Psoriasis doesn't have any set way of progressing -- it develops differently depending on the person. While some people may only have occasional and minor symptoms for their entire lives, others may have to cope with severe symptoms on a regular basis.
In most people, the symptoms come and go. Flare-ups might be brought on by some of the conditions mentioned above, such as dry weather or stress.
Untreated, extremely severe psoriasis can be dangerous. Although it happens very rarely, if lesions cover enough of the body, it's possible for the immune system to become overwhelmed trying to fight off infections. This increases your risk of developing serious bacterial infections. Be sure to see your doctor immediately if your psoriasis spreads to cover large parts of your body or if you show signs of infection, such as fever.
Coping with psoriasis can be exhausting and frustrating. It's important to try to stay emotionally and physically healthy during treatment.
Monday, August 29, 2005
Thursday, August 25, 2005
The Changing Picture of Psoriasis
While most people develop one type of psoriasis and have flare-ups and clearings from that type for life, this is not always the case. It is possible to experience only one outbreak. A child can experience one outbreak of guttate psoriasis and never have another psoriasis outbreak.
It is also possible for two types of psoriasis at the same time. A person with plaque psoriasis can develop a second type of psoriasis. Pustules could develop within or around the plaques. If this occurs, the person has both plaque psoriasis and pustular psoriasis.
Have psoriasis that begins as one type and transforms into another type. Plaque psoriasis can develop into guttate or erythrodermic psoriasis. Abruptly stopping a psoriasis medication, such as cyclosporine or methotrexate, is one such trigger that may cause this transformation
It is also possible for two types of psoriasis at the same time. A person with plaque psoriasis can develop a second type of psoriasis. Pustules could develop within or around the plaques. If this occurs, the person has both plaque psoriasis and pustular psoriasis.
Have psoriasis that begins as one type and transforms into another type. Plaque psoriasis can develop into guttate or erythrodermic psoriasis. Abruptly stopping a psoriasis medication, such as cyclosporine or methotrexate, is one such trigger that may cause this transformation
Saturday, August 20, 2005
The Erythrodermic or Exfoliative Psoriasis Picture
In the overall picture of psoriasis, one cannot forget the least known type of psoriasis. Erythrodermic Psoriasis also known as “exfoliative” psoriasis, this is the least common type. It occurs in about 1% or 2% of people who develop psoriasis. Erythrodermic psoriasis can be life-threatening because the skin loses its protective functions. The skin may not be able to safeguard against heat and fluid loss nor prevent harmful bacteria and other substances from entering the body. Patients are usually hospitalized and given intravenous fluids. Body temperature regulation may be required.
Erythrodermic psoriasis may occur suddenly in a person who has never had psoriasis or evolve from plaque psoriasis. Triggers include infection, emotional stress, alcoholism, and certain medications such as lithium, anti-malarial drugs, and a strong coal tar preparation. It also may be triggered by excessive use of potent corticosteroids, which is why it is important to use corticosteroids as instructed. Suddenly stopping a psoriasis medication, such as cyclosporine or methotrexate, also can trigger erythrodermic psoriasis.How to recognize erythrodermic psoriasis:
Severe redness and shedding of the skin that covers a large portion of the body.
Skin looks as if it has been burned.
Fluctuating body temperature, especially on very hot or cold days.
Accelerated heart rate due to increased blood flow to the skin — can complicate heart disease and cause heart failure.
Severe itching and pain.
Erythrodermic psoriasis may occur suddenly in a person who has never had psoriasis or evolve from plaque psoriasis. Triggers include infection, emotional stress, alcoholism, and certain medications such as lithium, anti-malarial drugs, and a strong coal tar preparation. It also may be triggered by excessive use of potent corticosteroids, which is why it is important to use corticosteroids as instructed. Suddenly stopping a psoriasis medication, such as cyclosporine or methotrexate, also can trigger erythrodermic psoriasis.How to recognize erythrodermic psoriasis:
Severe redness and shedding of the skin that covers a large portion of the body.
Skin looks as if it has been burned.
Fluctuating body temperature, especially on very hot or cold days.
Accelerated heart rate due to increased blood flow to the skin — can complicate heart disease and cause heart failure.
Severe itching and pain.
Wednesday, August 17, 2005
THE GUTTATE PSORIASIS PICTURE
Although not as common as plaque psoriasis; about 10% of people who get psoriasis develop guttate psoriasis, making this the second most common type. Guttate psoriasis most frequently develops in children and young adults who have a history of streptococcal (strep) infections. A mild case of guttate psoriasis may disappear without treatment, and the person may never have another outbreak of psoriasis. Some children experience flare-ups for a number of years. It also is possible for the psoriasis to appear later in life as plaque psoriasis. In some cases, guttate psoriasis is severe and disabling, and treatment may require oral medication or injections.
