Psoriasis

As your skin is worn away, it is replaced by cells produced beneath the surface. In psoriasis, the normal rate of cell production is speeded up in some areas, and skin cells pile up faster than they can be shed. The result is an unsightly thickening of the skin, called psoriasis. An outbreak of psoriasis is often triggered by (among other things) emotional stress, damage to the skin, or a period of generally poor health.

What are the symptoms?

Deep pink, raised patches, covered by white scales, appear on your skin. They usually cause no discomfort, but they may be slightly itchy or sore. You may have anything from a single small patch to many large ones. The most common sites are the knees, elbows and scalp. Less commonly, patches appear under the armpits and breasts, on the genitals, and around the anus. When psoriasis occurs on your hands and feet, it is usually in the form of raised areas with painful cracks or little blisters filled with white fluid. In some cases, your nails become thickened, pitted, and separated from the skin beneath.

Occasionally, psoriasis is associated with a mild form of arthritis, one that resembles rheumatoid arthritis.

What are the risks?

Psoriasis appears most commonly between the ages of 10 and 30, and tends to run in families. In most cases, it does not affect general health. In the elderly and the very young, however, psoriasis may cause serious illness if the condition is severe and widely spread on the body, and if it is neglected.

What should be done?

Many people learn to live with mild forms of psoriasis. In time, you can become familiar with your particular form of the disorder, and you may be able to avoid the factors that trigger an outbreak. But if you have a severe case, or if it is causing serious discomfort or distress, consult your physician.

What is the treatment?

Self-help: Sunbathing or using an ultraviolet lamp helps to clear up psoriasis, but a sunburn can make the condition worse.

Professional help: Your physician will probably prescribe one of several ointments, creams or pastes to apply to the affected areas. Among them are steroid preparations, which are effective but, if used over a long period, may produce adverse side effects, such as skin damage. Some drugs used to treat psoriasis must be applied very carefully because they burn unaffected skin and may also stain your bedding and clothing.

In many cases, skin medications clear up most of the psoriasis. If they have little effect, the doctor may arrange for you to receive intensive ultraviolet treatment. You may have to be hospitalized for this treatment; intensive therapy should be carried out under medical supervision.

If intensive ultraviolet treatment fails, you may be advised to enter the hospital for one or two weeks to receive intensive applications of a skin preparation, or a treatment involving very low doses of a cytotoxic drug that slows down cell division. This treatment is not used widely because the drug may affect certain other cells in the body.

For most people who have it, psoriasis is a long-term condition, and there is no permanent cure. The condition usually reappears throughout life with varying degrees of severity, though treatment is usually successful in clearing up each outbreak.