Psoriatic Arthritis: What Is The Connection
Psoriatic arthritis : 1 in 4 of people with psoriasis may develop an associated arthritis called psoriatic arthropathy, which causes pain and swelling in the joints and connective tissue, accompanied by stiffness particularly in the mornings and when rising from a seat. Most commonly affected sites are the hands, feet, lower back, neck and knees, with movement in these areas becoming severely limited. Chronic fatigue is a common complaint linked with this condition. If you are experiencing mild aches and pains and have psoriasis, even very mildly, consult your dermatologist for further advice and if necessary a referral to a rheumatologist for further assessments. For more detailed information on psoriatic arthritis see What is Psoriatic Arthritis?
Psoriasis Is Not The Same As Eczema
Psoriasis is thought to be an autoimmune condition, and its often confused with the most common form of eczema, atopic dermatitis. Psoriasis lesions typically have sharper borders and thicker scaling than atopic dermatitis, according to Wang.
Patients who have atopic dermatitis will usually start experiencing symptoms in early childhood, Wang says, and its often associated with allergic conditions, such as asthma, seasonal allergies and food sensitivities. Compared to psoriasis, atopic dermatitis tends to be itchier, less well-defined and present in different parts of the body, like the face and body fold areas of the arms and the legs.
And when people think of psoriasis, Wang says, theyre usually referring to chronic plaque psoriasis, which is the most common form of the disease. However, there are other subtypes that cause lesions in different areas of the body than is typical, he explains.
What Are Other Types Of Psoriasis
Plaque psoriasis is the most common type. About 80% to 90% of people with psoriasis have plaque psoriasis.
Other, less common types of psoriasis include:
- Inverse psoriasis appears in skin folds. It may look like thin pink plaques without scale.
- Guttate psoriasis may appear after a sore throat caused by a streptococcal infection. It looks like small, red, drop-shaped scaly spots in children and young adults.
- Pustular psoriasis has small, pus-filled bumps on top of the red patches or plaques.
- Sebopsoriasis typically appears on the face and scalp as red bumps and plaques with greasy yellow scale. This type is a cross between psoriasis and seborrheic dermatitis.
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What Type Of Psoriasis Treatment Will I Need
Several treatment options can relieve psoriasis. Creams or ointments may be enough to improve the rash in small areas of skin. If the rash affects larger areas, or you also have joint pain, you may need other treatments. Joint pain may be a sign that you have arthritis.
Your provider will decide on a treatment plan based on:
- Severity of the rash.
- Vitamin A or retinoid creams.
How Does Light Therapy Work For Psoriasis
Light therapy, also known as phototherapy, is a treatment that focuses specific types of light onto the skin.
Your doctor may suggest one or more of the following phototherapy or combination therapy approaches:
Ultraviolet B This is an effective choice and can be delivered as either broadband UVB or narrowband UVB . UVB phototherapy is a good course of treatment for people with moderate to severe cases of psoriasis, patients with plaque psoriasis, those with thin plaques, and people who are generally responsive to natural sunlight.
PUVA For advanced cases of psoriasis, a physician might suggest combining exposure to ultraviolet A light with prescribing psoralen, a light-sensitizing medication that is most commonly administered orally. Taken shortly before light treatment, psoralen seems to boost the therapeutic effect of light on the immune system. People with moderate to severe cases of plaque psoriasis, guttate psoriasis, and psoriasis of the palms and soles are good candidates for PUVA.
The therapy is done in a doctor’s office, psoriasis clinic, or at home with a phototherapy unit. The FDA regulates medical devices used in the application of phototherapy. Laser treatments, using a device known as an excimer laser, can administer highly targeted beams of ultraviolet light to treat select areas of affected skin.
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How Does Psoriasis Affect Quality Of Life
It is widely accepted that psoriasis can severely affect an individuals quality of life although for many the condition is mild and a mere inconvenience. The severity of the disease does not always relate to the severity of anxiety that an individual will have. The area where the psoriasis is located such as the hands or face can severely affect an individuals ability to work or lead to discrimination due to ignorance.
What Are The Types Of Psoriasis
Chronic plaque psoriasis: Raised, red, scaly patches mainly occurring on the limbs and the trunk, especially on the elbows, knees, hands, around the navel, over the lower back and on the scalp. The nails may be affected so that they become thickened and raised from their nail beds, and the surface of the nail may be marked with small indentations . This is the most common type of psoriasis, affecting approximately 9 out of 10 people with psoriasis.
Guttate psoriasis : So named because it manifests itself over the body in the form of scaly, droplet-like patches. Numerous small, red, scaly patches quickly develop over a wide area of skin, although the palms and the soles are usually not affected. It occurs most frequently in children and teenagers, often after a throat infection due to streptococcal bacteria. Some people who have had guttate psoriasis will go on in later life to develop chronic plaque psoriasis.
