare may produce no
reaction in another individual.
Why does my psoriasis itch, and how do I control the itching?
Itching that is associated with psoriasis arises when certain
chemicals stimulate nerve fibers just below the outer layer of the skin.
Itch messages travel to the brain along the same pathways in the nervous
system that carry pain messages. Itch messages trigger the urge to
scratch.
One of the simplest ways for people with psoriasis to control itch is
by keeping the skin moisturized. Dry skin can induce and aggravate itch.
Many people also rely on simple, inexpensive measures, such as pressing
a wet towel against the itchy spot. Others find cold showers and cold
packs offer relief. Other treatments for itch include antihistamines,
steroids, capsaicin, topical anesthetics, topical immunomodulators,
antidepressants and aspirin.
Will having psoriasis affect my lifestyle or quality of life?
For the most part, people with psoriasis function normally. Sometimes
people experience low self-esteem because of the psoriasis. Psoriasis is
often misunderstood by the public, which can make social interactions
difficult. This may lead to emotional reactions such as anxiety, anger,
embarrassment and depression. Psoriasis can affect the type of work
people do if it is visible.
What is the financial impact of psoriasis?
Psoriasis is a chronic (life-long) illness. Most people need ongoing
treatments and visits to the doctor. In severe cases, people may need to
be hospitalized. About 56 million hours of work are lost each year by
people who suffer from psoriasis, and between $1.6 billion and $3.2
billion is spent per year to treat psoriasis.
Is there hope for a cure?
Yes. Researchers are studying psoriasis more than ever before. They
understand much more about its genetic causes and how it involves the
immune system. The National Psoriasis Foundation and the federal
government are promoting and funding research to find the cause and cure
for psoriasis.
