Psoriasis

Psoriasis is a very common skin disease, characterized by changes in the life cycle of skin cells. Skin cells divide and reproduce at an extreme pace, which cause the emergence of thick and plaque-like bumps on the skin. These plagues are covered with a silver-white colored scaly skin and are extremely itchy. Scratching them may lead to bleeding. Also, these plaques sit on red and painful lesions.

Psoriasis is a life-long disease running on a cycle of periods marked by severe symptoms following mild courses. Severe periods may last for a few weeks or a few months, after which the healing period may continue for years.

The disease may evoke changes in the appearance of the skin and nails, and nail loss.

Psoriasis might emerge as small dots or as a scaly patch, or cover a large part of the body as well.

The plague psoriasis is the most prevalent type of this disease. Although may appear at any spot on the body, it is often come across on the back of the knees and forearms, the scalp, and the face. Patients of this type may also suffer from joint involvement accompanying psoriasis. It might cause stiffness in joints and progressive joint destruction.

The cause of psoriasis is unknown but it is considered to be a disorder associated with immune system.

Psoriasis episodes usually arise from preventable or restrainable causes.

Triggering factors include:

  • Throat and skin infections,
  • Irritation or scarring on the skin,
  • Stress,
  • Cold weather,
  • Smoking and drinking alcohol,
  • Medication with beta-blockers used for hypertension treatment, or medications with lithium used for psychological disorders.

Anybody is a potential patient of psoriasis. Still, individuals in high-risk group are:

  • People who have psoriasis history in their family members,
  • People who frequently suffer from strep throat infection,
  • AIDS patients,
  • People who pursue a very stressful life,
  • Patients with obesity,
  • Smokers.

Psoriasis patients are more prone to suffering from the following disorders;

  • Psoriatic arthritis,
  • Ophthalmia,
  • Obesity,
  • Type-2 diabetes,
  • Hypertension,
  • Cardiovascular diseases,
  • Metabolic syndrome,
  • Diseases resulting from immune system dysfunctions,
  • Renal diseases.

Psoriasis may also significantly reduce patients’ life standards, causing depression, low self-esteem, social isolation, and job loss.

The diagnosis of psoriasis is usually based on the patient’s history and physical examination, except for occasional cases where the physician performs a skin biopsy.

Examples of diseases that might be confused with psoriasis include:

  • Seborrheic dermatitis,
  • Lichen planus,
  • Fungal infections on the body,
  • Pityriasis rosea.

The treatment of psoriasis aims to prevent or ease down the rapid division of skin cells, while preventing scaling and skin eruption.

Principal treatment methods of psoriasis are categorized into 3 groups:

  • Topical therapy (creams, pomades and lotions applied on the skin)
  • Phototherapy
  • Systemic therapy (oral medications and intravenous medications)

The most preferred medication groups in topical treatments are as follows:

Corticosteroids: Reduce complaints by minimizing the inflammation on the skin. Suitable for treatment of the mild and moderate psoriasis.

Vitamin D analogs: Slow down the division of skin cells. They might be administered on treatments of the mild to moderate psoriasis patients on their own, or in combination with other medications.

Anthralin: Assumed to normalize the skin cell DNAs, but it is irritant and very difficult to use due to its dyeing feature.

Topical retinoids: These medications, often used in acne treatment, normalize the DNA activities of skin cells. They cause irritation on the skin and also increase the sunlight sensitivity. Women who are pregnant, or planning to become one, or breastfeeding should avoid using these medications.

Salisylic acid: Reduces scaling and flaking on the skin. May be used in combination with other medications.

Moisturizers: Reduce complaints of itching and dryness.

Planning the treatment, the physician starts with the lightest medications (topical creams) and administers a combination therapy with other medications, if necessary. If these treatments underperform, phototherapy and systemic treatments follow respectively. In addition to these treatments, it is important for patients to take daily warm bathes, keep their skin moist and sunbathe daily for the success of the therapy.

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