The Basics of Psoriasis: Questions & Facts
Sometimes it can be helpful to start with the basics. If you're newly diagnosed or find yourself a few years in, it can be helpful, insightful, and affirming to better understand the psoriasis condition and all that comes with it.
Well, let's start with the basics...
Psoriasis is an autoimmune condition that causes symptoms to develop on the skin. There are several different types of psoriasis, but the most common form is called plaque psoriasis, which affects between 80% and 90% of people with the condition. Plaques are patches of skin that are raised, red, dry, and often covered with a layer of silvery scales.
Psoriasis is a chronic, life-long condition. It cannot be cured, but most people will cycle through periods of flare-ups and remissions.
Flare-ups are periods of time when symptoms get worse. Remissions are periods of time when the symptoms get better or even go away completely for a time.
People who have psoriasis can learn to identify and avoid their own psoriasis triggers, which are things in the environment that can cause psoriasis symptoms to flare up.
How many people does psoriasis affect?
Although it is difficult to estimate exactly how many people are living with psoriasis, it is thought that the disease affects at least 125 million people around the world and at least 7.5 million people in the U.S. It is estimated that about 2-3% of the population has psoriasis. Unlike some other diseases, psoriasis affects men and women at equal rates.
Psoriasis is less common among children than among adults, and it is relatively rare among infants. Around 10% to 15% of people with psoriasis are diagnosed before the age of 10.
Researchers estimate that a child has about a 50% chance of developing psoriasis if both parents have the condition and around a 10% chance if one parent has the condition.
How is it different from other skin diseases?
Psoriasis is an autoimmune disease with a primary manifestation of the skin, but it is not “just” a skin condition. The chronic inflammation that is a hallmark of psoriasis can also manifest itself in joints, nails and your cardiovascular system. Strange symptoms can also occur in your eyes, and potentially other parts of your body as well.
The process of diagnosing psoriasis involves ruling out other conditions that often have similar symptoms. Your healthcare provider may call this process a differential diagnosis.
Visiting a dermatologist may help confirm a diagnosis of psoriasis. Other conditions that may present with similar symptoms of the skin include:
- eczema (atopic dermatitis)
- seborrheic dermatitis
- ringworm (tinea corporis)
- Pityriasis rubra pilaris
- Pityriasis rosea
A look at the autoimmune experience...
With psoriasis, the body’s immune system goes haywire, sending out faulty signals that speed up the growth of skin. The way psoriasis affects the skin is primarily driven by a type of white blood cell called a T cell, as well as myeloid dendritic cells.
Normally, T cells help protect the body against foreign invaders. Inflammatory myeloid dendritic cells release specific proteins to activate T cells. These T cells are then put into action by mistake and become so active that they trigger other immune responses, which lead to chronic inflammation and to the rapid turnover of skin cells.
What are the additional risk factors for psoriasis?
Scientists are still working to understand what causes a person to develop this disease. While the exact cause of psoriasis is still unknown, there is a growing amount of evidence about some of the risk factors that can make a person more likely to develop the disease. These include:
Let's break down the different types of psoriasis...
You've probably heard people refer to moderate to severe plaque psoriasis, but what does that really mean? Plaque psoriasis is generally classified into three categories: mild, moderate, or severe. Approximately 80% of people diagnosed with psoriasis have mild to moderate disease, and 20% are diagnosed with severe psoriasis.
Healthcare providers assess the severity of a patient’s psoriasis based on two types of information:
- How much of the patient’s body is affected by psoriasis?
- How much does having psoriasis affect the patient’s quality of life?
For people with more severe psoriasis, or with joint or vascular involvement, more aggressive treatment options may be warranted.
The severity information is also used to help your provider assess if there are potential comorbidities (other health conditions or complications) to monitor.
The diagnosis and treatment journey...
At this time, there is no specific blood test or other tests that can be used to diagnose psoriasis. Usually, a physical exam and medical history are enough for the healthcare provider to make the diagnosis.
However, some people may need to have a biopsy to find out if the symptoms are being caused by psoriasis or some other condition, such as eczema, that causes similar types of symptoms to develop on the skin.
Read more about tests and exams that may be part of diagnosing psoriasis here.
What are common symptoms?
- Plaques (red, scaly patches)
- Itching and burning
- Cracking and bleeding
- White pustules
- Small scaling spots
- Joint pain and swelling
- Nail changes
- Hair loss
- Dandruff-like flaking
How is psoriasis treated?
Psoriasis is a chronic, long-term condition that cannot be cured. However, there is a wide range of treatment options available and many people find that they are able to control their symptoms and manage their condition.
If you are diagnosed with psoriasis, then your healthcare provider will work with you to develop a treatment plan. The plan may include:
- Medications (include prescription and OTC Topicals, Corticosteroids, Systemic drugs, and Biologics)
- Phototherapy (or light therapy)
- Lifestyle considerations
- Home remedies
- Complementary and alternative medicines
Be sure to talk with your healthcare provider before adding, dropping, or changing any component of your treatment plan.
Can psoriasis be cured?
There is currently no cure for psoriasis. It is a chronic autoimmune condition, which means that it is will not go away completely.
Patients with psoriasis may have periods of time when symptoms are worse (called flare-ups), followed by periods of time in which the symptoms are much better (remission), and the cycle will generally continue over time.
With treatment, people can achieve high levels of clearance of plaques from their skin. In addition, it is possible to manage some of the other impacts of chronic inflammation to minimize the damage done to joints and other parts of the body if treated early.
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