Recognizing guttate psoriasis:
Drop-sized, red dots form — usually on the trunk, arms, and legs. Lesions occasionally form on the scalp, face, and ears.
Lesions widespread.
Appears quickly, usually a few days after a strep throat or other trigger, such as a cold, tonsillitis, chicken pox, skin injury, or taking certain medications.
Can first appear as another form of psoriasis, such as plaque psoriasis, and turn into guttate psoriasis.
Recognizing guttate psoriasis:
Drop-sized, red dots form — usually on the trunk, arms, and legs. Lesions occasionally form on the scalp, face, and ears.
Lesions widespread.
Appears quickly, usually a few days after a strep throat or other trigger, such as a cold, tonsillitis, chicken pox, skin injury, or taking certain medications.
Can first appear as another form of psoriasis, such as plaque psoriasis, and turn into guttate psoriasis.
Sunday, August 14, 2005
A Clinical Picture of Plaque Psoriasis
About 80% of people living with psoriasis have plaque psoriasis, which also is called “psoriasis vulgaris.” “Vulgaris” means “common.” How to recognize plaque psoriasis:
Raised and thickened patches of reddish skin, called “plaques,” which are covered by silvery-white scales.
Plaques most often appear on the elbows, knees, scalp, chest, and lower back. However, they can appear anywhere on the body, including the genitals.
Plaques vary in size and can appear as distinct patches or join together to cover a large area.
In the early stages, the psoriasis may be unnoticeable. The skin may itch and/or a burning sensation may be present.
Plaque psoriasis usually first appears as small red bumps. Bumps gradually enlarge, and scales form. While the top scales flake off easily and often, scales below the surface stick together. The small red bumps develop into plaques (reddish areas of raised and thickened skin).
Skin discomfort. The skin is dry and may be painful. Skin can itch, burn, bleed, and crack. In severe cases, the discomfort can make it difficult to sleep and focus on everyday activities.
Raised and thickened patches of reddish skin, called “plaques,” which are covered by silvery-white scales.
Plaques most often appear on the elbows, knees, scalp, chest, and lower back. However, they can appear anywhere on the body, including the genitals.
Plaques vary in size and can appear as distinct patches or join together to cover a large area.
In the early stages, the psoriasis may be unnoticeable. The skin may itch and/or a burning sensation may be present.
Plaque psoriasis usually first appears as small red bumps. Bumps gradually enlarge, and scales form. While the top scales flake off easily and often, scales below the surface stick together. The small red bumps develop into plaques (reddish areas of raised and thickened skin).
Skin discomfort. The skin is dry and may be painful. Skin can itch, burn, bleed, and crack. In severe cases, the discomfort can make it difficult to sleep and focus on everyday activities.
Wednesday, August 10, 2005
The Inverse Psoriasis Picture
Inverse or Flexural psoriasis is localized in the flexural surfaces of the skin, e.g., armpit, groin, under the breast, and other skin folds. Typically, it appears as smooth inflamed lesions without scaling and is particularly subject to irritation due to rubbing and sweating. This type of psoriasis is often white in color, appears softened as if soaked by water, and may resemble a fungal infection. There is very little scaling, although the patches are inflamed and can be very sore. Appearing as it does in the folds of the skin, it is moister than other forms of psoriasis, and can be more uncomfortable physically. Flexural psoriasis rarely occurs by itself. It is more likely to accompany common plaque psoriasis. Psoriasis sufferers in their middle years or old age are more susceptible to this type of psoriasis as are people who are overweight and have more folds of skin.
Sunday, August 07, 2005
Psoriasis Phototherapy
Phototherapy involves the use of light to treat a medical condition. Ultraviolet light therapy improves psoriasis symptoms in some people. Phototherapy may only use ultraviolet light, or may combine the use of ultraviolet light with psoralen, a drug that increases light sensitivity. While ultraviolet rays occur naturally in sunlight, excessive sun exposure causes sunburn, which can make symptoms worsen. Phototherapy uses carefully measured amounts of ultraviolet light; a safety measure that cannot be duplicated by simple exposure to the sun. A side effect of this is photo damage or increased risk of skin cancers.
Natural sunlight contains ultraviolet (UV) light. UV light kills T cells in skin, reducing redness and slowing the overproduction of skin cells that causes scaling. This is why brief, regular periods of sun exposure can help to clear psoriasis. Exposing the skin to UV light in carefully controlled doses is called phototherapy. Sunlight contains two kinds of UV light, known as UVA and UVB. Both can be used to treat psoriasis. In phototherapy, the affected person sits or lies inside a "light box," a booth fitted with special light-emitting tubes. Usually, people go to a doctor's office to receive phototherapy. Sometimes a light box can be purchased with a doctor's prescription for use at home.
