Psoriasis is a chronic skin disease whose physical
symptoms directly affect the emotional well being
of sufferers. The physical symptoms — red, patchy
skin topped by white or silvery scales — result
from skin growth that is seven times faster than
normal. Psoriatic skin grows faster than the body
can shed it, causing the build up commonly associated
with the disease. The cause of psoriasis is unknown,
but immune system and genetic factors are believed
to play a role.
Psoriasis affects more than 7 million people in
the U.S., including some 2.6 million children.
The emotional effects of psoriasis are many, including
loss of self-esteem and depression, and often directly
impact the quality of life of sufferers. According
to a May 2002 study by the National Psoriasis Foundation,
one third of people with moderate to severe cases
of the disease say it is a very large problem in
their lives. Among those with moderate to severe
cases, 75 percent said it had a moderate to large
impact on their everyday lives. More than a quarter
of respondents said the disease altered their daily
activity and 21 percent said they stopped normal
daily activities because of their psoriasis; 36
percent said it affected their sleep and the same
percentage said they bath more than normal, the
study reports.
Psoriasis generally manifests itself on the elbows
and knees. It does not cause scarring or hair loss,
and rarely affects the face. Psoriasis is not contagious.
There are several different types of psoriasis:
plaque, guttate, inverse, erythrodermic, generalized
pustular and localized pustular. Plaque psoriasis
is the most common form of the disease. Severity
of the disease - from mild to moderate to severe
- is measured by how much of the body psoriasis
affects and how it affects an individual's quality
of life.
It is estimated that 75- to 80 percent
of cases are mild and that 20- to 25-percent are
moderate to severe.
Psoriasis can disappear, but a predisposition for
its return remains and the condition can reappear
even after years of absence. It is thought that
stress can trigger the appearance of psoriasis.
Some people with psoriasis - perhaps 10- to 30-percent
-- also develop a related form of arthritis, known
as psoriatic arthritis.
Treatments:
While there is no cure for psoriasis, there are
many forms of treatment for its symptoms, including:
Topical preparations:
• Coal tar has been used for many years. It major
drawback is its strong odor and the
stains it produces.
• Dithranol, also known as anthralin, is a topical
treatment no longer prescribed often.
It produces brown stains, can irritate the skin
and is not tolerated well by fair-skinned
individuals.
• Topical steroids, which are clean and soothing.
On the weaker end of the scale of topical
steroids is hydrocortisone, sometimes used on delicate
areas; at the stronger end is Micronized
Betamethasone Dipropionate (see DermaZinc™
Spray/Drops compounded with Micronized
Betamethasone Dipropionate). Stronger steroids
must be used with care and for limited
periods, as long term use can result in thinning
skin and could - when used incorrectly
- aggravate psoriasis.
• Vitamin D-like compounds, such as calcipotriol,
are safe and reduce itching and scaling.
These work well for approximately one in three people;
one in five experience skin irritation.
Basic measures:
• Baths, including bath oil in warm water and use
of a non-detergent soap (such as DermaZinc™
Soap )can soften psoriatic skin and lift scales.
Detergent soaps and antiseptics are
not necessary and might even irritate skin.
• Emollients, or moisturizing agents, help keep
psoriasis plaques and scales soft, an
important element in treatment (see DermaZinc™
Cream).
• Occlusive dressings, or waterproof dressings adhered
to the skin, can help reduce psoriatic
patches.
• Scalp care includes specially medicated shampoos
or liquid lotions. Coal tar shampoo
may be purchased over the counter, along with DermaZinc™
Shampoo. For more severe scalp conditions,
DermaZinc™ Spray/Drops (which
comes with a special scalp applicator) or DermaZinc™
Shampoo can be compounded with Micronized
Betamethasone Dipropionate.
• Sunshine can help clear psoriasis in some cases.
The symptoms of psoriasis tend to improve
dramatically in summer months. Caution is advised,
however, as psoriasis can develop in sunburned areas
of the skin and premature aging that
could lead to skin cancer can result from exposure
to ultraviolet radiation, in either natural or synthetic
forms.
Oral medications:
These generally are reserved for cases where more
than 40 percent of the skin is affected or when
the condition interferes greatly with function.
Acetretin is an oral medication that produces slow
improvement in most cases, but has numerous side
effects that can include peeling of the skin on
the palms and soles of the feet, dry lips, muscle
pain, fatigue and liver damage.
Ultraviolet radiation:
This typically is used in winter months. A six-week
course of treatment generally is prescribed and
can lead to substantial clearance. However, ultraviolet
radiation can produce premature aging of the skin
that has been linked to skin cancer and, therefore,
should not be used indefinitely.
PUVA, or psoralens with long wave ultraviolet aradiation,
is known as photochemotherapy and is more effective
than ultraviolet radiation. It is popular for its
ease of use and efficacy, but can cause burning
and skin cancer.
Disclaimer: Dermalogix
Parnters, Inc., furnishes this information for educational
purposes only. It is not intended as medical advice
and Dermalogix Partners, Inc., claims no liability
for any information that might be inaccurate. Please
consult your physician for further information.
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WHAT
IS PSORIASIS?
