Wednesday, January 02, 2013

Effects, Causes and Remedies of Psoriasis

 History of psoriasis

It all started in the dark ancient times of humankind. For the entire history of humanity millions of people - from ordinary people to celebrities, from the Egyptian Pharaoh's to the important contemporary figures - suffered and do suffer from psoriasis.

The first historical mentioning of psoriasis was found in the ancient medicine treatises. Back in high antiquity there was known a disease, which was characterized by the peeling of the skin.



In the times of Hippocrates (an ancient Greek physician, considered one of the most outstanding figures in the history of medicine) medical terms often had a group meaning. This confusion caused Hippocrates to unite leprosy and psoriasis under one name - leprosy.

In the times of Hippocrates psoriasis was known under the names of lepra and psora, as well as alphos and leichen. So, under the term "psoriasis" they united the diseases which manifests by scaling, such as eczema, red flat lichen, tubercular lupus, leprosy etc.
Another famous historical figure - Greek doctor Galen (Claudius Galenus) first used the term "psoriasis" for the designation of scaly changes in the skin with a strong itch; however, the disease described by him little resembled the present description of psoriasis.

In the past centuries psoriasis was sometimes erroneously assumed as leprosy or mange, which frequently led to isolation and other negative consequences: people with psoriasis did not get any medical aid; they had to wear a special suit and to carry a rattle or a bell.



Herodotus and Plato united the group of the skin diseases, characterized by peeling, dryness and itch with the term "psora" (an ancestral historical name of psoriasis).The first clear description of psoriasis belongs to Celsus (a 2nd century Greek philosopher) (40 A.D.).
 
Only in the beginning of the 19th Century did English doctor R. Willan (1757-1812) and his students clearly described the concept of psoriasis, its manifestations and complications. They differentiated psoriasis from leprosy, and fungus diseases.

They also separated the common and uncommon flow of psoriasis (changes in the palms, feet, skin folds etc.). R.Willan distinguished two diseases: discoid psoriasis, which he called Lepra Graecorum (Lepra Vulgaris, Lepra Willani), and Psora Leprosa. In 1801 R. Willan gave a classical description of psoriasis.



E.Wilson (1809-1884) called psoriasis alphosis, and believed psoriasis to be an exfoliative form of eczema.
Dermatologists of the 19th Century (Polotebnov, Pospelov, Gebr, H.Koebner and others) significantly succeeded with studying psoriasis. They considered psoriasis to be a system disease ("psoriatic disease"), taking into account the connection of psoriasis with the state of the internal organs and the nervous system.

In the last 30-40 years there was acquired new data about the essence of psoriasis and there were proposed new methods for psoriasis treatment (PUVA, UVB, corticosteroids, retinoids, cytostatics, hemosorption etc.)



Only in the last decade of the 20th century there were published more than 10,000 studies on psoriasis, which makes it one of the most studied dermatitis. However, despite the timeline of more than a 2000 year history of psoriasis, none of the theories managed to explain psoriasis or its causes. Psoriasis still remains a riddle, just as it was hundreds of years ago.

At present many Research Centers research psoriasis and the development of new psoriasis treatment methods. In the USA the main scientific center of psoriasis is Stanford University, which unites 35 countries from around the world in the form of an international association on the studies of psoriasis.
Once every 5 years there is conducted the World Congress dedicated to psoriasis.



The 29th of October is World Psoriasis Day. It is an annual day dedicated to people with psoriasis and/or psoriatic arthritis. On October 29th, International Federation of Psoriasis Association (IFPA) and its member associations perform activities all over the world to raise the awareness about psoriasis and/or psoriatic arthritis, and give people with psoriasis the attention and consideration that they deserve. 

What is psoriasis?
Psoriasis is a noncontagious skin condition that produces red, dry plaques of thickened skin. The dry flakes and skin scales are thought to result from the rapid proliferation of skin cells that is triggered by abnormal lymphocytes from the blood . Psoriasis commonly affects the skin of the elbows, knees, and scalp.



Some people have such mild psoriasis (small, faint dry skin patches) that they may not even suspect that they have a medical skin condition. Others have very severe psoriasis where virtually their entire body is fully covered with thick, red, scaly skin.

Psoriasis is considered a non-curable, long-term skin condition. It has a variable course, periodically improving and worsening. It is not unusual for psoriasis to spontaneously clear for years and stay in remission. Many people note a worsening of their symptoms in the colder winter months.



