Psoriasis: types and triggers

Some facts about psoriasis

• It's estimated that at least 2% of the world's population has psoriasis.
• Psoriasis is a systemic disease.
• People who get psoriasis exhibit a wide range of symptoms that vary in severity.
• Psoriasis goes through cycles: sometimes better, at other times worse.
• No single treatment works for everyone.
• A form of arthritis, called psoriatic arthritis, affects up to 42% of the people who have psoriasis.
• Poor diagnosis and treatment means that many people with psoriasis and psoriatic arthritis suffer in silence.
• There is no cure for psoriasis or psoriatic arthritis.

What are the symptoms?

Normally there is a constant shedding of dead skin cells. However, due to the acceleration of the replacement process, both dead and live cells accumulate on the skin surfce. Often this causes red, flaky, crusty patches covered with silvery scales that shed easily. It can occur on any part of the body, although it is most commonly found on the elbows, knees and the scalp. It can also cause intense itching and burning.

Who is at risk?

Psoriasis affects approximately 2% of people globally, and up to 4% in some countries. It can start at any age. The condition is not contagious and many people only have small patches of their skin affected. There is a genetic link and psoriasis tends to run in families. About 30% of people with one first degree relative with psoriasis develop the condition. This genetic tendency appears to be triggered by infection; certain medicines (including ibuprofen and lithium); psychological factors (including stress), or skin trauma. There is no way of predicting who will develop psoriasis. 50-60% of people who first experience it do not know of anyone else in their family who has had it.

Genetics

Psoriasis runs in families. One in three people with psoriasis has a close relative with the condition. However, the exact role that genetics plays in causing psoriasis is unclear. Research studies have shown many different genes are linked to the development of psoriasis. It is likely that different combinations of genes may make people more vulnerable to the condition. However, having these genes does not necessarily mean you will develop it.

Common types of psoriasis

Plaque psoriasis

This is the most common form, accounting for about 90% of cases. Its symptoms are dry, red skin lesions, known as plaques, which are covered in silver scales. They normally appear on your elbows, knees, scalp and lower back but can appear anywhere on your body. The plaques can be itchy, sore or both. In severe cases, the skin around your joints may crack and bleed.

Scalp psoriasis

This can occur on parts of your scalp or on the whole scalp. It causes red patches of skin covered in thick silvery-white scales. Some people find scalp psoriasis extremely itchy, while others have no discomfort. In extreme cases it can cause hair loss, although this is usually only temporary.

Nail psoriasis

In about half of all people with psoriasis, the condition affects the nails. Psoriasis can cause your nails to develop tiny dents or pits, become discoloured or grow abnormally. Often nails can become loose and separate from your nail bed. In severe cases, your nails may crumble.

Guttate psoriasis

Guttate psoriasis causes small (less than 1cm or 1/3 inch) drop-shaped sores on your chest, arms, legs and scalp. There is a good chance that guttate psoriasis will disappear completely after a few weeks, but some people go on to develop plaque psoriasis. This type of psoriasis sometimes occurs after a streptococcal throat infection and is more common among children and teenagers.

Less common types of psoriasis

There are less common types of psoriasis:  Inverse (flexural) psoriasis, pustular psoriasis, Generalised pustular (von Zumbusch) psoriasis, Palmoplantar pustular psoriasis and acropustulosi. In very rare cases, erythrodermic psoriasis may develop.

What triggers the disease?

Many people's psoriasis symptoms start or become worse because of a certain event, known as a trigger. Knowing your triggers may help you to avoid a flare-up. Common triggers include:

• An injury to your skin such as a cut, scrape, insect bite or sunburn (this is known as the Koebner response)
• Drinking excessive amounts of alcohol
• Smoking
• Stress
• Hormonal changes, particularly in women (for example during puberty and the menopause)
• Certain medicines such as lithium, some antimalarial medicines, anti-inflammatory medicines including ibuprofen, ACE inhibitors (used to treat high blood pressure) and beta blockers (used to treat congestive heart failure)
• Throat infections - in some people, usually children and young adults, a form of psoriasis called guttate psoriasis (which causes smaller pink patches, often without a lot of scaling) develops after a streptococcal throat infection, although most people who have streptococcal throat infections do not develop psoriasis
• Other immune disorders, such as HIV, which cause psoriasis to flare up or to appear for the first time

Myths and misconceptions about psoriasis

Unlike other ailments, psoriasis can be seen on the skin and often people guess at what is wrong. They wonder if the lesions might be contagious, which they are not, or that the person who has the psoriasis is unclean, overly nervous or high-strung, which they may be, but that is not the reason they have psoriasis. Sometimes they may believe the person who has the skin disorder did something to cause psoriasis to appear, but that, too, is also false.

Psoriasis is a disorder stemming from a physical defect just like other disorders, such as arthritis, asthma, diabetes or nearsightedness. It is very important to educate the public about psoriasis and not allow myths to spread.

