What Is The Definition Of Psoriasis

How Does This Information Affect The Management Of Psoriasis

The bottom line is that the lack of precise information on the cause of psoriasis severely hampers the search for a cure. However, the current state of information has resulted in the development of new effective treatments, all based on trying to correct the faults within the immune system. It is hoped that future more effective treatments will be developed as understanding of the complex problems within the immune system increases.

Meantime, more straightforward actions such as reducing alcohol intake, stopping smoking and trying to cope with stress can be recommended. The course of psoriasis is unpredictable. Whilst remission of symptoms can occur, it may take weeks, months or even years.

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.

What If Those Psoriasis Treatments Dont Work

If psoriasis doesnt improve, your healthcare provider may recommend these treatments:

• Light therapy: UV light at specific wavelengths can decrease skin inflammation and help slow skin cell production.
• PUVA: This treatment combines a medication called psoralen with exposure to a special form of UV light.
• Methotrexate: Providers sometimes recommend this medication for severe cases. It may cause liver disease. If you take it, your provider will monitor you with blood tests. You may need periodic liver biopsies to check your liver health.
• Retinoids: These vitamin A-related drugs can cause side effects, including birth defects.
• Cyclosporine: This medicine can help severe psoriasis. But it may cause high blood pressure and kidney damage.
• Immune therapies: Newer immune therapy medications work by blocking the bodys immune system so it cant jumpstart an autoimmune disease such as psoriasis.

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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 Symptoms Of Psoriasis

Symptoms of psoriasis can be different for each person, but some common ones are:

• Patches of thick, red skin with silvery-white scales that itch or burn.
• Dry, cracked skin that itches or bleeds.
• Thick, ridged, pitted nails.

The symptoms of psoriasis tend to come and go. You may find that there are times when your symptoms get worse, called flares, followed by times when you feel better .

Some patients have a related condition called psoriatic arthritis, in which you have stiff, swollen, painful joints. If you have symptoms of psoriatic arthritis, be sure to tell your doctor as soon as you can.

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Selection Of Indices To Be Included In The Proposal

The Delphi survey was designed to gather the opinions of dermatologists with expertise in psoriasis concerning the indices that should be included in the severity classification. The degree of agreement was obtained through 5-level Likert responses, ranging from 1 = No agreement to 5 = Full agreement in anonymous rounds. In the first round, items voted in favour by more than 80% of the dermatologists were retained, while those agreed upon by 20% or fewer were deleted. Items with intermediate scores were subjected to a second round. After the last round, all those items attaining over 80% were accepted.

Are There Complications Of Psoriasis

In some people, psoriasis causes more than itchiness and red skin. It can lead to swollen joints and arthritis. If you have psoriasis, you may be at higher risk of:

• Use medicated shampoo for scales on your scalp.

Other steps you should take to stay as healthy as possible:

• Talk to your healthcare provider about lowering your risk for related conditions, such as heart disease, depression and diabetes.
• Lower your stress with meditation, exercise or seeing a mental health professional.

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Plaque Psoriasis Is The Most Common Type Of Psoriasis

Those thick, scaly patches that develop on the skin are called plaques . About 80% to 90% of people living with psoriasis get plaques, so they have plaque psoriasis1.

Plaque psoriasis on an elbow

When someone has plaque psoriasis, youll often see raised patches coated with a silvery-white scale.

Plaques can appear anywhere on the skin, but youre most likely to find them on the:

• Knees

• Lower back

• Scalp

Plaques tend to vary in size. They may appear on the skin as a single patch or join together to cover a large area of skin.No matter the size, plaques tend to be itchy. Without treatment, the itch can become intense. Some people notice that their skin stings, burns, or feels painful and tight.

What Can My Doctor Do To Help

The doctor may decide to start treatment themselves or refer you to a dermatologist for advice. It is essential to seek medical advice because of confusion in diagnosis. Although many treatments are available over the counter from pharmacies your doctor may be able to prescribe particular treatments that are specifically for psoriasis.

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Will Dietary Supplements Help With My Psoriasis

There are a lot of dietary supplements available over the counter and available on line. Please remember that some of these products may not be of a high quality or reputable standard. Please always consult your doctor or healthcare professional before embarking on any supplementation to avoid overdosing in vitamin nutrients as these may cause undesired side effects.