Scalp psoriasis: Raised, red, thick, scaly plaques on the scalp and around the hairline. It is common and approximately 1 out of 2 of all people with psoriasis have it on their scalp. The reason it deserves special mention is that it can be particularly difficult to treat and usually requires specifically formulated medicines. It is awkward to treat with creams and ointments because the hair gets in the way. See Scalp psoriasis for more information
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Ways Of Easing Penile Psoriasis
The good thing about penile psoriasis is that there are many ways of relieving the physical discomfort . While it may look like a desiccated salami, it can still feel great. You just have to treat it right, baby!
The more you touch it, the worse it gets. If you see psoriasis appearing, its best to go easy on the sex/masturbation, because any action will just mean further aggravating the skin and making it sore. For me, 2 to 3 days is enough for it to be back to normal.
Wear 100% cotton underwear and loose trousers. Now, you dont have to go the way of MC Hammer and get yourself parachute pants, but hipster, penis-rubbing, skin-tight jeans are a bad choice. So is tight underwear, latex, spandex and other ridiculously groin suffocating garb. Cotton allows the skin to breathe properly and absorb extra moisture, which means that any penile psoriasis wont be further aggravated by the type of clothes you wear. I stick to boxers, but Im sure Y-fronts or whatever else is fine if its cotton.
The third words of wisdom are to use moisturizer! Moisturizing the dry areas in the morning can make the daytime more tolerable but you will have to experiment with what brands to use to get something non-greasy . For me personally, a bit of vaseline works well after the shower, but other hypoallergenic creams are just as good.
What Causes Psoriasis Outbreaks
Psoriasis outbreaks differ from person to person. No one knows exactly what causes flare-ups. Common psoriasis triggers may include:
- Skin injury .
- Streptococcal or other infection that affects the immune system.
- Certain prescription medications .
- Cold weather, when people have less exposure to sunlight and humidity and more to hot, dry indoor air.
Psoriasis Is An Inflammatory Skin Condition Diagnosed By A Physician
It usually manifests as itchy, well-delineated, red, scaly plaques in locations across the body, most often the scalp, elbows and knees, Wang explains.
Patients are typically diagnosed with psoriasis in their 20s or later on in adulthood, usually based on a clinical examination and family history, and sometimes with a skin biopsy to confirm the diagnosis.
In addition, were finding psoriasis can be associated with a variety of other health problems, particularly when its more extensive, likely because there is inflammation beyond the skin, Wang says. For instance, patients are at risk for diabetes, high cholesterol, high blood pressure, fatty liver and cardiovascular disease. It also can be associated with arthritis, which often manifests with morning stiffness. Psoriatic arthritis can hinder peoples ability to do their normal activities.
What Are The Trigger Factors
Although the underlying cause of psoriasis stems from your body’s immune system, the trigger factors that can make it worse or cause flare-ups include:
- Weather: Cold and dry weather can dry out your skin, which makes the chances of having a flare-up worse. In contrast, hot, sunny weather appears to help control the symptoms of psoriasis in most people
- Stress: Having psoriasis can cause stress itself and patients often report that outbreaks of symptoms come during particularly stressful times
- Some medications: Certain drugs, such as lithium , drugs for malaria, and some beta-blockers , can cause flare-ups of psoriasis. Some common painkillers — called non-steroidal anti-inflammatory drugs — may also aggravate psoriasis, although they are still used in some people with psoriatic arthritis
- Infections or disease: Certain infections, such as strep throat or tonsillitis, can result in guttate or other types of psoriasis. Psoriasis may worsen in people who have HIV
- Trauma to the skin: In some people with psoriasis, trauma to the skin — including cuts, bruises, burns, bumps, vaccinations, tattoos and other skin conditions — can cause a flare-up of psoriasis symptoms either at the site of the injury or elsewhere. This condition is called Koebner’s phenomenon
- Smoking: Some experts think that smoking can worsen psoriasis.
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Psoriasis Drugs: Biologic Medication
Biologic drugs are protein-based medicines that are derived from living cells cultured in a laboratory.
These medicines are administered through an injection or IV and target parts of the immune system.
Biologics work by blocking the action of a specific type of immune cell and proteins in the immune system that play a major role in the development of psoriasis.
The following medicines are examples of biologics:
The Horror Of Penile Psoriasis
The horror of penile psoriasis is hard to describe to those that dont have it. Imagine your sexy, noodly appendage looking like its just been pulled through a paper shredder. Even if youre into S& M and like your sausage being butchered, its not a fun look, let me tell you!
Now imagine slicing this with a butchers knife.
Thankfully so far, knock on wood I havent had problems with P on the peepee.
Penile psoriasis, like psoriasis in general, can appear anywhere on your love vegetable from the base of the shaft all the way to the top of the glans. Even if youre circumcised or uncircumcised, it can get you. However, unlike the common plaque psoriasis, the skin looks smooth NOT rough and dry.
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Is Psoriasis The Same As Eczema
Psoriasis and eczema are two different skin conditions. They differ in where the disease appears on the body, how much it itches and how it looks. Eczema tends to appear more often behind the knees and inside the elbows. Eczema also causes more intense itching than psoriasis. Many people, especially children, can get both eczema and psoriasis.
