The American Osteopathic College of Dermatology defines psoriasis as a skin condition where some areas become thick and covered with silvery scales. Psoriasis is a common skin condition that millions of Americans have and it can present on the scalp as well, which is what some call hair psoriasis.
Cause
Psoriasis comes from an immune system disorder caused by a problem with the T lymphocyte or T cell portion of the white blood cells . These cells normally go through the body to find and fight foreign bodies, but in psoriasis the T cells go after healthy skin cells. When the T cells are overactive, they make other immune system responses go in to high gear. This means more healthy skin cells, more T cells and other white blood cells, which creates a buildup. The normal cycle of skin growth is thrown out of sync and the dead skin cells and white cells don’t slough off quickly enough, causing scales and red patches.
Symptoms and Diagnosis
Common symptoms include red patches of skin that also look like they have a silver scale effect; small scaling spots, normally presenting in children; dry or cracked skin that bleeds; an itching or burning sensation; thick or pitted nails; and stiff, swollen joints. Psoriasis can present in small patches or in large areas of the skin and can flare for a period of time and then be dormant. Diagnosis is given after a complete medical history but a skin biopsy may be done to identify psoriasis and not another skin disease.
Types
The National Psoriasis Foundation identifies five main types of psoriasis. Plaque is the most common and about 80 percent of those who have psoriasis have this type. Raised, swollen red lesions with a silvery white scale are indicative of this type. It is normally found on the elbows, knees, scalp and lower back.
Guttate normally starts in childhood and shows up as small, red spots on the trunk and limbs. The spots usually aren’t as thick as with plaque psoriasis. Inverse appears on the armpits, groin, under the breast and in the genital region. These spots look bright red and are smooth and shiny.
Pustular is generally seen in adults and shows as white blisters of pus with red skin around them. It can be localized to one part of the body or cover the entire body.
Erythrodermic affects most of the body surface and is a swelling form. It shows as widespread redness and shedding in sheets, not scales of skin.
Treatment
Psoriasis treatments try to interrupt the cycle of skin cell production and remove the scales to smooth the skin. There are topical, light therapy and oral medications for treatment. Moderate to severe cases may use a combination of any of the treatments. Topical treatments are used to reduce swelling, itching and suppress the immune system. Light therapy treatments use natural or ultraviolet light to encourage T cell growth to slow skin turnover. Oral medications are often used in severe cases or when psoriasis doesn’t respond to other treatments.
Considerations
Patients with psoriasis are at a higher risk to develop other health conditions like heart disease, diabetes and inflammatory bowel disease. Due to the visible nature of psoriasis, patients are also at a higher risk for having depression as the disease affects quality of life. These patients may have lower self-esteem and more emotional stress.
