What is Psoriasis Really?

I was interviewed on BBC radio last week and very naively found myself gawking in surprise to be asked ‘What is psoriasis?’ which is ridiculous on my part - they invited me onto the show to talk about psoriasis. The thing is- I talk about psoriasis almost every day with people like you. People already living with psoriasis or helping people that do.

It's a given that you know what it is. But that's stupid (on my part) because sometimes I don’t even know what it is- depending on my mood and the state of my condition. Thinking back over the last seven days - here are some of the definitions I have for psoriasis.

**Heads up- plenty of dry sarcasm ahead.**

The official definition (because it's the truth)

Psoriasis is an inflammatory immune-mediated condition where an overactive immune system generates inflammation. These inflammatory processes cause the skin cells to reproduce too quickly, forming red lesions where immature skin cells have risen to the top layer of the skin too quickly. This high skin turnover also causes flaking and scaling- particularly as the glue that holds younger skin cells together hasn’t broken down yet.

We often refer to the condition as autoimmune as the body is attacking itself- but actually, the correct term is immune-mediated. This is because the immune system plays a role- but unlike the ‘official’ autoimmune conditions, no specific antibody has been identified in psoriasis.  Instead, there are several genetic predispositions but no single identifier as far as we know.

Populations impacted by psoriasis

The estimates are around 2% of the population, but this could be under-estimated. I have spoken to two people this week who assumed they had mild eczema until they had their first full flare, so I tend to agree with the data skeptics with my biased conclusion based on a  sample size of two.

Males and females are affected equally and there tend to be two peaks of diagnosis (although you can develop psoriasis at any age). One peak is earlier in life- between the ages 20-30 and again in later life between 50-60 years.¹ Most people are diagnosed before the age of 40.²

Surprisingly only a third of patients have a known family history- which means a whopping 2/3 don’t!  Herein lies the beauty of genetics- though this is not fully understood, science is getting closer as we speak. It is generally accepted that to develop psoriasis you need both a genetic predisposition and a trigger event.

You cannot avoid most triggers (mine was chicken pox), but you can minimize them by learning effective stress coping strategies and having detailed conversations with your doctor about your mental and physical health.

Sunday's response

Psoriasis is the devil. It’s an outpouring of evil that moves through my skin. I ate 42 chocolate biscuits last night, my husband's lasagna and half a bottle of red wine. I am being punished for consuming this gluten, dairy, histamine, and tomato-rich food. This couldn’t possibly be my fault. Maybe it was a whole bottle of wine...It's not me, it's psoriasis- it's even the color of hell. Plus Hell looks like the kind of place that would be itchy.

Mondays Response

Psoriasis is an indicator of health. When I look after myself, eat right, invest in my mental health, meditate, buy $100 yoga leggings and then sit in my yoga gear and read health magazines instead of over-working then my skin accepts me and we are at peace with each other. O.K I bought my leggings on sale... if I worked out more, I might be able to buy some that fit better?

Tuesdays response

Psoriasis is something you are given to help you perfect lying to strangers. I lie about psoriasis frequently because I can't be bothered to explain how psoriasis is different to eczema and how it impacts all aspects of my life. Especially the stuff you don’t think about like getting dressed and bra underwiring. Don’t get me started on genital psoriasis and thongs. Maybe that's what they do to you in Hell? Perhaps I’m supposed to do the opposite and tell the next person in excruciating detail about my experience with depression last year.

I do try to tell the truth- but two sentences aren’t enough, so I stand there gawking like I don’t understand the concept of conversations.

Wednesday's response.

Psoriasis is a challenge that was given to me to help me develop the skills I need to succeed and fulfill the reason I have been put onto this earth. I'm 36 and not sure what that is yet, but I’m sure I will figure it out soon, psoriasis has to have been given to me for a reason. It's a gift...

Fridays response

Psoriasis is something that I have been given to test my patience. I have been super positive all week and I am succeeding in life. My kids are all dressed - although they made themselves a jam wrap for breakfast (that's 90% jam, 10% wheat - or 99% carbs) and I refrained from punching the stranger who just offered to sell me some magic cure moisturizer in the gym chaining rooms from her pyramid but not pyramids scheme health business. Is it too early for wine? No? You're right- wrong for my psoriasis... O.K pass me the corkscrew.

How about you?