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Psoriasis

What is Psoriasis?

Psoriasis is a persistent skin disease characterized by red skin patches that are covered by silvery white scales. These patches usually occur on the knees, elbows, trunk or scalp, though any areas of the skin can be involved. In some cases, psoriasis is so mild that people don't know they have it. At the opposite extreme, severe psoriasis may cover large areas of the body. Doctors can help even the most severe cases. Psoriasis is a common skin disorder affecting about 2% of the population. It occurs equally in men and women, at any age. The condition is not infectious, and is often not itchy. Psoriasis does not scar the skin.

Your skin and psoriasis !

The skin is a complex organ made up of several layers of different types of cells. Those in the outer layer - the epidermis - gradually change, as they move towards the surface where they are continually shed. This process normally takes between 3 and 4 weeks. In psoriasis, this rate of turnover is dramatically increased within the affected skin, so that the process may take as little as 3 to 4 days.

What causes psoriasis?

Although the exact cause of psoriasis is not known, some people are clearly more likely to develop it than others. Many patients know of someone else in the family who has psoriasis; in other words, it is a genetic or hereditary disease. However, several factors may start an episode of psoriasis, such as a throat infection, (especially in children), stress or injury to the skin. Nevertheless, in most patients who develop psoriasis, or who have a recurrence of it, no obvious cause can be detected. Usually, sunlight improves the condition, though occasionally, it may make it worse. A high alcohol intake may worsen psoriasis. There is no apparent relationship between diet and psoriasis.

Is there a Cure for Psoriasis?

There is no present cure for psoriasis, but there are a number of drugs and treatments that can relieve and control psoriasis, often for long periods of time. Psoriasis on its own can come and go often with long periods of remission. In most cases, however, psoriasis is persistent. It can come and go without any obvious reason. Psoriasis does not necessarily become worse with age. Psoriasis can occur at any age from infancy to the elderly. Psoriasis will often remain in small localized areas and does not spread.

How Is Psoriasis Treated?

The goal is to reduce inflammation and to control shedding of the skin. Moisturizing creams and lotions loosen scales and help control itching. 
Treatment is based on a patient's health, age, lifestyle, and the severity of the psoriasis. Different types of treatments and several visits to the dermatologist may be needed.
Treatment is usually effective. The skin becomes less scaly and may then look completely normal. However, even if your psoriasis disappears after treatment, there is a tendency for it to return. But this may not happen for many years, (or within a few weeks).

Topical therapy (applied to the skin) may include the following:
Emollients, salicylic acid, Topical Steroids, Tar preparations, Dithranol, Vitamin D analogues like Calcipotriol and Tacalcitol, Vitamin A analogues like Tazarotene 

PUVA therapy !

This treatment is commonly recommended when psoriasis has not responded to other treatments or is widespread, The treatment name comes from "Psoralen + UVA," the two factors involved. Patients are given a drug called Psoralen, then are exposed to a carefully measured amount of a special form of ultraviolet A (UVA) light. The treatment is given 2-3 times per week, each lasting 5-10 minutes. It takes approximately 25-30 treatments, over a two- or three-month period, before clearing occurs. About 30-40 treatments a year are usually required to keep the psoriasis under control. Because Psoralen remains in the lens of the eye, patients must wear UVA blocking eyeglasses when exposed to sunlight from the time of exposure to Psoralen until sunset that day. Narrow Band UVB treatment is a new development, which is more effective than UVA, more safer and can also be used in children.

There are other methods of treatment for patients whose psoriasis is considered:

    1. moderate or severe
    2. not helped by the simpler topical treatments
    3. frequently recurring

It is important to note these treatments cannot be used during pregnancy.
These oral medications include Methotrexate, Retinoids, Cyclosporine

The above treatments alone or in combination can clear or greatly improve psoriasis in most cases, but no treatment permanently "cures" it. Dermatologists and other researchers are continually testing new drugs and treatments.

 

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