Psoriasis is a common skin disease affecting about 1-3% of the population all over the world.
Causes of Psoriasis: Here in this disease, there is excessive skin production at certain sites of the body only, leading to skin thickening, thereby giving an appearance of reddish-silver flaky skin.
Epidermis is the upper layer of the skin. Basal layer, which consists of single layer of dividing cells, produces this layer & it is the lower most layer of the epidermis. In a normal individual everyday skin is produced in the basal layer (basal cell divides into two in 100hrs), this new skin is pushed to the surface of the skin, where it sheds invisibly & is washed away while bathing & cleaning. Basal layer takes about 4 weeks to reach the top.
In Psoriasis, this happens in 4-5 days, because here the basal cell divides into two in 36hrs. In fact in psoriasis there will be 2-3 layers of dividing cells at the basal layer. The exact cause for this uncontrolled excessive skin production only in certain individuals is not known. Extensive research is going since years to find out the root cause for this disease.
General Information about Psoriasis
- It is a genetic disorder but not a hereditary disease. It might be due to certain defect in the gene. So many people with psoriasis may not have any other family member with a similar problem.
- It is not related to any food habits.
- It is not a venereal disease.
- It affects only the skin & not any internal organs, such as brain, heart, kidney etc, so it is a mild disease of the skin only. It does not affect the general health.
- It is not contagious, i.e., it does not spread by contact, or clothing, or articles, or by talking or by sex & other any means.
Clinical appearance:
Here skin appears as reddish silvery scaly patches over elbows, knees, scalp, palm, sole, lower back & any other area of skin, which is prone for trauma.
Nails are affected with yellowish thickening & pits over the surface.
Rarely small joints of the hands, feet, neck & lower back are affected with swellings & pain.
It is associated with itching.
Mostly (in 80%of the patients) psoriasis begins to appear after the age of 30 yrs. In 10% of them it appears before the age of 30, while in 10% it appears after the age of 60 yrs.
Course of the disease: Psoriasis is very unpredictable in its course. Spontaneous appearance & disappearance are observed even without any medications. Sometimes it does not appear for months to years or it might persists for months to years without any improvement. Usually psoriasis improves with pregnancy & in summer season. Psoriasis can be aggravated by certain factors.
Aggravating factors for psoriasis:
- Trauma: Psoriasis will appear at the site of any type of injury to the skin. Even surgeries can aggravate it.
- Infection: Any bacterial or viral infection such as sore throat, respiratory (cough & cold), Gastro intestinal (loose motions) urinary, vaginal (discharge), skin (boils) or dental infection etc. can aggravate this disease.
- Climate: Usually psoriasis worsens in winter season.
- Hormonal factors: Certain hormonal factors do play a role in aggravating psoriasis. It is associated with Thyroid disease & Diabetes, which usually aggravates psoriasis.
- Alcohol & Smoking: They are known to aggravate psoriasis.
- Drugs: Iodides, Nystatin, Progesterone, Corticosteroids, Antimalarials (chloroquine), Antihypertensive (Beta blockers), Antipsychotic (Lithium Carbonate), Antiinflammatory (Pain killers-Aspirin, & other salicylates) drugs are known to aggravate psoriasis.
- Scratching: Psoriasis will appear at the site of scratching.
- Obesity: Over weight can aggravate the disease & also increases the recovery time.
Treatment of psoriasis:
General measures:
Strictly avoid the aggravating factors.
Weight reduction is a must in overweight individuals.
Balanced nutritious diet.
Eradication of any existing infections.
Moderate dose of sunlight exposure gives good relief.
Relieving emotional stress by meditation, yoga, listening to music, going for short vacations, picnics, playing games, indulging in good hobbies, being with family etc.
Specific Therapy:
Though there are no medications to completely cure this disease, there are various medications available for controlling this disease. There are economical to expensive creams & tablets to treat psoriasis. All the medications (including Biologic treatments) available at present will control the disease, improve the condition & can definitely give good clearance for a certain period. But the disease will reappear some time or the other, and then we have to give the treatment again. Unlike Diabetes or Hypertension where we have to give medications continuously, here we have to give the medications whenever the disease appears.
Proper care of the skin, avoiding the aggravating factors, understanding the disease & adjusting the life style to the disease will help the patient in gaining control over the disease, thereby giving good clearance for a longer time.
Advice to the psoriatic patients:
Patient has to regularly follow up with his skin specialist for changing the treatment regimen
according to the extent & severity of the disease.
Do not worry about psoriasis & to the society’s reaction to your condition. Less you worry, better it is for you & for your disease. Explain about this disease to your family members, friends & to others. Take them into your confidence & convince them about your simple disease. Be bold as there is nothing to hide. Final word is Don’t worry be happy, be good to your skin.
Important Web sites: National Psoriasis foundation-http://www.psoriasis.org/about