About psoriasis

What is psoriasis

By psoriasis there is an inflammation in the skin, and the cells in the epidermis, the outer layer of the skin, divide and grow faster than normally.

The basic processes in the chronic inflammation stimulate the increased proliferation of cells. This is common by chronic inflammations of several kind, not only psoriasis.

These processes occur usually on confined areas or spots, but can also affect greater skin areas. These areas, psoriatic plaques, then get thicker and get a thicker layer of horn substance. The plaques can in turn rupture and scale off so that there occur open sores.

The affected skin looks first silvery white and then the psoriatic plaques develop and these have the form of red scaly patches. Plaques frequently occur on the skin of the elbows and knees, but can affect any area including the scalp and genitals. In contrast to eczema, psoriasis is more likely to be found on the extensor aspect of the joint, that is on the front side of knees, on the outer parts of elbows, and on the upper parts of the wrists and the back parts of the ancles.

Spesific types of psoriasis

There are several variants and sub-variants of psoriasis. One main variant is the non-pustular psoriasis, where the plaque occur mainly as flat flakes.

Psoriasis vulgaris is a non-pustular and the most common variant of psoriasis.(chronic stationary psoriasis, plaque-like psoriasis), affecting 80 to 90% of people with psoriasis. This psoriasis consist of thickened areas of inflamed skin covered with silvery white scales.

Psoriatic erythroderma (erythrodermic psoriasis) is a non-pustular variant giving widespread inflamed skin with exfoliation of the skin over greater areas of the body. Sometimes the skin is severely thickened, swellollen and painful. It occurs often as a further development of the more common simpler psoriasis, often after sudden cessation of systemic treatment. The extreme disturbances caused by this form of psoriasis can at worst be life-threatening because the skin looses the ability to protect the body against impacts from outside and to keep fluid and electrolytes inside.

Pustular psoriasis consists of raised bumps that are filled with pus free from infectious microorganisms (pustules). The skin under and around the pustules is red and tender. Pustular psoriasis can be confined to specific areas, like the hands and feet (palmoplantar pustulosis), or spread around at several parts of the body.

There are many types of pustular psoriasis, often named after the body part where it mainly occurs like: Generalized pustular psoriasis - occuring randomly on the body, Pustulosis palmaris et plantaris - occuring mainly on hands and feet, Annular pustular psoriasis - where the lessons occur as rings, Acrodermatitis continua - with lessons beginning on fingers and toes and the spreading upwards, Impetigo herpetiformis - a severe psoriasis occuring during pregancy.

The mechanisms and causes of the disease

By psoriasis there is an autoimmune reaction against the skin, resulting in an inflammation. The action of the immune system and the inflammation then make the cells in the epidermis divide faster. Probably the immune sytem destroys structures in the skin, and fragments of the destructed structures then trigger repair mechanisms in an exaggerated way.

The cause of psoriasis is not known, but a genetic component is probably a pert of the cause. Factors that may aggravate psoriasis include stress, excessive alcohol consumption, and smoking.

It has also be found that obese people are more likely to get psoriasis.

Topical treatment of psoriasis

Topical treatment is usually the first approach to manage psoriasis. Topical treatment has the aim of loosening scales, to reduce inflammation, to reduce cell proliferation, and to hinder that sores get complicated by infection. Topical products can contain pharmacological substances to reduce inflammation or natural substances for the same purpose.

Coal tar is a traditional ingredient used in such products to loosen scales and to reduce the processes forming the scales. Natural and synthetic oils of various kind is also used to give the skin moisture and loosen the scales. Salts are also used to loosen the plaques. Dead sea salt is popular for this purpose. These natural remedies are often blended together in the form of salves, ointments or cleansers.

Coricosteroids like desoxymethasone are used to reduse inflammation.

Variants of vitamin D3 and dithranol are used to reduce cell proliferation.

Drugs containing kalcipotriol, a derivative of vitamin D3, is often used to decrease the inflammation and the cell formation and thereby the other symptoms of psoriasis.

Coal tar can cause cancer and steroid can destroy the strength of the skin and lead to thin skin. Sudden withdrawal of some topical substances, especially corticosteroids, can sometimes cause the symptoms to get back agressively, so called rebound of the condition.

Physiological ways to treat psoriasis

Use of ultraviolet light reduce the process that forms scales by psoriasis and can bring the disease to remission. To get ultraviolet light on the skin, sun-bathing is a common natural metods. Ultraviolet treatment lamps is another way.

The ultraviolet treatment must be done as short exposure several times each week in some weeks, and thereafter one time each week to maintain the effect opbtained.

Ultraviolet light are of these types according to wavelength: UVA (380–315 nm) UVB (315–280 nm), and UVC (< 280 nm). Ultraviolet B (UVB) (315–280 nm) is taken up by the epidermis and helps against psoriasis.

Systemic psoriasis treatment

Systemic treatment, tretment by mouth or injections is added if the other treatment modules do not work properly and the psoriasis is of a serious grade.

One type of systemic psoriasis treatment is by cystostatica like methotrexate that reduce cell divisjon or kill some of the new cells produced, and thus reduces the processes that make the psoriasis symptoms.

Immunosuppressive drugs like cyclosporine is sometimes used. Those reduse the action of the immune system that triggers the mechanisms of psoriasis.

Retionoids that are variants of vitamine A are also used as systemic treatment for psoriasis. These reduce cell divisjon and thus reduces the psoriasis symptoms.

The mensioned systemic drugs bear a great risk of dangeous reactions and must be used only under strict surveillance.

In the latest years so-called biological treatment of psoriasis has been initiated. Such treatment consists of administering drugs with signal substances that the body normally uses to controle internal processes, usually as injections. The signal substances used to controle psoriasis reduce cell division. These drugs are expensive and one knows little about side effects yet. Therefore they are only used by svere psoriasis that does not respond to other treatment.

Lifestyle or diet changes to treat psoriasis

Since psoriasis is linked to excessive weight, slimming may help to allviate the condition.

Surgical treatment of psoriasis

When the psoriatic plaques are few and small, these can easily be sliced away surgically. When the skin then heals the treated area will often be without plaques a long time.

Severely obese people with psoriasis that go through a gastric bypass surgery will often experience that the psoriasis also gets less severe.

These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease. This information is nutritional in nature and should not be construed as medical advice. This notice is required by the Federal Food, Drug and Cosmetic Act.