5 Must-Know Facts About Psoriasis

#1. Plaque Psoriasis is the most common type of psoriasis.

(But you can have more than one type at the same time.)

Plaque psoriasis is the most common type of psoriasis, seen in about 80% of people with psoriasis symptoms. The next most common type is guttate psoriasis, affecting around 18% of people with the disease. Guttate psoriasis tends to be more common among children and younger adults but can continue to affect people throughout their life as well.

The other three types of psoriasis are much less common, with each affecting around 2% or less of people with psoriasis. Pustular psoriasis, a very severe type, is more common among older people than younger people. Inverse psoriasis tends to affect the skin folds, while psoriatic erythroderma is a very severe form of the disease that affects more than 90% of the body. Erythrodermic psoriasis usually requires immediate hospitalization.

#2. Psoriasis affects more than just the skin.

Psoriasis is an autoimmune disease that causes chronic inflammation and impacts many systems of the body, involves multiple inflammatory pathways, and has a primary presentation affecting the skin.With psoriasis, the body’s immune system goes haywire, sending out faulty signals that speed up the growth of skin. These inflammatory processes can also affect the jointsvascular system, and eyes of people with psoriasis.

People with an autoimmune disease can have a complex set of symptoms that complicate both diagnosis and treatment options.  Autoimmune disease can also mean people will have periods when symptoms get significantly worse, or flare-ups, and periods of remission, when symptoms significantly lessen or seem to disappear. While treatment options depend on the disease, for treatment to be successful it is important to target the specific inflammatory pathway believed to be most important to the disease symptoms and severity.

#3. Psoriatic disease can lead to long-term health complications.

While the primary presentation of psoriasis involves the skin, it impacts systems throughout the body. People with psoriasis have a dysregulated immune system, which leads to chronic inflammation. Chronic inflammation affecting skin means that people with psoriasis often experience frequent flare-ups, even when treatment leads to significant clearance of plaques.

Chronic inflammation of psoriasis, in turn, can affect the joints, the heart, and eyes of people with psoriasis.  People with psoriasis are at risk for a number of other health conditions and may also be more likely to have another autoimmune condition. In addition to these affected body parts, other symptoms of chronic inflammation in people with psoriasis include fatigue, depression, inflammatory bowel disease, and vascular inflammation.

#4. Psoriasis treatment is complex.

Most people with psoriasis will go through cycles of flares and remission with psoriasis.  It is unclear how often remissions are triggered, and what specifically may cause them in each individual, but it is possible to enjoy a respite from symptoms.  On the other hand, it is possible to see symptoms spontaneously worsen with no apparent cause as well.

With the arrival of therapeutic biologic agents on the scene, many people with psoriasis and healthcare providers alike are excited about having an improved treatment toolbox. Even though biologics are powerful therapies that offer promise to people with psoriasis, they don’t work equally for everyone.  Because of this, there has been considerable interest in clarifying the role of combination therapy for people with psoriasis. Combinations of therapies may be necessary to deal with flares and meet treatment goals.

For example, people who also have psoriasis and psoriatic arthritis or those who are at risk of organ damage due to long-term use of systemic therapies, are most likely to be good candidates for combination therapy. People who have plaque psoriasis that is generally well controlled but is resistant to treatment in certain areas, like the scalp, might also be candidates for combination therapy.

#5. Stress in the most frequent trigger of psoriasis flare-ups.

Living with psoriasis can be very stressful for a variety of reasons, including the physical pain and discomfort from a variety of symptoms, constant fatigue, feeling self-conscious about having highly visible symptoms, and social isolation. The unpredictable nature of psoriasis, frequent flare-ups, the time and effort to effectively manage symptoms, and the impact on work and relationships, all add to the daily stress.

Researchers also believe that experiencing stress can affect the way a person’s immune system functions, thus furthering the chronic inflammation that led to psoriasis symptoms in the first place. This can create a vicious cycle of psoriasis flare-ups leading to endless frustration.  Managing stress or taking steps to alleviate it can help fight the cycle and leave those with plaque psoriasis feeling a little better, both physically and mentally.

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