Breaking down the possible causes

One of the most common autoimmune system diseases in the United States, psoriasis affects more than 7.5 million Americans, according to the National Psoriasis Foundation. Dr. Sarah Glorioso with Willis-Knighton Health System said psoriasis can occur anywhere on the skin of the body or scalp and can even affect the nger and toenails. Furthermore, the affected area can vary in appearance, depending on severity.

“Psoriasis is a persistent, in ammatory skin condition which can range from small, red, scaly patches to thick, silvery plaques,” Glorioso said. “Some people have mild cases, and alternatively, severe [cases] can cover large areas of the body.”

Although the exact cause to psoriasis is not known, Glorioso said the immune system plays a role, and there may be a genetic component. There are, however, other eliciting factors.

“Guttate psoriasis can be triggered by a strep infection,” she said. “Trauma, stress and certain medications can also [be triggers].”

The NPF listed Lithium, Antimalarials, Inderal, Quinidine and Indomethacin as medications associated with triggering psoriasis.

“Obesity, increased alcohol consumption and smoking have also been associated with psoriasis,” Glorioso said.

More than just an externally symptomatic disease, Glorioso said psoriasis can cause internal complications as well.

“Ten to 30 percent of patients have psoriatic arthritis, which causes in ammation of the joints,” she said. “Psoriasis is also linked with diabetes, heart disease and depression.”

According to the NPF, cardiovascular disease is linked with patients who have the more severe cases of psoriasis. The chronic autoimmune disease also puts patients at risk for Type 2 diabetes possibly because of insulin resistance caused by in ammation, and they are encouraged to get screened by their doctors.

Because of the visible effects of psoriasis, signi cant emotional distress is associated with the disease. The NPF states that depression is the No. 1 comorbidity of psoriasis and that people with the skin disease are twice as likely to become depressed. It’s important to keep aware of any symptoms of depression and to seek treatment if any are present. Common symptoms are an inability to sleep, lack of energy and lack of interest in things that were once enjoyed.

A trip to the dermatologist can typically determine whether or not a skin issue is psoriasis.

“The diagnosis of psoriasis can often be made with just a physical exam,” Glorioso said. “In some instances a skin biopsy may be necessary. For psoriatic arthritis, the rheumatologist can evaluate.”

Treating psoriasis varies from patient to patient and is an important role in maintaining overall health. Depending on what works best for each individual case, there are a range of options to combat symptoms.

“There is no cure for psoriasis, but a number of treatments are available to help control it,” Glorioso said. “Topical medications, such as topical steroids, topical vitamin D creams, topical retinoids and tar therapy are commonly used.”

If the symptoms are severe enough or need additional treatment, other medications are available.

“When topical medications aren’t enough, we use oral medications such as methotrexate or soriatane,” Glorioso said. “There are also shots called ‘biologics’ such as Enbrel, Humira, Stelara and Remicade which are good for severe psoriasis or hand/ foot psoriasis.”

Biologics, or biologic drugs, according to the NPF, are a protein-based drug derived from living cells and target speci c parts of the immune system.

Glorioso said that sunlight is another effective treatment that can even be prescribed to patients.

“We can prescribe ultraviolet light to help with psoriasis,” she said. “There is an Excimer laser in the UV spectrum that can be used.

“Each treatment is individualized for each patient depending on the severity of psoriasis, patient’s age, lifestyle and overall health,” Glorioso said. “If the patient has psoriatic arthritis then we would choose a treatment that also helps the joints.”

Keeping with a healthy lifestyle can aid signi cantly in combating psoriasis.

“Maintain a healthy BMI with diet and exercise,” Glorioso said.

The NPF also includes stress reduction to avoid triggering psoriasis, managing the itch and maintaining healthy relationships to cope with living with the disease.

As research continues for treatment, it remains important to have coping skills when dealing with psoriasis. For more information on the disease, visit www.psoriasis.org.