While psoriasis is not curable, modern science has made this itchy skin condition manageable, even as it worsens in the colder winter months.
By Victor Czerkasij, MSN, NP-C
Psoriasis is a very itchy skin condition that tends to worsen during the colder months of winter. The word comes from the Greek word ‘psora’, which means ‘to itch.’
Psoriasis is an auto-immune disease, which mean it is a result of the body attacking itself, not from catching it or touching another person.
A cascade of inflammatory factors in the person’s immune system inexplicably begins to trigger skin cell manufacturing. We don’t know if the trigger was an emotional event, or following exposure to the flu, or having a knee surgery, but the body begins making skin cells at a faster rate.
These cells begin to pile up and thicken, turn scaly and even bleed. This is the general, most familiar presentation of psoriasis.
There are many forms of this disease, but the most common affects approximately about 80% of those who have it. It is known as plaque psoriasis, and traditionally favors the elbows and knees. However, psoriasis can present itself all over the body.
In addition to the itching and the inflammation of the skin, people with psoriasis must also worry about psoriatic arthritis. The fingers, toes and joints become sore and painful, especially in the morning and under where plaques of psoriasis have been for years. The nails of the fingers and toes will appear pitted and cracked and some patients believe they have nail fungus (onychomycosis) when in fact, this is a result of the psoriatic arthritis.
Psoriasis affects about 7% of the population, and can show itself in childhood or at any time in life. There is a genetic predisposition and it does tend to run in families.
So what should a person do if they suspect they have psoriasis?
- First, understand that you are not alone. There are many good support groups that your dermatology provider can offer you for resources and help.
- Second, visit your dermatology provider for the correct diagnosis. Most of the time, simple questions and observation will provide the answer to your questions. In trickier presentations, a small biopsy – a sample of the psoriasis and some skin – will be sent to a lab for further examination.
- Third, understand that you will require treatment. There is no need to suffer. Also, delaying treatment will worsen the effects of the psoriatic arthritis, which are very difficult to reverse and can lead to premature aging and shortening ones’ lifespan.
Many treatments are simple. You may only require a cream or ointment occasionally. Some of are a steroid nature, and others are not. Sometimes, a simple anti-inflammatory injection may be all you need for relief.
There are treatments that included light therapy, and some systemic therapies that are pills by mouth.
An entirely new class of medications have been developed called biologics. Biologics have been on the medical scene now for nearly thirty years. Theses are extremely helpful injectables and oral pills that have been developed to specifically target one or more steps in the process of psoriasis. This targeting of the development of psoriasis limits side effects and insures a patients’ safety that was previously difficult to do.
All treatments are customized to a patient’s motivation and willingness, type of psoriasis and other health issues that are determined in a meeting with a dermatology provider.
Regardless what is finally decided, please be sure not to wait, as delay can make your condition more difficult to treat as time goes by.