Psoriasis: August is Psoriasis Awareness Month
Psoriasis is a skin disease that dates back thousands of years. It has been discovered on Egyptian mummies. The ancient Greeks called it psora - meaning 'to itch'. Hippocrates (460-377 BCE) prescribed a tar mixture to be applied to the skin, in addition to topical arsenic. Galen (~130-210 AD), the physician who named psoriasis, also attempted to treat the illness using arsenic, and a broth in which a viper had been boiled. In medieval Europe, when the disease was thought to be contagious, people with psoriasis were forced to warn others of their arrival by ringing a clapper (similar to a bell). Later treatments included applying cat and dog feces, goose oil, semen, and onions mixed with sea salt and urine to the skin.
Today, we know that Psoriasis is a lifelong autoimmune skin disease. Autoimmune diseases occur when your body’s immune system (the body’s defense against illness and infection) becomes overactive and attacks normal tissues in your body. When someone has psoriasis, the body is programmed to speed up the growth cycle of skin cells, producing an overgrowth of skin.
Psoriasis is a complex skin disorder with no known cause. Family history and genetics seem to play a central role. It is not contagious. Well-identified triggers that can cause a flare-up include:
· HIV infection
· Strep infection
· Certain drugs
· Emotional stress
· Alcohol consumption
· Tobacco smoking
There are 5 types of psoriasis, each with a different presentation:
· Plaque psoriasis is the most common type. Patches of the skin have a raised, thick appearance. The skin is red in color and covered with a silvery white buildup of dead skin cells. These patches are often located on the scalp, knees, elbows, and lower back. They are often itchy and painful, and can crack and bleed (above photo)
· Guttate psoriasis appear as small, red, scaly patches that can be all over the body, but are usually found on the trunk. It often begins in childhood and young adulthood. It can be triggered by a strep infection or a respiratory infection
· Inverse psoriasis can be found in your body’s creases, such as the arm pit, groin, and behind the knee. The lesions are red, and may be smooth and shiny
· Pustular psoriasis causes white blister-like lesions that are most commonly found on the hands and feet but can also be found all over the body. The blister is replaced with dry, scaly, crusting skin that can be painful
· Erythrodermic psoriasis causes widespread redness with a fine scaling. There is often severe pain and itching, and the skin can fall off in sheets. This is a life-threatening situation. (It occurs in only 3% of people with psoriasis)
Psoriatic arthritis occurs in about 30% of people with psoriasis. It can cause swelling, stiffness, and pain in and around the joints, nail changes, and fatigue. If left untreated, psoriatic arthritis can cause permanent joint damage.
Psoriasis can present anywhere on the body, including the eyelids, ears, mouth and lips, skin folds, hands and feet, genital area, and nails. The diagnosis is typically made after seeing the rash, and can be confirmed with a skin biopsy.
There is no cure for psoriasis. Treatment is often based on where the psoriasis is, how much of the skin is involved, and how it is affecting your life. Medical intervention is essential for treatment, which is typically provided by a Dermatologist (skin specialist). Psoriatic arthritis is often managed by a Rheumatologist.
For more information on Psoriasis, visit The National Psoriasis Foundation at https://www.psoriasis.org