Psoriasis is a chronic skin disease that accelerates the life cycle of skin cells. It causes cells to rapidly build up on the surface of the skin. The extra skin cells form scales and red patches that are itchy and painful.
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The main goal of treatment is to stop the skin cells from growing so fast. Psoriasis has no cure, but you can manage symptoms. Psoriasis patches can vary from a few spots of dandruff-like scaling to major eruptions that cover large areas of the body.
Symptoms of Psoriasis
Psoriasis signs and symptoms are different for everyone. Common signs and symptoms include:
- Thickened, pitted or ridged nails
- Red patches of skin covered with thick, silvery scales
- Dry, cracked skin that may bleed
- Itching, burning or soreness
- Swollen and stiff joints
- Small scaling spots (common in children)
Types of Psoriasis
Most types of psoriasis go through cycles, flaring for a few weeks or months, then subsiding for a time or even going into complete remission.
There are several types of psoriasis. These include:
- Plaque psoriasis:This is the most common form. It causes dry, raised, red skin lesions (plaques) covered with silvery scales. The plaques might be painful or itchy and there may be few or many. They can occur anywhere on your body, including your genitals and the soft tissue inside your mouth.
- Nail psoriasis:Psoriasis can affect fingernails and toenails, causing discoloration, pitting, and abnormal nail growth. Psoriatic nails might loosen and separate from the nail bed.
- Guttate psoriasis:This type affects young children. It’s usually triggered by a bacterial infection such as strep throat, characterized by small, water-drop-shaped, scaling lesions on your scalp, trunk, arms, and legs.
The lesions are covered by a fine scale and aren’t as thick as typical plaques are. You may have a single outburst that goes away on its own, or you may have repeated episodes.
- Inverse psoriasis:This mainly affects the skin in the armpits, in the groin, under the breasts and around the genitals. Inverse psoriasis causes smooth patches of red, inflamed skin that deteriorate with friction and sweating. This type of psoriasis may be caused by fungal infections.
- Pustular psoriasis:This rare form of psoriasis can occur in widespread patches or in smaller areas on your hands, feet or fingertips. It generally develops quickly, with pus-filled blisters appearing just hours after your skin becomes red and tender. The blisters may come and go frequently. It can also cause diarrhea, chills and severe itching.
- Erythrodermic psoriasis:The least common type of psoriasis, erythrodermic psoriasis can cover your entire body with a red, peeling rash that can itch or burn intensely.
- Psoriatic arthritis:Psoriatic arthritis causes swollen, painful joints that are typical of arthritis and inflamed, scaly skin. Symptoms range from mild to severe, and psoriatic arthritis can affect any joint. Although the disease usually isn’t as crippling as other forms of arthritis, it can cause stiffness and progressive joint damage that can lead to permanent deformity in the long run.
Causes of Psoriasis
Psoriasis is thought to be linked to an immune system problem with T cells and other white blood cells, called neutrophils, in the body. T cells normally travel through the body to defend against foreign substances, such as viruses or bacteria.
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In the case of psoriasis, the T cells mistakenly attack healthy skin cells, as if to heal a wound or to fight an infection.
Overactive T cells also trigger increased production of healthy skin cells, more T cells and other white blood cells, especially neutrophils. These travel into the skin causing redness and sometimes pus in pustular lesions. Dilated blood vessels in psoriasis-affected areas create warmth and redness in the skin lesions.
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The process becomes an ongoing cycle in which new skin cells move to the outermost layer of skin too rapidly, in days rather than weeks. Skin cells build up in thick, scaly patches on the skin’s surface, continuing until treatment stops the cycle.
Factors that may trigger psoriasis include:
- Vitamin D deficiency
- Infections, such as strep throat or skin infections
- Injury to the skin, such as a cut or scrape, a bug bite, or a severe sunburn
- Excess consumption of alcohol
- Certain medications — including lithium, which is prescribed for bipolar disorder, high blood pressure medications such as beta blockers, antimalarial drugs, and iodides
Anyone can develop psoriasis, but these factors can increase your risk of developing the disease:
- Family history.This is one of the most significant risk factors. Having one parent with psoriasis increases your risk of getting the disease, and having two parents with psoriasis increases your risk even more.
- Viral and bacterial infections.People with HIV are more likely to develop psoriasis than people with healthy immune systems are. Children and young adults with recurring infections, particularly strep throat, also may be at increased risk.
- Because stress can impact your immune system, high stress levels may increase your risk of psoriasis.
- Excess weight increases the risk of psoriasis. Lesions (plaques) associated with all types of psoriasis often develop in skin creases and folds.
- Smoking tobacco not only increases your risk of psoriasis but also may increase the severity of the disease. Smoking may also play a role in the initial development of the disease.
If you have psoriasis, you’re at greater risk of developing certain diseases. These include:
- Psoriatic arthritis.This can cause joint damage and a loss of function in some joints.
- People with psoriasis are more likely to be obese. It’s not clear how these diseases are connected.
- Type 2 diabetes.The risk of type 2 diabetes rises in people with psoriasis. The more severe the psoriasis, the greater the likelihood of type 2 diabetes.
- Eye conditions.Certain eye disorders such as conjunctivitis, blepharitis and uveitis are more common in people with psoriasis.
- High blood pressure.The odds of having high blood pressure are higher for people with psoriasis.
- Kidney disease.Moderate to severe psoriasis has been linked to a higher risk of kidney disease.
- Cardiovascular disease.For people with psoriasis, the risk of cardiovascular disease is twice as high as it is for those without the disease. Psoriasis and some treatments also increase the risk of irregular heartbeat, stroke, high cholesterol and atherosclerosis.
- Metabolic syndrome.This cluster of conditions — including high blood pressure, elevated insulin levels and abnormal cholesterol levels — increases your risk of heart disease.
- Parkinson’s disease.This chronic neurological condition is more likely to occur in people with psoriasis.
- Other autoimmune diseases.Celiac disease, sclerosis and the inflammatory bowel disease called Crohn’s disease are more likely to strike people with psoriasis.