All about Psoriasis
Psoriasis is a chronic skin disease that causes red, scaly plaques anywhere on the body. It can decrease the quality of life, but there are effective treatments to control it.
What are the symptoms of psoriasis?
The symptoms of psoriasis depend, most importantly, on the type and location. Plaque psoriasis is the most common type of psoriasis with the following signs & symptoms:
- Rounded red or oval spots lined with white or silver scales. Their size is variable ranging from small patches to large plaques that can cover a large body surface. The most typical locations are the elbows, knees, lower back area and scalp but can also appear in any area of the skin.
- Itching. Itching is one of the most frequent symptoms of psoriasis patients, and it may have a bigger impact on quality of life than the visible effect of the disease.
- Burning, pain or bleeding.
Another typical sign of psoriasis is Koebner’s phenomenon. In this condition, any skin trauma (scratches, burns, etc.) causes psoriasis lesions to appear 2 to 6 weeks after trauma to the skin. It happens to 1 in 4 people with psoriasis.
What is psoriatic arthritis?
Psoriatic arthritis is an inflammatory joint disease associated with psoriasis. It is estimated that between 25% and 30% of people with psoriasis develop psoriatic arthritis. The most common scenario is for psoriasis to appear on the skin before inflammation of the joints, but in some cases, arthritis appears first.
Psoriatic arthritis causes pain, stiffness and swelling around and in the joints of the body. It can affect any joint, including those in the spine. Wrists and hands are frequently affected, which can make day-to-day activities more difficult.
Other diseases associated with psoriasis include:
- Cardiovascular Diseases (such as myocardial infarction, angina, stroke or peripheral vascular disease). Research continues to link psoriasis and psoriatic arthritis with an increased risk for cardiovascular disease, especially in people with severe psoriasis. The good news is that treating your disease can reduce your risk of heart attack and stroke. Talk to your doctor about your risk for cardiovascular disease.
- Cardiovascular Risk Factors (such as diabetes, dyslipidemia, obesity, and hypertension):
- People with psoriasis are at an increased risk for type 2 diabetes. People with severe psoriasis, in particular, are 30 percent more likely to have type 2 diabetes. If you have symptoms of type 2 diabetes, such as increased thirst, hunger, blurred vision or fatigue, tell your doctor.
- There is a significant association between psoriatic disease and metabolic syndrome – a cluster of conditions that include dyslipidemia, abdominal obesity and high blood pressure. A recent study found that 40 percent of those with psoriasis had metabolic syndrome, compared with just 23 percent of the general population. More women with psoriasis had metabolic syndrome than men.
- Inflammatory Bowel Disease (such as Crohn disease, Ulcerative Colitis): There is a connection between psoriasis, psoriatic arthritis and inflammatory bowel disease. In a recent study of women with psoriasis, 10 percent developed a form of inflammatory bowel disease, such as Crohn's Disease or ulcerative colitis. Those who had psoriasis and psoriatic arthritis were at even greater risk of developing Crohn's. People with psoriatic disease and Crohn's share similar genetic mutations. Talk to your doctor if you have symptoms of inflammatory bowel disease such as diarrhea, abdominal cramping and bloody stools.
- Fatty liver. In this disease, fats accumulate in the liver.
- Kidney Disease: People with severe psoriasis are twice as likely to develop chronic kidney disease than those whose psoriasis was mild or had no psoriasis at all.
- Cancer. People with psoriasis are at higher risk of cancer, especially lymphoma, basal cell carcinoma and squamous cell carcinoma.
- Anxiety and depression. Psoriasis is associated with a multitude of psychological impairments. Related psychological problems can affect every day social activities and work. It causes embarrassment, lack of self-esteem, anxiety and increased prevalence of depression.
Anxiety and depression can exacerbate psoriasis and reduce overall the quality of life. Therefore, if you notice any symptoms of depression (sadness, apathy, fatigue, difficulty concentrating, etc.) or anxiety (anguish, nervousness, insomnia, etc.), you should talk to your doctor who will help you find a solution.
Additionally, to the associated comorbidity, evidence of associations between psoriasis and certain harmful lifestyle habits, such as tobacco consumption and ⁄ or alcohol consumption.
What to do if I observe any symptoms?
If you notice spots on your skin, schedule an appointment with your doctor. The doctor will make the diagnosis and decide the most appropriate course of treatment for you. In addition, if you have psoriasis, it is important that you inform your doctor if you notice any joint inflammation or any other symptoms that may worry you. As we have seen, psoriasis can manifest in far more places than just the skin.
- Dauden 2013. Clinical practice guideline for an integrated approach to comorbidity in patients with psoriasis JEADV 2013. Available at: https://www.ncbi.nlm.nih.gov/pubmed/23134338
- Dauden 2018. Position statement for the management of comorbidities in Psoriasis. JEADV 2018. Available at: https://www.ncbi.nlm.nih.gov/pubmed/29992631
- World Health Organization (WHO). Global report on psoriasis [Internet]. 2016. Available at: https://apps.who.int/iris/handle/10665/204417
Frequently asked questions about psoriasis
Psoriasis affects more than 60 million people worldwide.
It affects men and women equally and occurs more commonly in adults than in children. Psoriasis can occur at any age. While some studies indicated the average age of onset for psoriasis was 33 years of age, and 75% of cases occurred before 46 years of age (93), others suggested that the onset of psoriasis was bimodal with two peaks of the disease – the first between 16 and 22 and the second between 57 and 60 years of age.
Psoriasis has a hereditary component. That is, if you have psoriasis, your child is more likely to have it than other people. However, there are other factors that also play a role. The most important risk factors for psoriasis are obesity, smoking, alcohol use, infections, stress and some drugs.
No, psoriasis is not contagious, neither by contact nor by any other transmission mode.
Psoriasis cannot be cured. At present, there is no treatment that cures psoriasis. However, there are many medications that control the symptoms and allow you to lead a normal life.
Most people have mild psoriasis that is controlled with certain measures (such as hydrating the skin daily) and topical medications.
However, in some people, the disease affects a larger skin area or the joints or has a significant impact on the sufferer’s well-being and quality of life. In these cases, psoriasis may require other medications, either in tablets or in an injected form. Adequate and effective treatments are available for each person and for each type of psoriasis.
Psoriasis is a visible disease and because of that it can affect your quality of life. However, it does not impact all the people in the same way. It depends on many factors, such as the extension and intensity of the disease, the social environment and the personality of the sufferer. Anxiety and depression are frequent. To improve your quality of life, it is important for you to follow the treatment prescribed by your doctor, to maximize remission times and reduce the risk of other psoriasis-related diseases.
It is not known. It is impossible to predict how psoriasis will evolve in a specific person, or how long the flare-ups and remissions will last.
The doctor will adjust treatment based on disease course.
To date, diet has not been shown to be a risk factor to develop psoriasis. Therefore, there is no known food that causes psoriasis. Moreover, there is no scientific evidence to support a "diet for psoriasis".
However, it should not be forgotten that obesity is in fact a risk factor for psoriasis. Hence, following a hypocaloric or low-calorie diet to lose weight is beneficial for overweight people. In addition, psoriasis can be associated with cardiovascular diseases, and, therefore, a healthy, balanced and beneficial diet for the heart, such as a Mediterranean diet, is highly recommended.
Furthermore, if you have psoriasis and celiac disease, eliminating gluten from your diet can improve psoriasis, according to the National Psoriasis Foundation, which, on the other hand, does not recommend this type of diet in people without gluten intolerance.