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.

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How Is Psoriasis Diagnosed

Doctors usually diagnose psoriasis by examining the skin, scalp, and nails. They’ll also ask whether someone else in your family has psoriasis and if you recently had an illness or started taking a new medicine.

Rarely, doctors might take a skin sample to check more closely. A can tell the doctor whether it’s psoriasis or another condition with similar symptoms.

What Happens If My Gp Cannot Help

If you are referred for further treatment or advice it is likely to be to outpatients at your local hospital where a consultant dermatologist or a specialist dermatology nurse will assess you or it may be to another General Practitioner with enhanced role often referred to as GP with special interest .

It is likely that you may be offered the same treatment that your GP has already given you or other treatments that your GP is unable to prescribe.

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Is There A Test For Psoriasis

To see if you have psoriasis, your doctor usually examines your skin, scalp, and nails for signs of the condition. They may also ask questions about your health and history.

This information can help the doctor figure out if you have psoriasis, and, if so, identify which type. To rule out other skin conditions that look like psoriasis, your doctor may take a small skin sample to look at under a microscope.

What Is The Genetic Predisposition

Genetic predisposition means an inherited tendency to develop the disease. Recent research has greatly increased our knowledge about how and what we inherit from our parents and the role played by genes. As our knowledge increases so does our appreciation of the complexity of the process. While it was originally hoped that a specific disease might be associated with a specific gene, it now appears that for many diseases that have a genetic component, including psoriasis, there are probably multiple genes involved in producing the sequence of events that results in the expression of disease. This is further complicated by the way these genes interact.However, the evidence to support the belief that a genetic predisposition plays a major role in the cause of psoriasis can be summarised as follows:

• One third of people with psoriasis have a family member who is also affected
• There is an increased incidence of psoriasis in children when one or both parents have the disease
• In twins, psoriasis is more likely to appear in both identical twins than in both non-identical twins. This finding also confirms that more than one gene must be involved.

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Selection Of Indices To Be Included In The Definition: Delphi Study

The Delphi study was answered by 73 dermatologists . The indices with an agreement over 80% were PASI, BSA, and DLQI. The indices with an intermediate agreement were included in the second round, as follows: static Physician Global Assessment , Scalp Physician Global Assessment , static Physician Global Assessment of Genitalia , palmoplantar psoriasis Physician Global Assessment , fingernail Physician Global Assessment , and itching visual analogue scale . Of the 73 dermatologists who participated in the first round, 62 responded to the second . In the second round, sPGA and itching VAS had agreements over 80% and were thus added to PASI, BSA, and DLQI for the next phase.

Is Psoriasis Hereditary

Although psoriasis is not contagious from person to person, there is a known hereditary tendency. Therefore, family history is very helpful in making the diagnosis.

There are many effective psoriasis treatment choices. The best treatment is individually determined by the treating doctor and depends, in part, on the type of disease, the severity, and amount of skin involved and the type of insurance coverage.

For mild disease that involves only small areas of the body , topical treatments , such as creams, lotions, and sprays, may be very effective and safe to use. Occasionally, a small local injection of steroids directly into a tough or resistant isolated psoriatic plaque may be helpful.

For moderate to severe psoriasis that involves much larger areas of the body , topical products may not be effective or practical to apply. This may require ultraviolet light treatments or systemic medicines. Internal medications usually have greater risks. Because topical therapy has no effect on psoriatic arthritis, systemic medications are generally required to stop the progression to permanent joint destruction.

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Mild Moderate Or Severe

A key yardstick for grading your psoriasis is how much of your skin — called the body surface area — it covers. But your doctor also may factor in how red, scaly, and thick your patches are, and how much the disease hurts the quality of your life. Some scales sort psoriasis into just two camps instead of three: mild and moderate-to-severe.

