WHAT IS PSORIASIS?
Psoriasis is a common skin condition that changes the life cycle of skin cells. Psoriasis causes cells to build up rapidly on the surface of the skin. The extra skin cells form thick, silvery scales and itchy, dry, red patches that are sometimes painful.
Psoriasis is a persistent, long-lasting (chronic) disease. There may be times when your psoriasis symptoms get better alternating with times your psoriasis worsens.
The primary goal of treatment is to stop the skin cells from growing so quickly. While there isn't a cure, psoriasis treatments may offer significant relief. Lifestyle measures, such as using a nonprescription cortisone cream and exposing your skin to small amounts of natural sunlight, also may improve your psoriasis symptoms.
SYMPTOMS
Psoriasis signs and symptoms can vary from person to person but may include one or more of the following:
*Red patches of skin covered with silvery scales
*Small scaling spots (commonly seen in children)
*Dry, cracked skin that may bleed
*Itching, burning or soreness
*Thickened, pitted or ridged nails
*Swollen and stiff joints
Psoriasis patches can range from a few spots of dandruff-like scaling to major eruptions that cover large areas.
Most types of psoriasis go through cycles, flaring for a few weeks or months, then subsiding for a time or even going into complete remission.
Several types of psoriasis exist. These include:
Plaque psoriasis. The most common form, plaque psoriasis causes dry, raised, red skin lesions (plaques) covered with silvery scales. The plaques itch or may be painful and can occur anywhere on your body, including your genitals and the soft tissue inside your mouth. You may have just a few plaques or many.
Nail psoriasis. Psoriasis can affect fingernails and toenails, causing pitting, abnormal nail growth and discoloration. Psoriatic nails may become loose and separate from the nail bed (onycholysis). Severe cases may cause the nail to crumble.
Scalp psoriasis. Psoriasis on the scalp appears as red, itchy areas with silvery-white scales. The red or scaly areas often extend beyond the hairline. You may notice flakes of dead skin in your hair or on your shoulders, especially after scratching your scalp.
Guttate psoriasis. This primarily affects young adults and children. It's usually triggered by a bacterial infection such as strep throat. It's marked by small, water-drop-shaped sores on your trunk, arms, legs and scalp. The sores are covered by a fine scale and aren't as thick as typical plaques are. You may have a single outbreak that goes away on its own, or you may have repeated episodes.
Inverse psoriasis. Mainly affecting the skin in the armpits, in the groin, under the breasts and around the genitals, inverse psoriasis causes smooth patches of red, inflamed skin. It's worsened by friction and sweating. Fungal infections may trigger this type of psoriasis.
Pustular psoriasis. This uncommon form of psoriasis can occur in widespread patches (generalized pustular psoriasis) or in smaller areas on your hands, feet or fingertips. It generally develops quickly, with pus-filled blisters appearing just hours after your skin becomes red and tender. The blisters may come and go frequently. Generalized pustular psoriasis can also cause fever, chills, severe itching and diarrhea.
Erythrodermic psoriasis. The least common type of psoriasis, erythrodermic psoriasis can cover your entire body with a red, peeling rash that can itch or burn intensely.
Psoriatic arthritis. In addition to inflamed, scaly skin, psoriatic arthritis causes pitted, discolored nails and the swollen, painful joints that are typical of arthritis. Symptoms range from mild to severe, and psoriatic arthritis can affect any joint. Although the disease usually isn't as crippling as other forms of arthritis, it can cause stiffness and progressive joint damage that in the most serious cases may lead to permanent deformity.
When can I see a doctor?
If you suspect that you may have psoriasis, see your doctor for an examination. Also, talk to your doctor if your psoriasis:
CAUSES
The cause of psoriasis isn't fully known, but it's thought to be related to an immune system problem with cells in your body. More specifically, one key cell is a type of white blood cell called a T lymphocyte or T cell. Normally, T cells travel throughout the body to detect and fight off foreign substances, such as viruses or bacteria. If you have psoriasis, however, the T cells attack healthy skin cells by mistake, as if to heal a wound or to fight an infection.
Overactive T cells trigger other immune responses. The effects include dilation of blood vessels in the skin around the plaques and an increase in other white blood cells that can enter the outer layer of skin. These changes result in an increased production of both healthy skin cells and more T cells and other white blood cells. This causes an ongoing cycle in which new skin cells move to the outermost layer of skin too quickly — in days rather than weeks. Dead skin and white blood cells can't slough off quickly enough and build up in thick, scaly patches on the skin's surface. This usually doesn't stop unless treatment interrupts the cycle.
Just what causes T cells to malfunction in people with psoriasis isn't entirely clear. Researchers have found genes that are linked to the development of psoriasis, but environmental factors also play a role.
Psoriasis triggers
Psoriasis typically starts or worsens because of a trigger that you may be able to identify and avoid. Factors that may trigger psoriasis include:
*Infections, such as strep throat or skin infections
*Injury to the skin, such as a cut or scrape, bug bite, or a severe sunburn
*Stress
*Cold weather
*Smoking
*Heavy alcohol consumption
Certain medications — including lithium, which is prescribed for bipolar disorder; high blood pressure medications such as beta blockers; antimalarial drugs; and iodides.
RISK FACTORS
Anyone can develop psoriasis, but these factors can increase your risk of developing the disease:
Family history. Perhaps the most significant risk factor for psoriasis is having a family history of the disease. Having one parent with psoriasis increases your risk of getting the disease, and having two parents with psoriasis increases your risk even more.
Viral and bacterial infections. People with HIV are more likely to develop psoriasis than people with healthy immune systems are. Children and young adults with recurring infections, particularly strep throat, also may be at increased risk.
Stress. Because stress can impact your immune system, high stress levels may increase your risk of psoriasis.
Obesity. Excess weight increases the risk of psoriasis. Plaques associated with all types of psoriasis often develop in skin creases and folds.
Smoking. Smoking tobacco not only increases your risk of psoriasis but also may increase the severity of the disease. Smoking may also play a role in the initial development of the disease.
COMPLICATIONS
If you have psoriasis, you're at greater risk of developing certain diseases. These include:
Psoriatic arthritis. This complication of psoriasis can cause joint damage and a loss of function in some joints, which can be debilitating.
Eye conditions. Certain eye disorders — such as conjunctivitis, blepharitis and uveitis — are more common in people with psoriasis.
Obesity. People with psoriasis, especially those with more severe disease, are more likely to be obese. It's not clear how these diseases are linked, however. The inflammation linked to obesity may play a role in the development of psoriasis. Or it may be that people with psoriasis are more likely to gain weight, possibly because they're less active because of their psoriasis.
Type 2 diabetes. The risk of type 2 diabetes is upped in people with psoriasis. The more severe the psoriasis, the greater the likelihood of type 2 diabetes.
High blood pressure. The odds of having high blood pressure are higher for people with psoriasis.
Cardiovascular disease. For people with psoriasis, the risk of heart attack is almost three times greater than for those without the disease. The risk of irregular heartbeats and stroke is also higher in those with psoriasis.
This could be due to excess inflammation or to an increased risk of obesity and other risk factors for cardiovascular disease. Some psoriasis treatments may cause abnormal cholesterol levels and increase the risk of hardened arteries.
Metabolic syndrome. This is a cluster of conditions — including high blood pressure, elevated insulin levels and abnormal cholesterol levels — that increases your risk of heart disease. People with psoriasis have a higher risk of metabolic syndrome.
Other autoimmune diseases. Celiac disease, sclerosis and the inflammatory bowel disease called Crohn's disease are more likely to strike people with psoriasis.
Parkinson's disease. This chronic neurological condition is more likely to occur in people with psoriasis.
Kidney disease. Moderate to severe psoriasis has been linked to a higher risk of kidney disease.
Psoriasis can also affect your quality of life by increasing your risk of:
*Low self-esteem
*Depression
*Social isolation
*Problems at work, which can lead to a lower income
PREPARING FOR YOUR APPOINTMENT
You'll likely first see your family doctor or a general practitioner. In some cases, you may be referred directly to a specialist in skin diseases (dermatologist).
TESTS AND DIAGNOSIS
In most cases, diagnosis of psoriasis is fairly straightforward.
Physical exam and medical history. Your doctor usually can diagnose psoriasis by taking your medical history and examining your skin, scalp and nails.
Skin biopsy. Rarely, your doctor may take a small sample of skin (biopsy) that's examined under a microscope to determine the exact type of psoriasis and to rule out other disorders. A skin biopsy can generally be done in a doctor's office after application of a local anesthetic.
Conditions that can look like psoriasis
Other conditions that may look like psoriasis or may occur at the same time as psoriasis include:
Seborrheic dermatitis. This type of dermatitis is characterized by greasy, scaly, itchy, red skin. It's often found on oily areas of the body, such as the face, upper chest and back. Seborrheic dermatitis can also appear on the scalp as stubborn, itchy dandruff.
Lichen planus. This is an inflammatory, itchy skin condition that appears as rows of itchy, flat-topped bumps (lesions) on the arms and legs.
Ringworm of the body (tinea corporis). Ringworm is caused by a fungal infection on the top layer of your skin. The infection often causes a red, scaly ring or circle of rash.