UVB therapy: Treatment with UVB light is the safest form of phototherapy for widespread psoriasis or psoriasis that has not responded to medications applied to the skin. Usually 3 to 5 treatments a week are recommended, with a gradual increase in UV exposure depending on skin type. Significant clearing of psoriasis can be expected in 1 to 3 months. Exposure to UVB light must be carefully monitored to prevent sunburn. During treatment, the eyes must be shielded with goggles to guard against the possible formation of cataracts. Skin aging may be a side effect of UVB treatment. Large long-term studies have found no evidence of an increase in the risk of skin cancer as a result of UVB treatment. UVB phototherapy may be combined with tar, anthralin, topical steroids, or other medications applied to the skin. The Goeckerman regimen, developed at the Mayo Clinic, uses crude coal tar, tar baths, and UVB treatment to treat widespread psoriasis. The Ingram regimen uses coal tar baths, anthralin paste, and UVB therapy.
PUVA: This treatment combines a medication called psoralen with exposure to UVA light. (PUVA stands for Psoralen with UVA.) Psoralen may be taken by mouth or applied to the skin. It makes the skin more sensitive to light. Treatment is given 2 or 3 times a week, with a gradual increase in UV exposure depending on skin type. As with UVB therapy, significant clearing of psoriasis can be expected in 1 to 3 months. Compared with UVB therapy, PUVA clears skin more consistently with fewer treatments. However, PUVA has more short-term side effects, such as nausea, headache, fatigue, burning, and itching. When psoralen is taken by mouth, nausea may be avoided by taking food at the same time. As with UVB therapy, the eyes must be shielded with goggles during UVA exposure to guard against the formation of cataracts. Psoralen can be applied to the skin in the form of a cream, lotion, gel, or solution. After the paint, soak, or bath routine, the person is exposed to UVA light in a light box. UVA light is the same kind used in commercial tanning salons. Treating psoriasis in tanning salons is not recommended because attendants are untrained and the dose of UVA is not controlled. UVA therapy must be given in carefully controlled doses and supervised by a doctor. PUVA is recommended for people with moderate to severe psoriasis or who have not improved with other treatments. Long-term use of PUVA increases the risk of developing certain types of skin cancer. Regular medical examinations are advised to check for signs of skin cancer.
Natural sunlight contains ultraviolet (UV) light. UV light kills T cells in skin, reducing redness and slowing the overproduction of skin cells that causes scaling. This is why brief, regular periods of sun exposure can help to clear psoriasis. Exposing the skin to UV light in carefully controlled doses is called phototherapy. Sunlight contains two kinds of UV light, known as UVA and UVB. Both can be used to treat psoriasis. In phototherapy, the affected person sits or lies inside a "light box," a booth fitted with special light-emitting tubes. Usually, people go to a doctor's office to receive phototherapy. Sometimes a light box can be purchased with a doctor's prescription for use at home.
UVB therapy: Treatment with UVB light is the safest form of phototherapy for widespread psoriasis or psoriasis that has not responded to medications applied to the skin. Usually 3 to 5 treatments a week are recommended, with a gradual increase in UV exposure depending on skin type. Significant clearing of psoriasis can be expected in 1 to 3 months. Exposure to UVB light must be carefully monitored to prevent sunburn. During treatment, the eyes must be shielded with goggles to guard against the possible formation of cataracts. Skin aging may be a side effect of UVB treatment. Large long-term studies have found no evidence of an increase in the risk of skin cancer as a result of UVB treatment. UVB phototherapy may be combined with tar, anthralin, topical steroids, or other medications applied to the skin. The Goeckerman regimen, developed at the Mayo Clinic, uses crude coal tar, tar baths, and UVB treatment to treat widespread psoriasis. The Ingram regimen uses coal tar baths, anthralin paste, and UVB therapy.
