Rheumatoid Arthritis Psoriasis - Who Does It Affect

Rheumatoid Arthritis Psoriasis

Up to 15-30 percent of psoriasis sufferers will develop psoriatic arthritis. Psoriatic arthritis usually develops between the ages of 20 and 50, and is uncommon in children.
 
However, when the disease occurs in children, its development differs from that of adults. For example, in childhood, psoriatic arthritis affects females at three times the rate of males, whereas, in adulthood, women and men are affected equally. In addition, psoriatic arthritis develops before psoriasis in about 50 percent of children, compared to only 5 percent of adults. Almost 85 percent of adults with psoriatic arthritis develop psoriasis first.
 

Rheumatoid Arthritis Psoriasis

Psoriasis And Arthritis

Psoriasis And Arthritis

Psoriatic arthritis is a chronic (long-term), progressive, inflammatory arthritis (swelling and tenderness of the joints). People with psoriatic arthritis can have swollen, tender joints, as well as nail changes, and the scaly, raised, red skin changes of psoriasis.

Inflammation most commonly involves the joints of the hands, wrists, neck, back, knees, ankles, and feet. The pain and stiffness are usually worse in the morning, or after rest, and can improve with physical activity. The severity can vary from mild disease affecting only a few joints without any noticeable pain to severe disabling and painful arthritis with deformity and destruction of joints. In people with mild arthritis, the condition can remain undiagnosed and might have minimal impact on their quality of life. More severe forms of psoriatic arthritis can occur in people with multiple affected joints (more than four), and in younger, often female patients. Early diagnosis and treatment is important to prevent destruction and deformity of the joints.

Diagnosis Of Psoriasis

Diagnosis Of Psoriasis

With any disease, an accurate diagnosis is the first step in ensuring proper treatment. A doctor makes the diagnosis of psoriasis after she or he has asked a series of questions and carefully examined your skin. In most cases, the physical examination of your skin alone is enough to make the diagnosis. There are a few things doctors will ask when making a diagnosis:

• Is there a family history of psoriasis?
• How long have you had this condition?
• What treatments have you received?
• How effective were they?
• Do you have tender and/or swollen joints (arthritis)?
• Are your fingernails/toenails affected?
• Do you have a history of skin lesions improving in summer and worsening in winter?
• Do you have one or more raised, red, silvery, scaling areas?
• Is the disease in the classic locations with symmetrical involvement of the elbows, knees, lower back, scalp, finger and/or toenails (rough, discolored appearance, often with individual pits in the nail plate)?

Psoriasis Research Studies - What Triggers Psoriasis

Psoriasis Research Studies

While psoriasis has a definite genetic component, environmental factors also play a key role in the onset and severity of disease. Patients with psoriasis might note that they experience a worsening or flare-up of their disease in response to external or internal factors. There are many such factors that can indirectly trigger the onset of psoriasis or aggravate it in someone who is already affected. These include: 

• climate
• infection
• medications
• skin injury (Koebner phenomenon)
• stress

Psoriasis Immune System - Immunology For Everyone

Psoriasis Immune System

A key component in the immune system is a group of cells called white blood cells, which help defend the body against foreign invaders and microorganisms. One type of white blood cell that is believed to be of crucial importance in causing psoriasis is the T-lymphocyte.

The T-lymphocytes are very smart cells because they have terrific memories. In fact, once they are exposed to a foreign substance, they remember it forever. With subsequent exposures, the T-lymphocytes will recognize the substance and multiply to attack it. Hence, they are known as memory T-cells.

What Causes Psoriasis

What Causes Psoriasis

In the past decade, there have been many advances in our understanding of how psoriasis might develop and how it can be treated. The question remains: Why does it occur? 

Psoriasis is a complex disease that is caused by several factors. Although there is no known single cause for psoriasis, it is clear that genetics, the skin cells (keratinocytes), environmental factors, and the immune system play central roles in causing this disease. Psoriasis has a strong genetic component, and there are multiple genes that likely need environmental triggers to activate psoriasis. There are many theories as to why psoriasis occurs in susceptible people, but no one has been able to pinpoint the exact cause. We now understand, however, that there are several key steps in the process, and that the immune system plays a critical role.

Comorbid Psoriasis - Psoriasis and Other Diseases

Comorbid Psoriasis

The term "comorbid" describes the presence of one or more diseases in addition to the underlying primary disorder. Patients with psoriasis can be at increased risk for developing a number of other important medical conditions. These diseases or comorbid conditions are often chronic (long-lasting), and can have a significant impact on patients' quality of life, productivity at work, and general health. Comorbidities in patients with psoriasis can include arthritis (psoriatic arthritis), depression, inflammatory bowel disease, lymphoma, and the so-called metabolic syndrome (the coexistence of heart disease, high blood pressure, and obesity).
 
Heart Disease
 

Psoriasis Of Nails - Nail Psoriasis

Psoriasis Of Nails

Psoriasis can affect the nails in up to 50 percent of patients, and this number can be higher if psoriatic arthritis is present. Some people might have only nail psoriasis with no apparent skin changes on the rest of the body. Psoriasis of the fingernails is more common than psoriasis of the toenails. Several changes can occur in the nail with psoriasis.
 
Discoloration: The nail can develop a yellow-brown discoloration that might involve the entire nail. The discoloration can also occur in only one or a few localized areas in a spot-like manner and resemble an oil droplet.

