| Psoriasis is a noncontagious
skin disorder that most commonly appears as inflamed swollen
skin lesions covered with silvery white scale. This most
common type of psoriasis is called "plaque
psoriasis."
Psoriasis comes in many different variations
and degrees of severity. Different types of psoriasis display
characteristics such as pus-like blisters (pustular
psoriasis), severe sloughing of the skin (erythrodermic
psoriasis), drop-like dots (guttate psoriasis) and smooth
inflamed lesions (inverse psoriasis). Select the following
link to view photos and descriptions of the different types
of psoriasis. The degrees of severity of psoriasis are
divided into three important categories: mild, moderate and
severe. Select the following link to view photos and
descriptions of the different degrees
of severity of psoriasis.
Causes of Psoriasis
No one knows what causes psoriasis, though it
is generally accepted that it has a genetic component, and a recent
study has established that it is an autoimmune skin
disorder. Scientists believe that a person is born genetically
predisposed to psoriasis. One in three people report a family
history of psoriasis, but there is no pattern of inheritance.
There are many cases in which children with no apparent family
history of the disease will develop psoriasis.
Whether a person actually develops psoriasis
may depend on something "triggering" its appearance.
Examples of "trigger factors" include systemic
infections such as strep throat, injury to the skin (the
Koebner phenomenon), vaccinations, certain medications, and
intramuscular injections or oral steroid medications.
Once something triggers a person's genetic
tendency to develop psoriasis, it is thought that in turn, the
immune system triggers the excessive skin cell reproduction.
The Psoriasis Cycle
Skin cells are programmed to follow two
possible programs: normal growth or wound healing. In a normal
growth pattern, skin cells are created in the basal cell
layer, and then move up through the epidermis to the stratum
corneum, the outermost layer of the skin. Dead cells are shed
from the skin at about the same rate as new new cells are
produced, maintaining a balance. This normal process takes
about 28 days from cell birth to death.
When skin is wounded, a wound healing
program is triggered, also known as regenerative maturation.
Cells are produced at a much faster rate, theoretically to
replace and repair the wound. There is also an increased blood
supply and localized inflammation. In many ways, psoriatic
skin is similar to skin healing from a wound or reacting to a
stimulus such as infection.
Lesional psoriasis is characterized by cell
growth in the alternate growth program. Although there is no
wound at a psoriatic lesion, skin cells (called "keratinocytes")
behave as if there is. These keratinocytes switch from the
normal growth program to regenerative maturation. Cells are
created and pushed to the surface in as little as 2-4 days,
and the skin cannot shed the cells fast enough. The excessive
skin cells build up and form elevated, scaly lesions. The
white scale (called "plaque") that usually covers
the lesion is composed of dead skin cells, and the redness of
the lesion is caused by increased blood supply to the area of
rapidly dividing skin cells.
Living With Psoriasis
Psoriasis can be very painful, but the pain is
more than skin deep. The emotions suffer as well. It presents
people with physical limitations, disfiguration, and its
tedious, daily care always demands too much time.
Embarrassment, frustration, fear, and depression are common.
In extreme cases, a loss of self-esteem reults in a complete
withdrawal from society.
Various kinds of temporary relief are
available, and they work with varying degrees of success.
Treatments and medications are often time consuming and
expensive. They can be cosmetically unpleasant and pose
additional health risks for the patient. Select the following
link to see a listing and description of accepted therapies
for psoriasis.
Psoriasis does not follow a predictable
course. Each individual case breaks its own trail. Select the folowing link to view a selection of case
histories including photos and descriptions. One thing is
certain: the symptoms may come and go, but they almost always
come again. Its a life-long disease.
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The
Whole Story
