Psoriasis

Page 1 2 3

What is Psoriasis?

Psoriasis is a common chronic skin disorder. The most common type of psoriasis is plaque psoriasis. It is a recurring disease that causes one or more raised, red patches that have silvery scales and a distinct border between the patch and normal skin.

The skin (see anatomy and physiology of the skin) is the primary organ affected, but joints also are affected in 10% of cases (called psoriatic arthritis).

Who gets Psoriasis?

Psoriasis begins most often in people aged 10 to 40, although people in all age groups are susceptible. It occurs in two peaks, the first is in people aged 16-22 years. The second peak is in people aged 57-60 years. Incidence is influenced by the climate and genetics of the population. It is less common in the topics and in dark skinned people. In Australia, 1.8% of the population self-reported having psoriasis.

Men
Most men first develop psoriasis between the ages of 10 and 40. In clinical studies, men had psoriasis of the face, scalp and anogenital area more frequently than women.

Women
Psoriasis is slightly more common in women. Women tend to develop psoriasis about two and a half years earlier than males. In pregnancy, there may be improvement or even temporary disappearance of psoriasis. After childbirth, there is a tendency for exacerbation of lesions. However, psoriasis may behave differently from one pregnancy to the other. During menopause, lesions may change for the better or worse, with no set pattern of behaviour.

Children
Approximately 10-15% of new cases begin in children younger than 10 years. Patients with a family history of psoriasis tend to have an earlier age of onset.

Predisposing Factors

Psoriasis is not contagious but can be inherited. Research indicates that the disease may result from a disorder in the immune system. The immune system makes white blood cells that protect the body from infection. In psoriasis, the T cells (a type of white blood cell) abnormally trigger inflammation in the skin. These T cells also cause skin cells to grow faster than normal and to pile up in raised patches on the outer surface of the skin.

Those with a family history of psoriasis have an increased chance of having the disease. Some people carry genes that make them more likely to develop psoriasis. When both parents have psoriasis, the child may have a 50% chance of developing psoriasis. About one third of those with psoriasis have at least one family member with the disease.

Certain factors may trigger psoriasis, such as:

Injury to the skin: For example, a skin infection, skin inflammation, or even excessive scratching can trigger psoriasis.

Sunlight: Most people generally consider sunlight to be beneficial for their psoriasis. However, a small minority find that strong sunlight aggravates their symptoms. A bad sunburn may worsen psoriasis.

Streptococcal infections: Some evidence suggests that streptococcal infections may cause a type of plaque psoriasis. These bacterial infections have been shown to cause guttate psoriasis, a type of psoriasis that looks like small red drops on the skin.

HIV: Psoriasis typically worsens after an individual has been infected with HIV. However, psoriasis often becomes less active in advanced HIV infection.

Drugs: A number of medications have been shown to aggravate psoriasis. Some examples include:

Lithium
Beta-blockers
Antimalarials
Drugs used to reduce inflammation such as ibuprofen (Nurofen)
Emotional stress
Smoking
Alcohol
Hormonal changes

Progression

Psoriasis is usually more of an inconvenience rather than a life-threatening disorder. Once you have psoriasis, it is generally with you for life, with periods of remission and recurrence. Although treatments do not cure the condition, there are many effective therapies to help control the condition.

In some people with more severe disease, there may be social, emotional and economic effects. Studies have shown that psoriasis can actually impact on life, just like other chronic medical conditions (including diabetes and depression). Therefore it is very important to acknowledge your feelings towards the disease and seek medical help for any difficulties you may be experiencing with psoriasis.

Page 1 2 3