Psoriasis (Pso)
Social situations can be stressful and demanding enough without the itchy, red, flaky skin or inflamed, damaged nails caused by Psoriasis, also called Pso. When you have Pso, especially in visible places on your body, you may feel self-conscious and embarrassed, and avoid socializing. The stress and emotional burden of Pso, unfortunately, can worsen the symptoms. But know that you can take charge of your life and make sure your body is as well-prepared as possible by taking a holistic view of your self-care: healthy nutrition, regular exercise, and looking after your skin and nails. And most importantly, know that you are not alone – and you are certainly not contagious!
What is Psoriasis?
Psoriasis is a common condition that affects skin and nails. It is characterised by inflammation caused by a dysfunction of the immune system, building new skin cells on top of, or just below, existing ones. Our skin cells are replaced on average every 21-28 days. In Pso, however, skin cells are replaced every 4-7 days. Because the life cycle of skin cells is sped up, the skin cells don’t grow and flake off gradually in a natural exfoliation process, but rapidly build up on the surface of the skin, which causes itchy, sometimes painful, red patches or silvery scales.
The patches, also known as plaques, typically appear on the elbows, knees, feet, scalp, hands or lower back, but can appear anywhere on the body. Pso is not contagious.
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What are the symptoms of Psoriasis?
Psoriasis can manifest in a few different ways and can appear anywhere on your body. It can feel like an itching, burning sensation, which can be painful and make it hard to relax, sleep, or simply enjoy life. It can also cause thick, pitted or ridged nails.
There are five types of Psoriasis:
- Plaque psoriasis is the most common. It appears as raised, red patches covered with a silvery-white build-up of dead skin cells, usually on the scalp, knees, elbows and lower back. They are often itchy and painful, and they can crack and bleed.
- Guttate psoriasis appears as small, dot-like lesions that often start in childhood or young adulthood and can be triggered by a bacterial infection such as strep throat. This is the second-most common type of psoriasis.
- Inverse psoriasis shows up as smooth, shiny, red lesions in body folds, such as behind the knee, under the arm or in the groin.9
- Pustular psoriasis is characterized by white blisters surrounded by red skin. It occurs most often on the hands or feet.10
- Erythrodermic psoriasis is particularly severe, but rare (3%). It leads to severe redness over most of the body and can cause intense itching and pain.11
How common is Psoriasis?
Psoriasis is the most common immune system-related skin disorder. It affects about 125 million people worldwide, including 14 million people across Europe.12
Often, people first develop Pso before the age of 40. It is particularly common in teenagers and young adults, a time when people may be especially conscious of their appearance.
Men and women develop Pso at equal rates. It also occurs in all racial groups aged 20 or over, but at varying rates. For example, about 1.9% of African Americans have Pso, compared to 3.6% of Caucasians.13
Treatment and Care
Psoriasis is a chronic disease that comes and goes, and for which there, unfortunately, is no cure. The main goal of treatment is to stop the skin cells from growing so quickly and to remove scales.
There are no special blood tests or tools to diagnose psoriasis. A dermatologist may take a piece of the affected skin (a biopsy) and examine it under the microscope.14
Depending on where the Pso appears on your body, you may require a different type of treatment. When the Psoriasis is limited to a specific part of your body, light therapy or topical treatments can be used. When it is moderate to severe or other treatments are not working, your doctor may prescribe oral or injectable drugs instead.
Certain lifestyle choices can also be helpful, such as eating healthy, exercising, stopping smoking, managing stress, and moisturizing well especially after bathing. Pay attention to what may trigger flare-ups and avoid those triggers as much as possible. Infections, injuries, stress, smoking and intense sun exposure can all worsen Psoriasis.
Living with Psoriasis
Psoriasis is both physically painful and mentally burdensome. The discomfort, resulting insomnia, as well as the social exclusion or even discrimination15 can make those suffering from Pso extremely unhappy.16
A study found the mental and physical impact of Psoriasis comparable to that seen in cancer, heart disease and depression. 37% of people with Pso have experienced suicidal thoughts.17 If you have Pso and are feeling low, it is important to speak to your doctor about finding mental health support. In addition to asking to be referred to a mental health professional, find local support groups to connect with others who share your experience and plight to find comfort in knowing you are not alone in this.
Learning as much as you can about Pso so that you are fully aware of your treatment options and can prevent flare-ups by recognising possible triggers, can help restore a feeling of control. Educate your family and friends too so that they may feel empowered to support you in dealing with the disease.
What to ask your doctor?
The list below includes example questions to help start a conversation with your health care provider. There may be other relevant questions based on your symptoms, stage, and medical history that are not listed here.
- What might be causing my signs and symptoms?
- Do I need diagnostic tests?
- What treatments are available, and which do you recommend for me?
- What types of side effects can I expect?
- Will the treatment you recommended cause a remission in my symptoms?
- How quickly can I expect results?
- What are the alternatives to the primary approach you're suggesting?
- I have other medical conditions. How can I manage these conditions together?
- What skin care routines and products do you recommend to improve my symptoms?
- Will I develop psoriatic arthritis?
- …
Glossary
- Epidermis: the surface of your skin.18
- Dermatology: the branch of medicine concerned with the diagnosis and treatment of skin disorders.
- Phototherapy: Medical treatment using ultraviolet rays.19
- Systemic therapy: Pills or injections that act throughout the entire body.19
- Biological therapy: Injections or infusions made from protein and that regulate the immune system.19
المراجع
[1]
Memorial Sloan Kettering Cancer Center. Multiple Myeloma Symptoms. https://www.mskcc.org/cancer-care/types/multiple-myeloma/multiple-myeloma-symptoms. Last accessed April 2021.
[2]
American Cancer Society. Non-medical treatments for pain. https://www. cancer.org/treatment/treatments-and-side-effects/physical-side-effects/pain/ non-medical-treatments-for-cancer-pain.html. Last accessed Oct 2018.
[3]
Yong K, et al. Br J Haematol. 2016;175:252–264.
[4]
Snowden JA, et al. Br J Haematol. 2011;154:76–103.
[5]
Drugs.com. Multiple Myeloma. Available at: https://www.drugs.com/cg/multiple-myeloma.html. Last accessed April 2021.
[6]
Myeloma UK. Fatigue infoguide. Available at: www.myeloma.org.uk/wp-content/ uploads/2018/03/Myeloma-UK-Fatigue-Infoguide.pdf. Last accessed Aug 2018.
[7]
Multiple Myeloma Research Foundation website. Symptoms, side effects and complications. http://www.myeloma.org/sites/default/files/images/publications/UnderstandingPDF/concisereview.pdf. Last accessed April 2021.
[8]
Myeloma UK. Myeloma and the kidney infoguide. Available at: www.myeloma. org.uk/wp-content/uploads/2018/03/Myeloma-UK-Kidney-Infoguide.pdf. Last accessed Aug 2018.