I never knew that such a condition as Psoriasis existed until I came to Canada. Two of my co-workers have it. What is it? It is a condition which can be mild to severe, and is marked by scaly, silvery plaques of raised, reddish skin that tend to occur on the elbows, knees, lower back, and scalp. It is not contagious and it’s not just a skin disease. Psoriasis is a chronic skin condition.
What causes Psoriasis? The exact cause is unknown, however, researchers believe that psoriasis has hereditary and environmental components and is mediated by the immune system. Another website explains how the Immune System and the environment cause this condition.
Immune System Causes of Psoriasis
In a normally functioning immune system, white blood cells produce antibodies to foreign invaders such as bacteria and viruses. These white blood cells also produce chemicals that aid in healing and fighting infective agents. But with psoriasis, special white blood cells called T-cells become overactive.
These T-cells “attack” the skin and set off a cascade of events that make the skin cells multiply so fast they start to stack up on the surface of the skin. Normal skin cells form, mature, then are sloughed off every 30 days. But in plaque psoriasis the skin goes through this whole process in 3-6 days.
Normally T-cells produce chemicals that help heal the skin. In psoriasis, T-cells produce an abnormally large amount of these chemicals and actually cause more inflammation in the skin and joints.
Environmental Causes of Psoriasis
Not everyone who has these gene mutations gets psoriasis and there are several forms of psoriasis that people can develop. Certain environmental triggers play a role in causing psoriasis in people who have these gene mutations. Learn more about other psoriasis triggers.
Here are other factors which can trigger a psoriasis flare:
Sometimes an injury to the skin can cause the formation of a psoriasis patch. This is known as the Koebner Phenomenon, and it can occur in other skin diseases, such as eczemaand lichen planus. It can take 2 to 6 weeks for a psoriasis lesion to develop after an injury. Types of injuries that can trigger a flare include:
- Abrasion – even mild abrasion
- Increased friction from clothing or skin rubbing against skin in folds, such as armpits or under breasts
- Viral rashes
- Drug rashes
Weather is a strong factor in triggering psoriasis. Exposure to direct sunlight, which usually occurs in the warmer months, often improves the rash. On the other hand, cold, short days seen in the winter months can trigger the rash to worsen.
Psychological stress has long been understood as a trigger for psoriasis flares, but scientists are still unclear about exactly how this occurs. Studies do show that not only can a sudden, stressful event trigger a rash to worsen, daily hassles of life can also trigger a flare. In addition, one study showed that people who were categorized as “high worriers” were almost two times less likely to respond to treatment compared to “low worriers.”
Infections caused by bacteria or viruses can cause a psoriasis flare. Streptococcal infections that cause tonsillitis, or strep throat, tooth abscesses, cellulitis, and impetigocan cause a flare of guttate psoriasis in children. The human immunodeficiency virus (HIV) does not increase the frequency of psoriasis, but it does increase the severity of the disease.
Low levels of calcium have been reported as a trigger for psoriasis. Oddly enough, even though medications made from vitamin D are used to treat psoriasis, low levels of vitamin D do not trigger a flare-up.
The following drugs are known to either worsen psoriasis or induce a flare-up:
- Chloroquine— used to treat or prevent malaria
- ACE inhibitors — used to treat high blood pressure. Examples include monopril, captopril, and lisinopril.
- Beta blockers – also used to treat high blood pressure. Examples include lopressor and atenolol.
- Lithium— a medication used to treat bipolar disorder
- Indocin— an anti-inflammatory medication used to treat a variety of conditions, including gout and arthritis
- Corticosteroids, such as prednisone or solumedrol, can actually dramatically improve psoriasis. However, abruptly stopping the drug or rapidly tapering off of it can trigger a flare-up.
The classic symptoms of psoriasis are thick, raised red patches of skin covered with a dry, silvery white build-up of scales. The patches can appear anywhere on the body. While a doctor can diagnose psoriasis, it is typically done by a dermatologist – a physician who specializes in diagnosing and treating conditions that affect the skin. If you suspect that you might have psoriasis, see a dermatologist.