PUVA: This treatment combines a medication called psoralen with exposure to UVA light. (PUVA stands for Psoralen with UVA.) Psoralen may be taken by mouth or applied to the skin. It makes the skin more sensitive to light. Treatment is given 2 or 3 times a week, with a gradual increase in UV exposure depending on skin type. As with UVB therapy, significant clearing of psoriasis can be expected in 1 to 3 months. Compared with UVB therapy, PUVA clears skin more consistently with fewer treatments. However, PUVA has more short-term side effects, such as nausea, headache, fatigue, burning, and itching. When psoralen is taken by mouth, nausea may be avoided by taking food at the same time. As with UVB therapy, the eyes must be shielded with goggles during UVA exposure to guard against the formation of cataracts. Psoralen can be applied to the skin in the form of a cream, lotion, gel, or solution. After the paint, soak, or bath routine, the person is exposed to UVA light in a light box. UVA light is the same kind used in commercial tanning salons. Treating psoriasis in tanning salons is not recommended because attendants are untrained and the dose of UVA is not controlled. UVA therapy must be given in carefully controlled doses and supervised by a doctor. PUVA is recommended for people with moderate to severe psoriasis or who have not improved with other treatments. Long-term use of PUVA increases the risk of developing certain types of skin cancer. Regular medical examinations are advised to check for signs of skin cancer.
Thursday, August 04, 2005
The Scalp Psoriasis Picture
Psoriasis that affects the scalp is also called seborrheic psoriasis. The scalp may be the first site to be affected by psoriasis. The condition may resemble severe dandruff. Patches of thick, flaky skin may extend to the forehead below the hairline. Scales may build up in the outer ear. Other than the forehead and the ears, the face is usually spared. However, some people may have patches of inflamed skin that resemble seborrheic dermatitis a type of dandruff eczema that affects the scalp and face.
Psoriasis on the scalp is common and, in many cases, it is the only area affected. It usually consists of red, scaly patches that are sometimes lumpy. The edge of the patch tends to be well defined. This type of psoriasis can extend beyond the hairline, onto the forehead. Psoriasis of the scalp does not damage the hair follicle and is not associated with alopecia (hair loss), but if the scale is thick and forms hard lumps, it can lead to temporary hair thinning. However, this is not permanent and will grow back again after the psoriasis clears.
This form of psoriasis can be extremely uncomfortable. It is often very itchy, and the psoriatic patches that are inflamed and sore can start to bleed if they are scratched or picked. The condition is not caused by poor hygiene or hair care. Scalp psoriasis can be demoralizing, as the look of dead skin cells on clothing can be embarrassing, and it is not always easy to brush them off inconspicuously. Itchiness is another big problem, not only because of the social implication but also because it inflames the condition and makes it worse. Forehead along the hairline is a common site as is the temples, nape of the neck, around the ears, as well as the hair parting. Massaging a little warm baby/olive/coconut oil gently into the scalp, preferably before going to bed to allow plenty of time to soak (bind up the head in an old towel) will help. Wash out with cream shampoo (i.e. Dry Hair Products), add a little lemon juice to the final rinse to get rid of excess grease. Only shampoo three times a week, more than this and the natural oils may be washed out. Always treat the head as gently as possible, do not comb or brush harshly. Perms and colorants can be used as long as the skin is not broken. Shampoo the hair and scalp with a tar-based shampoo that can be purchased over-the-counter or by prescription. Shampoos, scalp steroid lotions, vitamin D analogues and some tar preparations such as tar pomade may be used on the scalp.
Psoriasis on the scalp is common and, in many cases, it is the only area affected. It usually consists of red, scaly patches that are sometimes lumpy. The edge of the patch tends to be well defined. This type of psoriasis can extend beyond the hairline, onto the forehead. Psoriasis of the scalp does not damage the hair follicle and is not associated with alopecia (hair loss), but if the scale is thick and forms hard lumps, it can lead to temporary hair thinning. However, this is not permanent and will grow back again after the psoriasis clears.
This form of psoriasis can be extremely uncomfortable. It is often very itchy, and the psoriatic patches that are inflamed and sore can start to bleed if they are scratched or picked. The condition is not caused by poor hygiene or hair care. Scalp psoriasis can be demoralizing, as the look of dead skin cells on clothing can be embarrassing, and it is not always easy to brush them off inconspicuously. Itchiness is another big problem, not only because of the social implication but also because it inflames the condition and makes it worse. Forehead along the hairline is a common site as is the temples, nape of the neck, around the ears, as well as the hair parting. Massaging a little warm baby/olive/coconut oil gently into the scalp, preferably before going to bed to allow plenty of time to soak (bind up the head in an old towel) will help. Wash out with cream shampoo (i.e. Dry Hair Products), add a little lemon juice to the final rinse to get rid of excess grease. Only shampoo three times a week, more than this and the natural oils may be washed out. Always treat the head as gently as possible, do not comb or brush harshly. Perms and colorants can be used as long as the skin is not broken. Shampoo the hair and scalp with a tar-based shampoo that can be purchased over-the-counter or by prescription. Shampoos, scalp steroid lotions, vitamin D analogues and some tar preparations such as tar pomade may be used on the scalp.
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