How Is Psoriasis Diagnosed And Treated

Psoriasis often has a typical appearance that a primary care doctor can recognize, but it can be confused with other skin diseases , so a dermatologist is often the best doctor to diagnose it. The treatment of psoriasis usually depends on how much skin is affected, how bad the disease is , or the location . Treatments range from creams and ointments applied to the affected areas to ultraviolet light therapy to drugs . Many people who have psoriasis also have serious health conditions such as diabetes, heart disease, and depression. Some people with psoriasis also have an inflammatory condition which affects their joints, called psoriatic arthritis.

Psoriatic arthritis has many of the same symptoms as other types of arthritis, so a rheumatologist is often the best doctor to diagnose it. The treatment of psoriatic arthritis usually involves the use of drugs .

Psoriatic disease may be treated with drugs or a combination of drugs and creams or ointments.

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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.

Psoriasis Is Often A Life

Most people who get psoriasis have it for life. Thats true no matter what type of psoriasis you have, with one exception. Some children who have guttate psoriasis see their psoriasis go away.Because psoriasis tends to be a life-long disease, it helps to learn about it and see a board-certified dermatologist. A bit of knowledge and help from a board-certified dermatologist can give you some control over the psoriasis. By gaining control, you can see clearer skin. Gaining control can also help you to feel better, improve your overall health, and prevent the psoriasis from worsening.

Gaining control often involves:

• Learning what triggers your psoriasis

• Sticking to a good psoriasis skin care routine

• Living a healthy lifestyle

• Using medication when necessary

Seeing a board-certified dermatologist has another benefit. Psoriasis can increase your risk of developing certain diseases, such as psoriatic arthritis or diabetes. Your dermatologist can watch for early signs of disease. If you do develop another disease, early treatment helps to prevent the disease from worsening.When you see a board-certified dermatologist about psoriasis, your dermatologist may talk about the type of psoriasis you have. Its possible to have more than one type. You can learn about the different types and see pictures of what each type looks like by going to: Psoriasis: Signs and symptoms

Related AAD resources

All content solely developed by the American Academy of Dermatology

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The Immune System And Psoriasis

It takes most people with healthy skin about a month for their bodies to produce new skin cells and shed old ones. But when you have psoriasis, your bodys skin cells go through an accelerated cycle.

Thats because people with psoriasis have an overactive immune system, which causes excess inflammation. This inflammation forces your body to produce new skin cells at a much faster rateabout a 4- to 5-day cycle. Thats roughly seven times faster than normal. Skin cells rapidly pile up and get pushed to the surface, as your body is unable to shed them quickly enough.

Those skin cells become the scales and plaques you see on your skinwhich can be silvery, red, itchy, flaky, raised, or inflamed. Thats how inflammation deep down in your body can contribute to symptoms all the way up to your skins surface.

DEFINED: Inflammation is the bodys natural defense system. In normal amounts, it helps your body heal. But too much and your body starts to attack healthy cells.

How Is Psoriasis Treated

While there is currently no cure for psoriasis, there are treatments that keep symptoms under control so that you can perform daily activities and sleep better. Your treatment may include:

• Medications you put on your skinsuch as creams, ointments, lotions, foams, or solutionsor others that are injected or taken by mouth.
• where your doctor shines an ultraviolet light on your skin in their office.

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Who Treats Psoriasis

Psoriasis is treated by:

• Dermatologists, who specialize in conditions of the skin, hair, and nails. You may want to find a dermatologist that specializes in treating psoriasis.

Other health care providers who may be involved in your care include:

• Mental health professionals, who provide counseling and treat mental health disorders, such as depression and anxiety.
• Primary health care providers, including family doctors, internists, or pediatricians.

Who Gets Psoriasis

Psoriasis affects 24% of males and females. It can start at any age including childhood, with peaks of onset at 1525 years and 5060 years. It tends to persist lifelong, fluctuating in extent and severity. It is particularly common in Caucasians but may affect people of any race. About one-third of patients with psoriasis have family members with psoriasis.

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Who Does It Affect

It affects men, women and children alike. It can appear at any age in varying degrees but usually between the ages of 10 and 30. The extent of disease varies enormously from a minute patch to large patches covering most body areas. Psoriasis can also run in families and much research is being done into the genetics of this disease. It is known that the disease is multi genetic and therefore children may not necessarily inherit psoriasis.