Women with psoriasis are at a higher risk of developing diabetes, and high blood pressure. Women with psoriasis have concerns about becoming pregnant. They worry that they might pass the condition to their unborn children. They wonder if they will be able to breastfeed or if their psoriasis treatments are safe for their babies or if their psoriasis will get worse during pregnancy. Treatment for pregnant women with psoriasis can be problematic, especialy if their condition is severe. They need to stop most systemic medication as it may lead to congenital abnormalities.
It is very important that women tell their dermatologist early on if they are planning to become pregnant. This will help the dermatologist to better assess if their psoriasis treatment can be continued during pregnancy and to prescribe a new medication if necessary. Women who suffer from psoriatic arthritis sometimes feel greater pain because of pregnancy-related weight gain. Most studies involving pregnant women show that pregnancy affects psoriasis. It is advised that women who have suffered from psoriasis during pregnancy and/or after childbirth, should not hesitate to breastfeed. Only women who have to use a systemic treatment or local treatment on extensive areas of the skin should avoid breastfeeding as these treatments can be absorbed into the breast milk and may be transmitted to the child.
Clearly psoriasis is more than just a skin condition. It affects a person’s life in so many ways. It has a major negative impact on patient’s quality of life in the following ways:
Interaction at work or school has been identified as being highly affected by skin disease, e.g. severe psoriasis can make it impossible for patients to work.
Psoriasis can be mistaken to be contagious and mistaken by others for a different disease or condition. These misconceptions contribute to the exclusion of psoriasis patients from public facilities, such as public pools and health clubs.
Patients with psoriasis, particularly females, have difficulty in starting sexual relationships.
Drinking and smoking
A high alcohol intake and smoking are risk factors for development of psoriasis; in addition, the stress of having psoriasis can lead to relief drinking/smoking and neglected treatment.
comprises a number of serious negative feelings observed in psoriasis patients: anticipation of rejection, feelings of being flawed, sensitivity to attitude of others, guilt and shame, negative attitudes and secretiveness.
Approximately 10% of psoriasis patients have had suicidal thoughts, underlining the relationship between mind and skin, compared to 3% among general medical patients.
Psoriasis can also impair the quality of life of families. Treatment time, reluctance to leave home or avoidance of public places such as swimming pools, beaches and sporting facilities may all interfere with family leisure time. Treatment for severe psoriasis may be seen as hazardous and the cost of treatment can be a further burden on the patient’s family.
What can you do to cope with your psoriasis?
Maintain a healthy lifestyle. By doing this you are more likely to successfully cope with your psoriasis and a healthy lifestyle improves the immune system which is beneficial for your psoriasis.
The right clothing. Tight clothing can irritate the skin and make psoriatic symptoms worse. Choose soft, natural fibres such as cotton for your clothes, including underwear.
Prevention. Even though triggers of psoriasis flare ups can vary for each person, there are triggers you can try to avoid such as getting stressed and excessive drinking or smoking.
For those of you who suffer from psoriasis, don’t give up hope. Seek support from others who are going the same challenges as you. Here is a resource that I hope you will take the time to check out. http://www.inspire.com/groups/talk-psoriasis/discussion/encouraging-words/ It will encourage you and help you. It’ s place where you can connect with people who share your health concerns.
Sources: http://news.health.com/2009/04/20/psoriasis-skin-diabetes-blood-pressure/; http://dermatology.about.com/od/psoriasisbasics/a/psorcause.htm; http://www.psoriasisconnections.ca/en/learn/what-is-psoriasis.jsp?source=google&group=symptoms&gclid=CP6y_OeZi6oCFYrJKgodL0GF0A; http://www.psorinfo.com/Pregnancy.aspx?ID=30; http://www.psorinfo.com/Quality-of-life.aspx?ID=58