What Are The Symptoms Of Psoriasis
The following are the most common symptoms of psoriasis. Psoriasis comes in several forms and severities. Symptoms may include:
Plaque psoriasis. This type of psoriasis is the most common. Symptoms may include patches of red, raised skin on the trunk, arms, legs, knees, elbows, genitals, and scalp. Nails may also thicken, become pitted, and separate from the nail beds.
Guttate psoriasis. This type of psoriasis affects mostly children. Symptoms may include many small spots of red, raised skin. A sore throat usually proceeds the onset of this type of psoriasis.
Pustular psoriasis. Symptoms may include small pustules all over the body or just on the palms, soles, and other small areas.
The symptoms of psoriasis may look like other skin conditions. Always talk with your healthcare provider for a diagnosis.
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You Can Probably Blame An Out
Doctors arent sure why some people have these faulty immune systems and others dont, says Dr. Reichenberg, but genetics seems to be a driving force behind psoriasis. In a recent meta-analysis published in Nature Communications, University of Michigan researchers linked 16 genetic markers to psoriasisbumping the genetic regions linked to the condition to 63after analyzing data from more than 39,000 people.
How Can I Manage My Psoriasis
- Take care of your skin: Apply emollients, lubricants, or moisturizing creams to your skin regularly. Apply these while your skin is still damp when you bathe. Stop using them if they sting or irritate your skin. Use mild soaps and add bath oils to soothe your skin when you bathe.
- Protect your skin from sun exposure: When you get sun exposure for short periods of time, it can help your psoriasis. Too much sun exposure or a sunburn can make your psoriasis worse. Talk to your dermatologist or healthcare provider about how much sun exposure is right for you.
- Manage stress: Stress can trigger a flare-up. Find healthy ways to manage stress, such as deep breathing or meditation.
- Watch for symptoms with new medicines or herbal supplements: Some medicines, including herbal supplements, may trigger a psoriasis flare-up. Ask if any of the medicines you take may be making your psoriasis worse. Always check for skin changes when you take your medicines.
- Do not smoke: Smoking can trigger a flare-up of psoriasis. If you smoke, it is never too late to quit. Ask for information about how to stop.
- Avoid triggers: Injury to the skin, cold weather, and heavy alcohol use are other things that can trigger psoriasis flare-ups.
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Ways To Treat Psoriasis At Home
Even though it affects your skin, psoriasis actually begins deep inside your body in your immune system.
It comes from your T cells, a type of white blood cell. T cells are designed to protect the body from infection and disease. When these cells mistakenly become active and set off other immune responses, it can lead to psoriasis symptoms.
Even though theres no cure, many treatments exist to ease the symptoms of psoriasis. Here are 12 ways to manage mild symptoms at home.
What Else Should I Know
Making healthy choices can help with psoriasis. Here are some things you can do:
- If you smoke, quit. Smoking can trigger outbreaks of psoriasis in some people.
- Avoid alcohol. It can make psoriasis treatments less effective.
- Eat healthy foods. Eating a lot of fruits and vegetables can help fend off diseases that might trigger psoriasis.
- Stay at a healthy weight. This decreases the risk of inverse psoriasis.
- Keep skin clean and well moisturized. Bathing daily with bath salts or oils and then applying moisturizer can help ease the symptoms of psoriasis.
People who have psoriasis may feel self-conscious about how it looks. That’s one reason why some people turn to a therapist or join a support group of people who understand what they might be going through.
The key to psoriasis treatment is keeping up on whatever your doctor prescribes. If that means applying an ointment twice a day, then find a way to remind yourself to do it so you don’t forget. Psoriasis is one of those things that you need to stay focused on treating, even when you’re feeling OK.
Whether your psoriasis is mild or severe, learn all you can about it. Talk to your doctor or check websites like:
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Research Is Still Ongoing Into The Causes Of Psoriasis
Although research is continuing to advance, theres still more to learn about how and why patients develop psoriasis.
Were starting to understand the inflammatory pathways involved in psoriasis, and addressing that inflammation is making treatment much more effective nowadays, Wang says.
Genetics play an important part, Wang says, so if someone has a parent with the condition, they are at higher risk for developing it. However, there are likely multiple factors involved that eventually lead to development of psoriasis.
Complementary And Alternative Therapies
Mind-body therapies and stress management, including meditation and hypnosis, may help treat psoriasis. Studies show that people who practice meditation before getting light therapy do better than people who had light therapy alone. Exercise can help, too, as can drinking plenty of water.
Taking daily baths with lukewarm water and mild soap can help slough off scales. After your bath, gently pat skin dry and immediately apply a moisturizer to seal in water.
Talk to your doctor before taking any supplements or herbs, because some can have serious side effects or interact with common prescription medications, such as blood thinners and birth control pills. If you are pregnant or breastfeeding, ask your doctor before taking any supplement, herb, or over-the-counter medication. Be sure all your health care providers know about all therapies you use, including complementary and alternative therapies.
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