Psoriasis and Psoriatic Arthritis
What is Psoriasis and Psoriatic Arthritis?
Psoriasis is a chronic skin condition that involves changes in skin cells, causing them to build up rapidly, and form thick scales and dry patches on the skin. Sometimes the skin is itchy and painful, but, at other times, symptoms get better and flare up again.
Psoriasis and psoriatic arthritis is a baffling skin disease, and symptoms can get better or worse with time. It typically affects the scalp and the skin over the knees, elbows, torso, palms, and soles. The goal of treatment is to reduce the rapid multiplication of skin cells using a combination of lifestyle measures, exposure to small amounts of sunlight, and various medications.
Epidemiology
The National Institutes of Health estimates that psoriasis affects approximately two percent of the United States population. This skin disease can begin at any age, but the median age of onset is at 28 years. It is more likely to affect women, but men with the condition are more likely to develop complications affecting the eyes. Dark-skinned individuals and those living in the tropics are less likely to have psoriasis.The exact cause of psoriasis and psoriatic arthritis is unknown, but it is believed to be due to an immune reaction that causes an increase in the production of T cells and other white blood cells. The T cell or lymphocyte is a white blood cell that travels throughout the body and detects and protects the body from foreign substances like viruses and bacteria. In people who have psoriasis, however, T cells mistakenly attack even healthy skin cells as if they were fighting an infection. Psoriasis also causes widening of the blood vessels in the skin and an abnormal increase in the production of skin cells, which form patches and silvery scales.
Factors that trigger the worsening of symptoms include:
- Cold weather
- Heavy alcohol intake
- Infections
- Skin injury
- Smoking
- Stress
- Certain medications (lithium, iodides, beta blockers, and antimalarial drugs)
Signs and Symptoms
The signs and symptoms of psoriasis are quite irritating and unpredictable. These may vary according to the different types of the disease. Aside from affecting the skin, psoriasis may also affect the scalp, the nails, the eyes, and the joints. Affected individuals can have dandruff; pitting, discoloration and abnormal nail growth; sores on the trunk, arms, and legs; inflammation in the armpits, groin, and around the genitals and under the breasts; and swelling and pain in the joints.
Diagnosis
In most cases, doctors can diagnose psoriasis through clinical evaluation, which includes a thorough medical history and physical exam. A skin biopsy is rarely needed. Other laboratory studies may include a test for rheumatoid factor and erythrocyte sedimentation rate to rule out other conditions such as rheumatoid arthritis and lupus.
Treatment
The management of psoriasis may involve a combination of lifestyle changes, stress reduction, topical and systemic medication, and use of moisturizers, salicylic acid, and other keratolytics, as well as phototherapy.
Some of the medications used to treat psoriasis include:
- Topical treatments – creams and ointments
- Methotrexate
- Cyclosporine
- Biological therapy
- Vitamin D analogues
- Coal tar
- Calcineurin inhibitors – tacrolimus and pimecrolimus
- Anthralin – to regulate DNA activity in the skin cells
- Medicated shampoo/scalp solutions containing salicylic acid
Medication
At American Infusion Centers we use the following drugs for psoriasis and psoriatic arthritis: