Psoriasis Guru

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How is Psoriasis Diagnosed?

Tuesday, October 6th, 2009

Most of the time a dermatologist can determine whether a person has psoriasis by asking questions and making basic observations.  A skin biopsy can be requested if there is any doubt.

Psoriasis might be confused with seborrheic dermatitis and other forms of dermatitis or eczema (general name for skin irritations), which are similar both in appearance and cause.

Psoriasis indicators:

  • Well defined skin lesions.
  • Affected areas showing primarily on the elbows, scalp, knees and torso.
  • A family history of psoriasis.
  • Pitted finger and toenails.
  • Swelled, arthritic joints (this would be psoriatic arthritis).
  • Silver colored, small scales.
  • Dryness.
  • Itchiness.
  • Swollen, irritated skin.

What is the Koebner Phenomenon?

Monday, October 5th, 2009

The Koebner Phenomenon can occur with people who have psoriasis.  This is a circumstance in which psoriasis lesions flare up where skin has been damaged or traumatized.  This is related to the fact that psoriasis can be triggered by other infections (especially skin irritations).

It’s not that the other diseases help psoriasis explicitly — these outbreaks are more of side-effect of the immune system becoming temporarily overworked.  In military terminology, psoriasis waits until there’s a weakness in the body’s defenses, at which point it launches an offensive that is more likely to succeed than under normal circumstances.

The Koebner Phenomenon is named after a German dermatologist from the 1800′s who discovered it.

What Causes Psoriasis Itchiness?

Sunday, October 4th, 2009

The medical community tends to have a hard time classifying itchiness.  It is similar to pain in many respects, though pain makes you want to avoid touching affected areas and itchiness makes you want to scratch.  As a primordial impulse, scratching at skin irritations seems to be the nearest source of therapy or release that we have.

The medical term for itchiness is “pruritus.”  One of the most common treatments for calming down pruritus is hydrocortisone cream.  For mild cases of psoriasis, doctors will sometimes recommend hydrocortisone.

Scratching areas of the skin affected by psoriasis is a bad idea since this tends to compound the problem.  It damages the affected area more than the psoriasis would on it’s own, thus opening up the skin to other kinds of infection, thus providing more opportunity for psoriasis flare-ups.   For this reason, simply avoiding the urge to scratch is a can be a reasonable first step to treating psoriasis.

Pruritus (itchiness) can be cased by nerve endings in the skin acting up, or it can be initiated from the central nervous system (the brain and the spinal cord).   Itchiness can be induced by a variety of stimuli, coming from both inside or from an outside source.  For example, if something touches your skin lightly, this can make you want to scratch at that area of your skin.

My take on itching (or why it happens at all) is:  The skin itches to let you know that it needs attention or to let you know that something’s not right, much like pain.  Thus, allergens and insect bites (poison) give rise to itchiness, so you can know that something is amiss.  From a practical perspective, it seems like itchiness might be a mechanism by which the skin sheds dead cells faster than waiting for the wind or gravity to take them away.  It makes sense to me that healthy, living skin would want to get rid of old, dead skin.

In the case of psoriasis there is a fine line between itching and stinging pain.  On one hand, as stated above, I suspect that the skin itches to inspire the removal of extraneous skin cells (psoriasis makes the body produce so much extra skin that it begins to create scales, or lots of flaky dead skin).  Then again, psoriasis has the effect of turning the body against it’s own skin, thus creating a lot of pain and irritation.

What is Erythrodermic Psoriasis?

Friday, September 25th, 2009

Erythrodermic psoriasis is the most severe type of psoriasis I have ever heard of, but luckily it occurs rarely.  It wreaks such havoc on the body as it causes most of the skin on the body to become swelled up and sore.  The loss of control over nutritional distribution (protein loss) and bodily temperature lead to other complications such as infection or even heart attacks.  Obviously, this is a life-threatening side effect.

This is a great example of a kind of psoriasis that begs to be treated topically for immediate relief, but should be treated from the inside-out for long term improvement (especially since one’s life may literally depend on it).

Erythrodermic psoriasis manifests itself with reddening, soreness and scales over most of the body.  Also, the skin can peel off in larger “sheets” rather than the smaller flakes that are characteristic of more common types of psoriasis.  Also, like most other types of psoriasis, affected areas of the skin will itch intensely.

As the body battles off this particular strand of psoriasis, a lot of fluid buildup (edema) and other incidental infections can occur.  This fluid buildup is related to protein drainage and loss of temperature control mentioned earlier.

See a doctor as soon as possible if you are suffering from symptoms that seem to indicate erythrodermic psoriasis.