Chronic Skin Conditions Incomprehensible even to Today: Psoriasis
Although the progression of medicine and technology has vastly expanded since a century ago, there still remain numerous conditions, diseases, and illnesses which are yet to develop proper treatments and cures for. Many treatments developed only account for temporary relief rather than the whole scope of the issue thereof which fundamentally means that people will continue to suffer.
Countless lives have been affected by these certain conditions, namely the skin condition, psoriasis which according to, the World Psoriasis Day consortium, affects about 8 million Americans and 125 million people worldwide which is roughly 2-3% of the world population.
What is it?
Psoriasis is a chronic skin condition in which the skin overproduces skin cells and in turn accumulates patches of scaly skin due to the overactivity of the immune system. Normally, skin cells will grow and shed within a month’s time, however, those with psoriasis experience this cycle within 3 to 4 days which does not give enough time for the skin to shed but rather allows it to occupy the surface and gradually accumulate which is why the skin appears to be scaly. These patches of scaly skin are not limited to but are most commonly found on the scalp, elbows, knees, feet, and even eyelids. Anyone is susceptible to psoriasis (although, it is not contagious) but usually starts appearing around the ages of 15-25. The majority of cases of psoriasis are by family genetics but the trigger of the overactivity in the immune system remains completely unknown which leaves those with psoriasis hopeless for a permanent cure. Though, over time treatments have been developed.
Some external factors, however, have been found to be linked to the development of psoriasis. These factors include:
Certain Medicines such as: beta-blockers, lithium, and antimalarial drugs
Obesity
Smoking
Stress
Weather
Infections
Symptoms
Symptoms of psoriasis are not constant, but rather flare in cycles with unpredictable periods which may last a few weeks or even months. Nevertheless, it is possible to take the initiative to control external factors to keep symptoms at bay when possible.
Not all people will experience the same symptoms, yet, most may experience a painful burning and/or itchy sensation on patches of red skin with scales. It may also cause extremely dry skin to crack, bleed, and itch which can be quite painful. These patches generally appear on both sides of the body, symmetrically. The inflammation and irritability of these symptoms may lead to poor sleep which can become a continuous cycle of poor sleep, worsening inflammation, and again poor sleep.
Furthermore, there have been links of psoriasis increasing the risk of:
Psoriatic Arthritis (Rather than skin inflammation, joints and etheses inflame; usually starts with psoriasis and may later lead to psoriatic arthritis)
Heart attacks/strokes
Mental health issues (low self-esteem, depression, anxiety)
Types
Plaque Psoriasis - The most common type of psoriasis, affects 80-90% of all cases. Plaque psoriasis is where red patches of skin appear with the white buildup of dead skin cells, also known as scales. This may also occur with nail psoriasis where there may be discoloration, nail bed separation, or even pitting which may appear as dents in the nail.
Guttate Psoriasis - Affecting only 8% of cases, guttate psoriasis generally starts from childhood to early adulthood. It appears as papules which are small, round spots that may or may not be scaly which differs from plaque psoriasis which appears with red patches and scales.
Pustular Psoriasis - The second least common type of psoriasis affects about 3% of cases and is usually developed as most cases are found in older adults, though, it can appear at any age. This psoriasis appears on red or discolored skin as pustules, painful yellow/white bumps filled with pus.
Inverse Psoriasis - Affecting about 21-30% of all cases, inverse psoriasis appears as purple, brown, or red lesions in body folds, unlike plaque psoriasis, it does not develop scales due to sweat in those areas. Due to the location thereof, it can be easily irritated because of the sweat and rubbing of those areas.
Erythrodermic Psoriasis - The least common type of psoriasis only affects about 2% of cases. Unlike the other 4 types of psoriasis which is concentrated in certain areas, this type spreads along the entire body and can possibly be life-threatening as it disrupts the body’s homeostasis as it causes changes in temperature and fluidity which can cause shivering episodes and edema, a type of swelling caused by a concentration of fluid in one area. Symptoms may be shedding in a large area of the body, severe redness, severe itching and pain, and an abnormal heart rate.
Treatments
There is no definite solution to psoriasis. However, it is possible to minimize symptoms by using topical therapy, light therapy, and oral/injected medications. All treatment options should be discussed with a doctor beforehand to ensure effectiveness and minimized risks. Topical therapy can include corticosteroids which over time may become ineffective and thin the skin depending on the concentration and strength thereof; vitamin D analogues can slow skin cell growth and can be paired with topical corticosteroids; and even salicylic acid to decrease the amount of scaling in the scalp. Light therapy can include sunlight exposure which can slow the skin cell growth; Psoralen plus ultraviolet A (PUVA) which allows for UVA light to penetrate deep in the skin and paired with the psoralen (a light sensitizing medication) allows for the skin to be more reactive to the light and is usually used for more severe cases of psoriasis; and excimer laser where a strong laser is pointed at a specific area of the skin, due to the strength of the laser it may cause inflammation and blistering. Oral/injected medication can include steroids for mild cases of psoriasis where a dose of triamcinolone may be injected into affected areas; retinoids such as acitretin can decrease the amount of skin cells produced but may leave the skin dry; and biologics which are injected drugs that change the immune system to break the cycle and in turn reduce symptoms. Although biologics are one of the most effective ways of treating psoriasis it carries the risk of increasing the chance of contracting more serious diseases and thus should be treated with caution. All treatment options should be discussed with a medical professional before being administered.
Article Written By: Sunny Han
Sources
Psoriasis Basics: Overview, Symptoms, and Causes - National Health Institutes
Psoriasis Statistics - National Psoriasis Foundation
About Psoriasis - National Psoriasis Foundation
Causes and Triggers - National Psoriasis Foundation
