Medical & Legal Information on Psoriasis: Causes & Treatment Options
• Psoriasis Overview
• Symptoms of Psoriasis
• The Causes of Psoriasis
• Diagnosing Psoriasis
• Psoriasis-Related Joint Pain
• Psoriasis Treatments
• What You Can Do
Psoriasis is a condition where patches of thick red skin can develop on any area of the body but especially the knees, elbows, lower back, scalp, palms of the hand, face, and soles of the feet. It can also develop in the mouth, and on toenails and fingernails. Most patches also present silvery scales.
Plaque psoriasis is the most common form of the condition. However, many people also suffer from psoriatic arthritis. This inflammatory form of arthritis usually happens to up to one out of five psoriasis cases. While this is significantly different than rheumatoid arthritis or osteoarthritis, many scientists believe there is a correlation between these diseases and the underlying conditions of psoriasis. Doctors sometime referred to psoriasis and psoriatic arthritis as psoriatic disease.
There is no known specific group of people who are more at risk of developing psoriasis compared than any other. However, adults tend to develop the non-contagious condition more than children, but both women and men are at equal risk of the disease. Psoriasis and psoriatic disease are autoimmune conditions. This means that the body’s immune system overstimulates and attacks the body’s normal tissues.
Symptoms of Psoriasis
Not every individual suffering from the disease experiences identical symptoms. The common symptoms associated with most cases of psoriasis include:
- Inflamed, red, raised lesions
- Dry skin that bleeds or cracks
- Silvery scaly plaque
- Burning, sore or itching skin
- Individual, read small spots (usually seen in young adults and children)
- Nail bed separation
- Pitted nails
The Causes of Psoriasis
Psoriasis skin cells tend to grow at a rate that is five times faster than normal skin cells grow. Because the body is unable to slough away the old cells accumulating at an accelerated rate, they instead build up and produce flaky, thick, itchy patches. Scientists believe this action is a combination of environmental or external triggers and inherited genetics.
Research shows that the genes in charge of the immune system signals get crossed and instead of guarding the body against invaders promotes the inflammation of skin cells at an faster than normal rate. Scientists have found that individuals suffering from psoriasis have about 25 genes that are different from others who do not suffer from the disease. Certain factors believed to trigger psoriasis flares include:
- Skin Injuries – Any bug bite, scrape, cut, sunburn, infection or continuous scratching could have the potential of triggering psoriasis.
- Infections – There is a correlation between acquired infections, especially strep infections, and psoriasis formations that appear as red, small drops. Young children tend to develop strep throat prior to their initial flareup of psoriasis. However, tonsillitis, bronchitis, respiratory infections and earaches can also trigger psoriatic skin problems.
- HIV – The disease tends to worsen at the early onset stage of HIV.
- Drugs including lithium (bipolar medication), heart medicines, high blood pressure drugs, beta blockers, clonidine, ACE inhibitors, antimalarial drugs and inflammation medicines including Indocin (indomethacin) are known to make psoriasis worse.
- Alcohol – Heavy drinking, especially in young men, seems to worsen or trigger common symptoms of psoriasis and interfere with the effectiveness of treatments. Combining alcohol with some psoriasis treatment drugs can produce dangerous side effects, especially in childbearing women.
- Smoking – Along with secondhand smoke, smoking cigarettes, cigars and other tobacco products escalates the potential risk of developing psoriasis or worsening existing conditions.
Diagnosing psoriasis may be difficult because the condition appears like many other diseases of the skin, especially eczema. Typically, the doctor will need to obtain a small sample of skin that can be evaluated by a pathologist under a microscope. Dermatologist (skin doctors) are usually highly trained in detecting, identifying and diagnosing psoriasis as is a rheumatologist in identifying psoriatic arthritis.
Psoriasis-Related Joint Pain
Many individuals suffering from the disease also experience swelling, stiffness, and pain in the joints and the surrounding area. Joint pain-related psoriasis is often referred to as psoriatic arthritis, which involves chronic inflammation condition that affects both the joints and skin. The symptoms of psoriatic arthritis are different than psoriasis, and include:
- Swollen toes and fingers
- Morning stiffness
- General fatigue
- Reduced range of joint motion
- Plaque – scaly Redskin patches
- Swollen, painful and tender joints
- Pain in the upper back, lower back, and neck
Doctors consider psoriasis-related diseases to include symmetric arthritis, asymmetric arthritis, spondylitis, DIP (distal interphalangeal predominant), and arthritis mutilans.
Even though psoriasis has no known cure, the disease does respond extremely well to systemic and topical treatments. Relief can be found in approximately nine out of every ten cases by minimizing the potential of flare-up pain. The most common treatments for psoriasis include:
- Topical Treatments – Topical medications and ointments are available that can be rubbed into the patient’s affected skin to avoid many of the associated side effects of drug medications taken orally. These topical treatments include:
- Salicylic Acid – Usually prescribed as an ointment, this topical medication smooths the skin and promotes the sloughing of psoriatic scales. However, this topical is commonly used only in small areas because too much of the ointment or lotion can cause over-absorption of the medication, which could lead to serious side effects like weakening hair shafts, skin irritation, temporary hair loss or hair breakage.
- Steroid-Based Cream – This type of treatment for psoriasis is most popular because it relieves itching, decreases inflammation and blocks psoriasis cell production. These creams come mild to strong (more effective) but can cause significant side effects including skin thinning, skin irritation, dryness, and burning.
- DMARDs (Disease Modifying Antirheumatic Drugs) – These medications are highly effective at treating severe symptoms. The medication is administered through injections or orally and is known to limit or slow joint damage while reducing inflammation and pain.
- Dovonex (calcipotriene) – This vitamin D-related ointment is highly effective in the treatment of psoriasis, especially when used concomitantly with topical corticosteroid creams. Small amounts are better to prevent the development of undesirable side effects.
- Coal-Tar Shampoos and Ointments – These products are highly efficient at relieving common psoriasis symptoms and diminishing the rapid growth of psoriasis cells. However, there are significant side effects including folliculitis, so it is only prescribed when the treatment can be supervised by a doctor.
- Prescription Retinoids – This synthetic form of Vitamin A preparation improves the conditions surrounding psoriasis. While considered slow acting compared to steroids, it also has side effects including skin irritation and dryness.
- Psoriasis Light Therapy – UVA (Ultra-Violet A) light used in conjunction with the psoralen medication is highly effective at treating difficult cases of psoriasis. Many doctors no longer recommend this treatment because of its correlation to the development of skin cancer.
What You Can Do
Because psoriasis has no known cure, it can last a lifetime, requiring sufferers to take control through a variety of methods including:
- Learn important facts about psoriasis including effective treatments
- Eat healthily and take proper care of your health
- See a dermatologist if your joints begin feeling sore and stiff
- Take notice of your fingernails and toenails for signs of psoriasis
- Visit a dermatologist on a routine basis, especially if you are considering stopping its treatment medication