Psoriasis Treatment

This chronic, recurrent disease is marked by epidermal proliferation. Its lesions, which appear as erythematous papules and plaques covered with silver scales, vary widely in severity and distribution. Psoriasis affects about 21 % of the population in the United States.
Although this disorder often affects young adults, it may strike at any age, including infancy. Psoriasis is characterized by recurring partial remissions and exacerbations. Flareups are often related to specific systemic and environmental factors but may be unpredictable; they can usually be controlled with therapy.

Causes

The tendency to develop psoriasis is genetically determined. Researchers have discovered a significantly higher-than­normal incidence of certain human leukocyte antigens (HLA) in families with psoriasis, suggesting a possible immune disorder. Onset of the disease is also influenced by environmental factors.

Trauma can trigger the isomorphic effect or Koebner's phenomenon, in which lesions develop at sites of injury. Infections, especially those resulting from betahemolytic streptococci, may cause a flareup of guttate (drop shaped) lesions. Other contributing factors include pregnancy, endocrine changes, climate (cold weather tends to exacerbate psoriasis), and emotional stress.

Generally, a skin cell takes 14 days to move from the basal layer to the stratum corneum, where after 14 days of normal wear and tear, it's sloughed off. The life cycle of a normal skin cell is 28 days, compared to only 4 days for apsoriatic skin cell. This markedly shortened cycle doesn't allow time for the cell to mature. Consequently, the stratum corneum becomes thick and flaky, producing the cardinal manifestations of psoriasis.

Signs and symptoms

The following are the most common symptoms of psoriasis. However, each individual may experience symptoms differently, as psoriasis comes in several forms and severities. Symptoms may include:

• discoid psoriasis
  Also called plaque psoriasis, this type of psoriasis is the most common. Symptoms may include patches of red, raised skin on the trunk, arms, legs, knees, elbows, genitals, and scalp. Nails may also thicken, become pitted, and separate from the nail beds.
• guttate psoriasis
  This type of psoriasis affects mostly children. Symptoms may include many small patches of red, raised skin. A sore throat usually proceeds the onset of this type of psoriasis.
• pustular psoriasis
  Symptoms may include small pustules (pus-containing blisters) all over the body or just on the palms, soles, and other small areas.

The symptoms of psoriasis may resemble other skin conditions. Always consult your physician for a diagnosis.

Diagnosis

Diagnosis depends on patient history, appearance of the lesions and, if needed, the results of skin biopsy. Typically, serum uric acid level is elevated in severe cases, due to accelerated nucleic acid degradation, but indications of gout are absent. HLA-Cw6, B-13, and Bw-57 may be present in early-onset familial psoriasisl.

Is psoriasis contagious?

Treatment

Appropriate treatment depends on the type of psoriasis, the extent of the disease and the patient's response to it, and what effect the disease has on the patient's lifestyle. No permanent cure exists, and all methods of treatment are palliative.

UVB exposure

Methods to retard rapid cell production include exposure to ultraviolet light (UVB or natural sunlight) to the point of minimal erythema. Tar preparations or crude coal tar itself may be applied to affected areas about 15 minutes before exposure or may be left on over night and wiped off the next morning.

A thin layer of petroleum jelly may be applied before UVB exposure (the most common treatment for generalized psoriasis). Exposure time can increase gradually. Outpatient or day treatment with UVB avoids long hospitalizations and prolongs remission.

Drug therapy

Steroid creams and ointments are useful to control psoriasis. A potent fluorinated steroid works well, except on the face and intertriginous areas. These creams require application two times a day, preferably after bathing to facilitate absorption, and overnight use of occlusive dressings, such as plastic wrap, plastic gloves or booties, or a vinyl exercise suit (under direct medical or nursing supervision).

Small, stubborn plaques may require intralesional steroid injections. Anthralin ointment or paste mixture may be used for well-defined plaques but must not be applied to unaffected areas because it causes injury and stains normal skin. Apply petroleum jelly around the affected skin before applying anthralin. Often used concurrently with steroids, anthralin is applied at night and steroids during the day. A new topical agent is calcipotriene ointment, a vitamin 03 analogue.

Home remedies for psoriasis

• Take cod liver oil, lecithin, linseed oil, vitamin E, and zinc to aid the healing process.
• Regular long-term use of moisturizers can make the skin look and feel better. Thick and greasy moisturizers are usually the most effective at reducing scales and inflammation.
• Brief exposure to sunlight on a daily basis can clear mild psoriasis lesions. Be careful not to burn and don't stay in the sun for long periods of time.
• Take chickweed, dandelion, red clover, redmond clay, and yellow dock for symptom relief.
• Other home remedy for psoriasis is to apply aloe vera gel, garlic oil, and comfrey and goldenseal tea.

Prevention

• Avoiding environmental factors that trigger psoriasis, such as smoking, sun exposure, and stress, may help prevent or minimize flare-ups of psoriasis. Sun exposure may help in many cases of psoriasis and aggravate it in others.
• There is an association between increased alcohol intake and smoking and the development of severe psoriasis. However, whether a cause or effect is not known.
• Being overweight increases your risk of inverse psoriasis. In addition, plaques associated with all types of psoriasis often develop in skin creases and folds.