Psoriasis

What is Psoriasis?

Psoriasis is a chronic autoimmune condition that affects the skin, and is probably best known among all autoimmune conditions. It is a troublesome condition known for frequent recurrence. Its severity is greatly variable.

Psoriasis is the result of an erroneous immune response. The skin regenerates and heals itself regularly in response to two things: the death of skin cells, and injury. The death of skin cells is frequent. The human body sheds skin cells on a constant basis, and the entirety of the skin is actually replaced every two weeks to a month as this occurs. Psoriasis causes the body to believe that the skin needs to grow and that the replacement cycles of the cells need to be activated when there is no injury present and the skin cells currently composing the skin have yet to die.

This results in thickness and scaling of the skin, which in turn leads to rapid and itchy flaking of the skin. This, in turn, leads to the discoloration of the skin in patches. These patches vary greatly in size.

Who gets Psoriasis?

The origin of psoriasis is not fully understood. Consequently, it is not fully understood what sufferers of psoriasis have in common. There are two primary theories regarding the origin of psoriasis which indicate some details and offer some clout to theories about its origin.

Individuals that suffer from other autoimmune diseases are far more likely to suffer from psoriasis. Autoimmune diseases have a tendency to group together in clusters (usually with a ‘primary’ ailment that is significantly worse than the others, with the others presenting more like additional symptoms than anything else), and psoriasis is no exception to this. However, many individuals suffer from psoriasis without any other autoimmune condition at hand. Further, many go on to suffer psoriasis after one or both of their parents have, hinting that there may be a genetic component in addition to the genetic component that drives autoimmune disorders.

Because psoriasis is such a unique and unpredictable condition, however, it would be very difficult to isolate everything that sets an individual aside and makes them more or less likely to suffer from psoriasis.

What causes Psoriasis?

The cause of psoriasis is not completely understood. Research on breakouts of psoriasis is fairly limited in scope. Because there is no causal origin and nothing known induces psoriasis as a condition, it is impossible to create a truly controlled study. Thus, must of the data accrued about psoriasis comes from details gleaned from hospital records—useful data, to be sure, but not as ‘pure’ as it could be by any stretch.

There are two schools of thought that color the debate over the origin of psoriasis. Complicating matters somewhat, the two schools of thought are not incompatible in the least and can easily coexist. Some hypotheses indicate that the two conditions must necessarily coexist to cause psoriasis.

The first of these conditions is simple: a dysfunction of the skin itself and the skin cells that compose the skin, prompting it to constantly produce excess, useless cells. This is supported for its simplicity and ease of application; this is roughly the same function of a cancer, albeit far less damaging, in that the skin is simply prompted to produce cells in a flawed manner. This is not to say that psoriasis is linked to skin cancer, but simply to indicate the parallel. With skin cancer, the cells and their formation are dysfunctional and result in tumors, and with psoriasis, the formation of new cells is dysfunctional and effectively creates unnecessary skin, which is then shed.

The second of these possible conditions is an autoimmune response. This is supported by two primary factors. First is the role of the immune system in responding to skin damage and penetration, which psoriasis is very similar to. Second is that psoriasis breakouts can be reduced or eliminated by the application of immunosupressant drugs and that psoriasis has a tendency to be reduced when the immune system is otherwise suppressed.

There are two difficulties with these theories, however, one for each angle. Because data on psoriasis is fairly limited, it may be some time before the true cause is elucidated.

The problem with the first theory is that whatever dysfunction of the skin cells might bring about psoriasis is not understood yet. Whatever dysfunction exists, if indeed a dysfunction does exist, it cannot presently be documented and analyzed. Cellular biology is a field without much disclarity. This puts a rather large hole in the argument.

The second problem is attached to the second theory: some immunocompromised individuals suffer from psoriasis, seemingly as a condition comorbid with psoriasis. Individuals with HIV, for instance, frequently suffer from psoriasis, creating a huge rift of disparity between this and other data: HIV reduces t-cell count and eviscerates the body’s ability to deal with external threats, which is why it is such a dangerous virus. However, a reduction in t-cells generally reduces the incidence and recurrence of psoriasis in other individuals. Obviously, this does not make sense.

