Psoriasis — It’s more than skin deep

People who suffer from psoriasis know that is it is an uncomfortable and embarrassing skin disease. It is unpredictable and irritating, and is one of the most baffling skin disorders. It is usually characterized by patches of thick, pink-red skin that may be itchy, dry and covered with loose, silvery scales.

While it is a chronic condition that can’t be cured, it can be effectively managed.

Washington University dermatologist Becca Chibnall, MD says, “We know psoriasis is an autoimmune disease, with genetics playing a major role.  When something triggers psoriasis to flare, the skin cells grow at an unusually fast rate, up to 10 times faster than normal — causing the buildup of lesions. Psoriasis can appear anywhere—on the scalp, eyelids, ears, skin folds, hands, feet, and nails. Because the skin at each of these sites is different, different treatments are required.

Even though we believe some patients are predisposed to psoriasis, we have no way to prevent its occurrence. Psoriasis often develops between the ages of 15 and 35, but it can occur at any age. Some patients have psoriatic arthritis, others just the skin disease. We don’t know why some patients get both types and others just one.

 Psoriasis also may be more than just a skin or joint disease. To complicate matters, newer research seems to indicate an increased cardiovascular risk, especially in patients with severe psoriasis.”

The symptoms of psoriasis vary — there are five types of psoriasis:

Plaque psoriasis is the most common type of the disease. It causes raised, red patches covered with a silvery white buildup of dead skin cells. These patches may itch or burn and can appear anywhere on the body, but they most often show up on the scalp, knees, elbows and lower back.

Guttate psoriasis appears as small, pink-red spots most often on the trunk, upper arms, thighs and scalp. It often starts in childhood or young adulthood, and can be triggered by a strep infection, stress or a skin injury. This is the second-most common type of psoriasis.

Inverse psoriasis shows up as bright red lesions that are smooth and shiny, but don’t have scales. The most common areas are armpits, groin, under the breasts, and skin folds around the genitals and buttocks.

Pustular psoriasis is an uncommon form that causes pustules (pus-filled bumps) surrounded by red skin.  While it may look infectious, it is not.  Pustular psoriasis can occur on any part of the body, but occurs most often on the hands or feet.

Erythrodermic psoriasis is a very rare, but serious form of psoriasis that leads to widespread, fiery redness over most of the body. It can cause severe itching, pain and peeling skin, a faster heart rate and changes in body temperature.  If you have these symptoms, you should see your doctor right away.

Dr. Chibnall explains, “While there is no cure for psoriasis, there are treatments that include light therapy, steroid-based creams, topical ointments and tar shampoos — used when psoriasis is limited to a specific part of the body.

However, we may prescribe oral or injectable drugs if the psoriasis is widespread or greatly affects your quality of life. These injectables have revolutionized psoriasis treatment.”

Patients are not solely at the mercy of their psoriasis, there are ways to control and prevent flare-ups. Because symptoms get worse when the skin is dry, keep it moist with creams and lotions, use a humidifier. Never pick at patches or scales, avoid dry, cold weather and make sure your dermatologist knows all the medications you take, as some can cause flare-ups.

For more information on treatment options for psoriasis, or to make an appointment with Dr. Chibnall, please call 314-942-6386.

Center for Advanced Medicine – South County
5201 Midamerica Plaza, Suite 2300
St. Louis, MO 63129