Psoriasis is seen worldwide, in all races, and both sexes. Although psoriasis can be seen in people of any age, from babies to seniors, most commonly patients are first diagnosed in their early adult years.
Patients with more severe psoriasis may have social embarrassment, job stress, emotional distress, and other personal issues because of the appearance of their skin.

Causes of psoriasis

Although the exact cause of psoriasis is not known, a wide number of factors interplay to cause this debilitating disorder. The defense system of the body known as the immune system is affected by these factors, which results in the formation of additional blood vessels and increased number of skin cells.
Psoriasis is said to be an hereditary disorder, as it tends to affect members of the same family. Increased stress (both physical and emotional) has been proposed to precipitate the occurrence of psoriasis in individuals who are genetically prone to develop psoriasis. Streptococcal throat infections.



Candida infections (thrush) and certain yeast infections can result in flaring up of the psoriasis. Some of the medications such as lithium, beta-blockers and antimalarials have been known to aggravate the existing psoriasis. Other factors such as obesity, increased alcohol intake or smoking also have also been associated either with the occurrence or with the severity of the disorder.

Signs and Symptoms of psoriasis
 

Psoriasis is typically characterized by the formation of circular, red eruptions or plaques with a gray or silvery-white, dry scale on the skin. These eruptions or scales are noticed in a symmetrical pattern on the scalp, elbows, knees, lower back region and in the body folds such as the armpits. The joints referred to as psoriatic arthritis, nails and genital areas may also be affected. Occasionally these plaques may be observed on the inner cheek or tongue.

 
Itching at the affected sites is a commonly noted symptom, which may or may not be associated with burning sensation or pain. A small point of bleeding may be noticed if the scales on the skin are pulled out. In case of psoriatic arthritis, joint pain is noted along with the signs and symptoms of the skin. The affected nails may display pits on the nail surface with accumulation of yellowish material under the nail plate or detachment of the nails.

 

psoriasis has been categorized as follows:
  • Plaque-type psoriasis—This is the commonest type of psoriasis, characterized by scales on the skin.
  • Guttate psoriasis—Small oval/tear drop-shaped papules.
  • Pustular psoriasis—Pus-filled eruptions; these may be observed only in certain specific areas (localized) or spread over a wide area (generalized)
  • Erythrodermic psoriasis—scales associated with reddening of the skin (erythema).

Diagnosis of psoriasis

The diagnosis is easily made based on the characteristic appearance of the scales or the reddish papules on the skin and other features specific to the area affected. A skin biopsy may be advised at times to rule out the presence of any other associated conditions.

Treatment of psoriasis

Although there is no permanent cure for psoriasis various types of treatment modalities are available that control the severity of the condition in most of the affected individuals.
The main categories of drugs that are used to treat the symptoms of psoriasis include corticosteroids, vitamin D3 analogs (calcipotriene), coal tar products, retinoids (tazarotene) and anthralin. These are available as ointments, creams, lotions, shampoos, bath oils and soaps. On basis of severity and extent of the disorder, the doctor will decide the type of medication to be applied and the duration of the treatment. These medications are helpful in reducing the inflammation of the skin, decrease the formation of scales and enhance normal skin formation. The medications can be advised either as an individual agent or in combination with other medications or treatment modalities.
Other treatment modalities that have been associated with varying degree of success include sunlight exposure, UV light therapy (phototherapy), injection of corticosteroids into the affected skin and oral tablets. Self-decided sun exposure and phototherapy should be avoided, as it may lead to flare up of the symptoms in certain cases. Biological treatments, which block some of the important steps in the occurrence of psoriasis are being studied and advised in certain cases that are unresponsive to other types of treatment.

Complications of psoriasis
Common complications associated with psoriasis are the burning sensation or pain in the affected areas. Intense scratching can result in infection of the affected areas. Psoriasis may be disabling in certain individuals who suffer from the severe variant. The symptoms may relapse after a symptom free period.

Prevention for psoriasis

There are no known methods to prevent the occurrence of psoriasis. Leading a stress free life and a healthy lifestyle are helpful in preventing the flare up of psoriasis. Daily baths, avoiding hard scrubbing of the skin and keeping the skin clean and moist may be helpful in reducing the flare up of psoriasis.

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