Pityriasis rosea. This common skin condition usually begins as one large spot (herald patch) on your chest, abdomen or back, which then spreads. The rash of pityriasis rosea often extends from the middle of the body, and its shape resembles drooping pine tree branches.
TREATMENTS
Psoriasis treatments aim to:
*Stop the skin cells from growing so quickly, which reduces inflammation and plaque formation
*Remove scales and smooth the skin, which is particularly true of topical treatments that you apply to your skin
Psoriasis treatments can be divided into three main types: topical treatments, light therapy and systemic medications.
LIFESTYLE AND HOME REMEDIES
Although self-help measures won't cure psoriasis, they may help improve the appearance and feel of damaged skin. These measures may benefit you:
Take daily baths. Bathing daily helps remove scales and calm inflamed skin. Add bath oil, colloidal oatmeal, Epsom salts or Dead Sea salts to the water and soak. Avoid hot water and harsh soaps, which can worsen symptoms; use lukewarm water and mild soaps that have added oils and fats.
Use moisturizer. Blot your skin after bathing, then immediately apply a heavy, ointment-based moisturizer while your skin is still moist. For very dry skin, oils may be preferable — they have more staying power than creams or lotions do and are more effective at preventing water from evaporating from your skin. During cold, dry weather, you may need to apply a moisturizer several times a day.
Expose your skin to small amounts of sunlight. A controlled amount of sunlight can significantly improve lesions, but too much sun can trigger or worsen outbreaks and increase the risk of skin cancer. Before beginning any sunbathing program, ask your doctor about the best way to use natural sunlight to treat your skin. Keep a record of when and how long you're in the sun to help avoid overexposure. And be sure to protect healthy, unaffected skin with a broad-spectrum sunscreen with an SPF of at least 30. Apply sunscreen generously, and reapply every two hours — or more often if you're swimming or perspiring.
Avoid psoriasis triggers, if possible. Find out what triggers, if any, worsen your psoriasis and take steps to prevent or avoid them. Infections, injuries to your skin, stress, smoking and intense sun exposure can all worsen psoriasis.
Avoid drinking alcohol. Alcohol consumption may decrease the effectiveness of some psoriasis treatments.
ALTERNATIVE MEDICINE
A number of alternative therapies claim to ease the symptoms of psoriasis, including special diets, creams, dietary supplements and herbs. None have definitively been proved effective. But some alternative therapies are deemed generally safe, and they may be helpful to some people in reducing signs and symptoms, such as itching and scaling.
Aloe vera. Taken from the leaves of the aloe vera plant, aloe extract cream may reduce redness, scaling, itching and inflammation. You may need to use the cream several times a day for a month or more to see any improvements in your skin.
Fish oil. Omega-3 fatty acids found in fish oil supplements may reduce inflammation associated with psoriasis, although results from studies are mixed. Taking 3 grams or less of fish oil daily is generally recognized as safe, and you may find it beneficial.
Oregon grape. Also known as barberry, topical applications of Oregon grape may reduce inflammation and ease psoriasis symptoms.
If you're considering dietary supplements or other alternative therapy to ease the symptoms of psoriasis, consult your doctor. He or she can help you weigh the pros and cons of specific alternative therapies.
COPING AND SUPPORT
Coping with psoriasis can be a challenge, especially if the disease covers large areas of your body or is in places readily seen by other people, such as your face or hands. The ongoing, persistent nature of the disease and the treatment challenges only add to the burden.
Here are some ways to help you cope and to feel more in control:
Get educated. Find out as much as you can about the disease and research your treatment options. Understand possible triggers of the disease, so you can better prevent flare-ups. Educate those around you — including family and friends — so they can recognize, acknowledge and support your efforts in dealing with the disease.
Follow your doctor's recommendations. If your doctor recommends certain treatments and lifestyle changes, be sure to follow them. Ask questions if anything is unclear.
Find a support group. Consider joining a support group with other members who have the disease and know what you're going through. You may find comfort in sharing your experience and struggles and meeting people who face similar challenges. Ask your doctor for information on psoriasis support groups in your area or online.
Use cover-ups when you feel it necessary. On those days when you feel particularly self-conscious, cover the psoriasis with clothing or use cosmetic cover-up products, such as body makeup or a concealer. These products can mask redness and psoriasis plaques. They can irritate the skin, however, and shouldn't be used on open sores, cuts or unhealed lesions.
TREATMENT AVAILABLE HERE
HERBAL MEDICINES BY DR MTONGA N. ISAAC THE HERBALIST
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Contact us:
Mtonga Isaac Pharmacy,
Email: mtongaisaacpharmacy@gmail.com,
Tel: +260974272433/+260966399444,
Lusaka, Zambia.
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