Psoriasis

PSORIASIS is an inflammatory skin condition characterized by well-defined red plaques with a white scale surface. Psoriasis affects both children and adults with an incidence roughly equal between men and women. Over six million Americans, involving all races, are affected. Caucasians, however, have a slightly higher incidence. First involvement usually occurs between adolescence and middle age. The areas involved can be anywhere on the body. The most common sites are the scalp, elbows, knees and upper buttock area.

The exact cause of psoriasis is unclear; however, genetics and environment play key roles. Examples of environmental influences include climate, trauma to the skin, or an infection of the ear or upper respiratory tract. There is clear evidence that psoriasis is genetically linked. The National Psoriasis Foundation® reports incidence rates of approximately ten-percent if one parent has psoriasis compared to fifty-percent if both parents have psoriasis.

Psoriasis is not a skin disease. It is a skin condition characterized by rapidly dividing skin cells. The cells divide and grow at a rate almost ten times faster than normal skin. The most common type of psoriasis is psoriasis vulgaris (vulgaris meaning common). This presents as plaque-like involvement on the scalp, trunk and extremities. Guttate psoriasis (numerous small plaques) is another type of psoriasis frequently associated with an ear or upper respiratory tract infection. Other types of psoriasis include pustular psoriasis (numerous vesicles) and erythroderma (ill-defined and confluent red scaling areas on the trunk and extremities).

Exacerbating Factors
Injury: Avoid skin injury! Local injury can exacerbate or cause new psoriatic lesions. This is called the Koebner phenomenon. Examples of injuries include trauma, sunburn, scratches, tight jewelry or restrictive clothing.

Infections: Infections may stimulate the onset of psoriasis. Research in this area is ongoing. It is thought that the stimulus of streptococcal infection (strep throat) may initiate or exacerbate psoriasis. Guttate psoriasis, in particular, is associated with streptococcal infection. If there is any question of infection, consult your physician for treatment.
Medications: Some medications may exacerbate psoriasis. Examples include antimalarials, lithium, quinidine, indomethacin, Inderal and other beta-blockers.

Stress: In some people, stress may flare psoriasis. This type of reaction may be seen up to 30 days after a stressful event. If the psoriasis is uncontrollable, the stress factor may need to be addressed with relaxation, exercise or possibly stress reduction medications.

Diet and Psoriasis
There are varied opinions and theories concerning diets, foods and dietary supplements when treating psoriasis. Unfortunately, most diets and supplements for psoriasis sound too good to be true. Claims lack long-term clinical follow-up. Diets that have been used historically include: the turkey diet, the low-protein diet, the starvation and weight-loss diet, the Pagano diet, zinc supplementation, fish oil supplementation, evening primrose oil, lecithin and sassafras.

In addition, vitamins have also been used to treat psoriasis, specifically, vitamins A and E. These vitamins, however, are not beneficial when taken in safe daily doses. Chinese medicine and acupuncture have also been used to treat psoriasis. These treatments have varying degrees of success and are not universally recommended as "predictable treatments."

Much of the problem when treating psoriasis is acknowledging the fact that this is a medical condition. A person's response to therapy depends on their genetic background as well as environmental influences. In fact, psoriasis may improve or clear with little or no treatment at all. Conversely, there may be times when psoriasis is extremely resistant to potent treatments that may have worked in the past.

Keep in mind that psoriasis responds to the physical and emotional well being of the individual. Maintaining a low stress lifestyle along with a balanced healthy diet is very beneficial in conjunction with proposed treatments.

Emotions and Psoriasis
Psoriasis is an emotional issue. People with psoriasis may feel "different" from others. There is a sense of depression that may affect day-to-day interaction as well as personal relationships. Feelings must be addressed so that the condition can be accepted and people can move on with their lives. Many times, physicians are not responsive to the emotional needs of psoriasis patients. Additional support from close friends and family is essential. Often, consultation with a professional counselor is beneficial.