Treatment for Chronic Skin Inflammation
Psoriasis is a lifelong skin disease. According to the National Institutes of Health, as many as 7.5 million Americans have psoriasis. The most common form, plaque psoriasis, appears as raised, red patches or lesions covered with a silvery white buildup of dead skin cells, called scale. Psoriasis patients not only suffer from the disease it self, but from social embarrassment and misconceptions held by the general public.
Psoriasis [pronounced sore-EYE-ah-sis] is a chronic inflammatory disorder in which the immune system attacks the skin from the inside out. We really don’t know why that happens. But it’s the effects of the inflammatory cells on the skin that cause the skin to get red, thick, and scaly.
As a result, patients develop these unsightly plaques that are visible on the skin’s surface. Examples of Psoriasis (University of Michigan)
An activated immune system triggers the skin to reproduce every three to four days, building up on the outer layers (epidermis and keratin). The epidermis thickens, blood flow increases and reddens the skin, and silver-gray scales cover it.
Psoriasis is not contagious.
People cannot “catch” it by touching the skin of someone who has psoriasis. Dr. Cobos recommends early skin examination if you or your child experience patchy skin buildup or flaking.
According to the National Psoriasis Foundation, psoriasis tends to run in families; scientists are exploring genetic links to the disease. The condition commonly appears between the ages of 15 – 35, and often becomes a life-long, chronic illness. Patients usually experience alternating periods of flare-ups and remissions. Psoriasis is known as an “equal opportunity” disease — it affects people of every socioeconomic class.
Stress to the skin can trigger a flare-up of psoriasis. Patients have reported new plaques appearing about two weeks after the skin is cut, scratched, rubbed or severely sunburned. Psoriasis typically starts as small, red bumps that develop into larger scaly plaques.
Infections, such as strep throat, can encourage a flare-up, as can the use of certain medications such as lithium. Emotional stress has been linked to outbreaks of psoriasis. Climate can also be a contributing factor; many patients say their psoriasis is worse in the winter, when their skin is dry and exposed to less sunlight.
There are five types of psoriasis.
Click the links thru the National Psoriasis Foundation to learn more.
- Plaque: Most common form of the disease
- Guttate: Appears as small red spots on the skin
- Inverse: Occurs in armpits, groin and skin folds
- Pustular: White blisters surrounded by red skin
- Erythrodermic: Intense redness over large areas
Where it Occurs
Psoriasis commonly affects the elbows, knees, groin, buttocks, scalp and nails. Nails affected by psoriasis may become pitted or discolored. The nails may loosen, thicken or crumble. Inverse psoriasis shows up in the armpit, the skin under the breast, and in skin folds around the groin, buttocks and genitals. Guttate psoriasis affects children and young adults. It often occurs after a sore throat and may clear up in weeks or a few months. Pustular psoriasis may be widespread or localized with pus-filled blisters that form on the skin, and then dry and peel. Erythrodermic psoriasis is the rarest form, but can affect most of the skin and causes tremendous discomfort.
Psoriasis often appears in the same place on both sides of the body. About 10% of all cases are described as extensive, involving more than 20% of the body’s surface area. Mild to moderate psoriasis affects less of the body’s surface area. (One percent of the body surface area is usually the size of the palm of the hand.)
Approximately 10-30% of those with psoriasis also develop arthritis. Similar immune cells affect inflammation in both skin and joints. Some patients say their arthritis improves when the condition of their skin gets better and vice versa.
Treatments for Management of Psoriasis
Topical lotions, ointments, creams, gels, and shampoos for the skin and scalp are prescribed for mild-to-moderate cases of psoriasis or in combination with other treatments for more severe cases. FDA-approved prescription topicals to treat psoriasis include corticosteroids, retinoids, calcipotriene, and coal tar products. These drugs slow down skin cell production and reduce inflammation.
Moderate to severe psoriasis may be treated with one of the new “biologics” which are injectable proteins. Dr. Cobos may recommend the biologic Enbrel. Injections are once weekly for 12 weeks followed by periodic injections and topical support therapy.