Psoriasis Scalp Treatment

Psoriasis Scalp Treatment

Treatment of scalp psoriasis is challenging, but there are many therapies that can help. Sometimes, the best treatments are arrived at by trial and error, so it is important to be patient when treating and awaiting results. The following are some common forms of treatment.
 
Anthralin: Anthralin can reduce the turnover of skin cells that cause the excessive buildup of scale, and reduce inflammation. As a result, it can be highly effective in treating scalp psoriasis. However, anthralin can be messy and cause staining of the skin, blond or gray hair, and clothing.

Psoriasis On Scalp

Psoriasis On Scalp

The scalp is one of the most common and persistent areas affected by psoriasis (occurring in about 50 percent of all patients) and can be one of the most difficult places to treat. The scales on the scalp can be thick and silvery-white, and can stick together tightly to form dense crusts that can be very itchy. Picking at the scales and scratching the scalp can worsen the psoriasis.
 
Scalp psoriasis can be localized, involving only a few discrete areas or can affect the entire scalp. The lesions often appear behind the ears and along the hairline, but can spread beyond the hairline. If the ear canal is affected and accumulates enough scales, hearing may be impaired. Hair loss is uncommon because psoriasis does not affect the hair root, but in severe cases hair loss can occur. Hair usually regrows once the psoriasis is controlled.

Different Types Of Psoriasis (Part 2)

Different Types Of Psoriasis

Inverse Psoriasis

Inverse psoriasis (also known as flexural psoriasis) affects areas where the body folds, such as the skin in the armpits, groin, under the breasts, and in the perianal location. This type of psoriasis usually occurs in conjunction with plaque-type psoriasis, but can also occur on its own. It differs from other types of psoriasis because rather than appearing scaly, the skin is smooth, moist, and salmon-colored. Inverse psoriasis can be confused with a yeast (candida) or fungal infection (jock itch).

People with inverse psoriasis can feel extremely uncomfortable because their skin is often raw, tender, or itchy, which is most distressing for those affected as scratching these areas in public is embarrassing. Sweating can irritate the skin further. Inverse psoriasis can usually be controlled with topical corticosteroids. A mild to mid-potency topical steroid is usually tried first as the skin in these locations is thinner and more likely to develop local side effects from topical steroids (thinning of the skin, stretch marks). As noted earlier, a new kind of topical nonsteroidal therapy is now available and is also used to treat psoriasis in these locations. The new therapies are available in cream formulations.

Types Of Psoriasis (Part 1)

Types Of Psoriasis

There are five different types of psoriasis: 

• plaque-type psoriasis
• guttate psoriasis
• inverse psoriasis
• erythrodermic psoriasis
• pustular psoriasis

Each type has its own unique characteristics; some types can occur alone or coincide with other forms. Therapy can differ for each; some therapies are briefly outlined in later posts, which focus on the safety and benefits of various treatments.

Signs Of Psoriasis - What Is Psoriasis

Signs Of Psoriasis

Psoriasis is a chronic (long-lasting and recurring) inflammatory, noncontagious skin disease, characterized by itchy, thick, raised, red areas of skin covered with silvery-white scales. Psoriatic lesions are most commonly found on the elbows, knees, scalp, and lower back, although any part of the body can be affected, including the fingernails and toenails. Affecting 1-3 percent of the world's population, psoriasis is one of the most common skin disorders.
 
Psoriasis can vary in presentation and severity. The majority of patients (approximately 80-90 percent) present with relatively mild disease with only limited involvement of the skin, which can be controlled with topical creams. It is important to recognize that even though psoriasis might involve only limited areas of the body, it can still pose a significant burden on patients' lives. This fact was emphasized recently when a major conclusion of a consensus meeting of the American Academy of Dermatology stated that it is important for doctors to not rely only on the amount or area of a patient's psoriasis when determining the severity of the disease and treatment, but also to take into account the effect the disease has on the patient's quality of life.

Psoriasis Skin Condition - Our Skin As A House

Psoriasis Skin Condition

It is easier to understand the normal appearance and function of the skin if we compare it to a house and the earth on which that house rests. For example, at its most basic level a house can be considered to comprise two parts: the house itself and the earth it rests on. A two-storey house has a basement and two floors. The basement, or foundation, of the house rests on the earth. The house itself consists of bricks and a roof. The bricks are joined together by cement.

The skin, like a house, is also divided into two parts: the outer, thinner portion called the epidermis (which we can think of as our house) and the inner, thicker layer called the dermis (which we can think of as the ground or earth). Just as a house rests on the earth for stability, the epidermis rests on top of the dermis.

I Have Psoriasis - Is Psoriasis A Skin Disease

I Have Psoriasis

Psoriasis, originating from the Greek word psora (meaning "to itch"), is a chronic, incurable, noncontagious skin disease. For centuries, psoriasis was confused with leprosy. Because of the failure to differentiate between these diseases, people with psoriasis could experience.humiliation and abandonment by their family and community.
 
In the nineteenth century, Dr. Hebra and Dr. Kaposi realized that leprosy was different from psoriasis and helped classify the latter as a distinct medical disease. Since then, scientists have been trying to find the root cause of the disease, effective and safe treatments, and, most importantly, a cure.