Common myths about psoriasis

Myth: "Psoriasis is contagious"

Fact: Psoriasis, especially in moderate or severe forms, is highly visible. Because of the abnormal growth of skin cells, thick red scaly inflamed patches of skin appear. However, psoriasis is not contagious.. You can't "catch" the disease from another person and you can't pass it on to someone else by touching them or having close contact. Actually, psoriasis is as contagious as freckles!

Myth: "Psoriasis is just a skin disease. A cosmetic problem."

Fact: Psoriasis is a chronic disease of the immune system that causes the abnormal growth of skin cells. While a normal skin cell matures in 28 to 30 days and is shed from the skin's surface unnoticed, a psoriatic skin cell takes only 3 to 4 days to mature and move to the surace, resulting in cells piling up and forming the scaly lesions. Psoriasis lesions can be painful and itchy, and they crack and bleed.

About 30-50% of all people with psoriasis also develop psoriatic arthritis which causes pain, stiffness and swelling in and around the joints.

Skin inflammation in psoriasis is just the tip of the iceberg. There is increasing evidence suggesting links with serious health concerns such as cardiovascular disease, diabetes, liver disease, depression and obesity.

Myth: "Psoriasis only affects patients physically."

Fact: Aside from the physical burden of the disease, there is also a significant psychological and emotional impact experienced by psoriasis sufferers. People with psoriasis often report feelings of helplessness, hopelessness, anger, frustration and even depression related to the appearance of their skin and how others react to their condition. Some patients with severe psoriasis have even experienced thoughts of suicide.

Many individuals react to their condition by wearing concealing clothing, curtailing everyday activities such as swimming or going to the gym if it means they will attract stares or negative comments. Psoriasis sufferers often compare the dysfunction and disability of the condition to that experienced by people with other chronic conditions such as diabetes or heart disease.

Myth: "Psoriasis is caused by poor hygiene."

Fact: Psoriasis is a disease of the immune system and has nothing to do with poor hygiene. Triggers that can influence the course of psoriasis include infections, stress or worry, hormonal changes, injury to the skin, alcohol, obesity, poor diet and certain medicines.

Myth: "Psoriasis can be cured"

Fact: Psoriasis is a chronic, life-long disease. There is no known cure yet, but with new options and improved exisiting treatments, people have a wide variety of ways to help manage the the symptoms of psoriasis. Until a cure for psoriasis is found, pharmaceutical research continues to hold the best hope for increasingly more effective therapies, leading to a better overall management of psoriasis. Research into the immune system has led to the development of new biological drugs that target the underlying causes of the condition.

Myth: "Psoriasis is easily diagnosed"

Fact: Many conditions affecting the skin look alike. For example, some early symptoms of psoriasis, such as itching and redness, look the same as eczema or atopic dermatits. This can sometimes make the disease difficult to diagnose. It is important to see a doctor who can do the necessary tests to make a proper diagnosis.

Myth: "Psoriasis cannot be inherited"

Fact: While many patients with no family history of the disease develop psoriasis, there is a gentic link in approximately 40-60% of patients with the condition. Numerous studies point to a genetic predisposition, or inherited tendency, for these patients to develop psoriasis. Having the genetic predisposition, however, does not necessarily mean that individuals will develop the disease. Other contributing factors, such as injury or infection, may act in conjunction with several genes, or specific patterns of genes, to set in motion the chain of events resulting in psoriasis.

Stick with your goals

It is so tempting to say "I give up" when starting a New Years resolution, and it is usually at week 3 of January that people stop their efforts.

The best thing you can do is get a calendar print out and write how many days you have been successful at it and tell yourself "well done" each time you do it.  You will begin to look forward to writing in the next number and enjoy that feeling of success.

It is also good to tell people what your goals are so you get support in your efforts.  Once you commit it out loud to others it is hard to give up.  Our pride keeps us going forward.

AND as always, write down your goals and the plan of action.  It is easier when we have specific and clear idea on how we will achieve our goals.

Happy New Year!

Christmas gift ideas from MG Hypnosis and The Putney Clinic

Weight loss workshop

Saturday 11 January 2014, 1pm – 4.30pm  

Want to lose weight permanently and effectively?  Here are 5 reasons why you should attend:

• Successful proven results in long term weight loss
• Learn how you can eat to sustain appetite and energy levels and lose the cravings
• Discover solutions to stop over eating and take effective control of emotional eating
• Receive a body composition analysis and learn what foods affect  your ability to maintain a stable weight
• Experience a 40 minute relaxation and confidence boosting  session using positive affirmations to achieve your goals, look better and feel better

 

Cost £95

You will be given handouts, a free CD on relaxation and confidence, and a personalized nutritional health assessment (10% discount when booked and paid before Christmas)

Booking is essential as spaces are limited. Please call reception on 020 8789 3881 to book your place or send an email to info@putneyclinic.co.uk.