There are several points of information that do contribute some certainty to the case, however.

Psoriasis is not contagious. There is no viral, bacterial nor fungal component, and it consequently cannot spread from person to person.

Psoriasis may be caused by environmental triggers. This goes both for the initial breakout and all subsequent breakouts. There are a great number of possible triggers. Stress may cause a breakout of psoriasis, whether the stress is physical or mental. Damage to the skin may cause psoriasis breakouts during the healing process (which contributes somewhat to the theory of psoriasis-as-skin-dysfunction). Changes in the season or weather may trigger psoriasis cases in some sensitive sufferers; heat and dryness are the most likely offenders, making the summer and winter months the worst for possible breakouts.

Genetics play a very relevant role, and there are a great number of genes that have connections to psoriasis. What is not understood is exactly how the genes correlate; because the actual origin of the disease is not fully understood, the actual connection of the genes to the disease is not understood fully either. The genetic component of autoimmune diseases likely plays a role. Others may be related to the generation of new cellular tissue.

What does Psoriasis cause?

Psoriasis causes extreme itching and flaking of the skin. There are a number of psoriasis variants that require more specific elucidation, but the common rule is that psoriasis causes the formation of skin plaques. These plaques are discolored, white and scaly in nature, and scratch away easily. Following their formation, they flake away.

Psoriasis has a severe effect on one’s day-to-day living and plays a huge role in one’s health. While psoriasis itself is not dangerous, it is very disruptive due in part to its discomfort and in part to the damage it does to the skin. The location of plaques can range from embarrassing and unsightly to debilitating; plaques on the hands can prevent typing or writing, plaques on the feet can prevent walking or running, plaques near the joints can make movement of limbs difficult, and the greater the density of the plaques on the body, the worse the disruption of its itching can grow.

Psoriasis plays a large psychological role. While it is effectively benign, it has a huge impact on one’s appearance, and the flaking of the skin can easily be mistaken for dandruff or other embarrassing skin conditions. Because the skin is raised and scaly in the form of plaques, it is more difficult than other skin conditions like acne to simply cover up and hide from sight. Because it remits and recurs so often, individuals frequently find that it is a completely unpredictable ailment, which leads many to feel even more distressed.

How serious is Psoriasis?

Psoriasis is a very serious medical condition. While it is not deadly and does not pose a risk to life, it poses a very real risk to one’s quality of life. Psoriasis is unsightly and irksome in the best of cases, and the more severe it gets, the more it has a tendency to be disruptive. Psoriasis can interfere with work and recreation in many ways. Depending upon their location, plaques can restrict movement, making some physical tasks difficult. Regardless of where they form, plaques consistently itch, detracting from one’s focus on mental tasks.

Psoriasis is a chronic condition that cannot be cured. Individuals diagnosed with psoriasis must be prepared to deal with it for the rest of their lives, significantly contributing to its severity. Symptomatic treatment is available and quite effective. Many of the most effective treatments, however, pose a risk to one’s greater skin health. Psoriasis can spread progressively throughout the duration of one’s lifespan, but it is unknown what, if anything, should provoke this specifically.

What does Psoriasis treatment look like?

Treatment for psoriasis varies depending upon the specific symptoms at hand. Treatment options include systemic treatments and topical treatments, both available depending upon the severity of the psoriasis. Severity is determined, in this case, by how widespread the breakouts are. For most sufferers of psoriasis, a topical application of corticosteroids to the areas of outbreak is more than sufficient to end the itching and render the plaques easy to forget about. Generally, this is all that is required, as the majority of psoriasis cases are not severe.

More severe cases may warrant that steroids be administered orally or through injection. This carries them throughout the entire body and is the most efficient means by which to treat all psoriasis plaques simultaneously. However, this poses some risk to liver health, as the appropriate drugs are taxing on the system in this way.

How do I know if I have Psoriasis?

Psoriasis is positively identified by a dermatologist by way of a biopsy. The symptoms are otherwise fairly easy to recognize, although self-diagnosis is never a good option.

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