What Is Psoriasis Caused By [ Symptoms, Risk, Treatments]

In this post, I am going to show you EXACTLY what is psoriasis, what is psoriasis caused by, symptoms, triggering factors, types, risk factor, diagnosis, preventions, and treatments.

What Is Psoriasis Caused By

What is Psoriasis

The Psoriasis is an inflammatory skin disease. In most patients, psoriasis manifests itself with the appearance of lesions. It is characterized by thickened skin with silvery-white scaly appearance, often associated with itching.

It manifests itself especially on

  • elbows,
  • knees,
  • scalp,
  • the lumbar area of ​​the back,
  • face,
  • palms of the hands,
  • soles of the feet,
What Is Psoriasis Caused By
Source: NIH

Although in fact, it can occur in any part of the body.

Psoriasis can be very uncomfortable or even painful when it is manifested in the palms, soles, or folds of the skin. The extent of the disease varies considerably from person to person. Depending on where the plaques are located and their extent, psoriasis can be embarrassing and harming social life. Indeed, the eyes of others on skin diseases are often offensive.

About 15% of people with psoriasis suffer from an inflammation of the joints that causes the symptoms of arthritis (this form is called psoriatic arthritis).

This chronic disease evolves in cycles, with periods of remission. It is not contagious and can be well controlled by treatments.

Psoriasis affects:-

About 2 to 4% of the Western population would be affected. Psoriasis mostly affects Caucasians.

The disease usually appears in adulthood, the late twenties, or early thirties. It can, however, affect children, sometimes even before 2 years. Psoriasis affects both men and women.

What Is Psoriasis Caused By

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Causes Of Psoriasis [What Is Psoriasis Caused By]

Psoriasis affects men and women equally and can occur at any age. Although generally, the first episode occurs before the age of 35 and only rarely in children.

The precise cause of psoriasis is not known. Several factors would be involved in the onset of the disease,

especially genetic and environmental factors. Thus, there is a family history of psoriasis in about 40% of cases.

Physical stress (infections, injuries, surgery, drugs, etc.) or psychological (nervous fatigue, anxiety, etc.) can contribute to the onset of the disease.

The cutaneous manifestations of the condition are the consequence of a higher rate of replacement than normal skin cells. It is not yet clear why this happens, but it is strongly suspected that the reason must be sought in the immune system.

Normally the body produces new cells in the deeper layers of the skin. Which gradually tend to emerge upwards, replacing the outermost ones that undergo programmed and eliminated death.

The whole process takes 3-4 weeks in physiological conditions. While in the psoriasis patient it occurs within 7 days. The consequence is that still immature cells reach the surface of the skin manifesting the classic plates covered with silver or opalescent scales.

The immune system, which normally deals with defending us from external aggressors (bacteria, viruses), by mistake in the psoriatic patient attacks the healthy cells of the skin. Thus stimulating the wild production of new cells.

Why this happens:-

The reason why this happens is not known exactly, but it is thought to be the result of a combination of genetic and environmental factors. It is quite clear that the disease shows marked familiarity (one patient in three has close relatives suffering from the same problem), but this aspect alone is not sufficient to determine the appearance of the disease.

Research has shown that there are numerous genes (units on DNA) potentially linked to the development of dermatitis and have not yet been clarified how they interact with each other. But it is possible that there is more than one combination that makes the subject vulnerable to the development of symptoms. If you have these genes, however, it does not necessarily mean that you will develop psoriasis.

Triggering factors

The skin manifestation cyclically improves to then worsen again, among the conditions that can cause the deterioration we find:

  • skin trauma (irritation, cuts, insect bites, sunburn ),
  • excessive consumption of alcohol,
  • hormonal changes (puberty, menopause ),
  • climate changes,
  • infections (candida, streptococcus, respiratory tract infections),
  • stress (divorces, deaths, professional difficulties),
  • dry skin,
  • obesity,
  • smoke,
  • diseases of the immune system ( HIV ),

drugs (beta-blockers, lithium, ACE inhibitors, anti-inflammatory

Types of psoriasis

There are several types of psoriasis. The most common form is plaque psoriasis, also called psoriasis Vulgaris (because it accounts for more than 80% of cases). The other forms are

Psoriasis drops

Observed mainly in children and young adults. It corresponds to an efflorescence of small lesions of psoriasis less than 1 cm in diameter predominant on the trunk and the root of the arms and thighs. sparing most often the face and occurring the most often within 15 days of an infectious ENT (but also anogenital) episode with β-hemolytic streptococcus group A (2/3 of cases), C, Gou viral.

Most of the time, the eruption of psoriasis in drops develops during 1 month approximately, then persists 1 month then are in half of the spontaneously resolving cases the 3rd or the 4th month. However, it happens that psoriasis in gout becomes chronic, in the form of some residual plates, even outbreaks of the disease for several years.

In addition, gout psoriasis may be a mode of the treatment of gout psoriasis is most often based on Ultra Violets delivered in the cabin under medical supervision

Erythrodermic psoriasis (generalized form)

Pustular psoriasis.

The locations of the plaques vary from one person to another, and we can distinguish among others:

  • The scalp psoriasis, very common;
  • The psoriasis palms and soles, which affects the palms and soles of the feet;
  • Inverse psoriasis, which is characterized by plates in skin folds (groin, armpits)
  • The nail psoriasis (or nail).

In nearly 7% of people, psoriasis associated with joint pain with swelling and stiffness, known as psoriatic arthritis or psoriatic arthritis. This form of arthritis requires specific management by a rheumatologist and may require heavy treatments.

Symptoms Of Psoriasis

There are many possible forms of psoriasis, but in 80% of cases, it is plaque psoriasis, which occurs with skin that forms thickened and reddened patches, covered with gray scales that are usually called plaques and often cause itching and burning.

The skin at the joints can crack. The lesions can appear of different size and severity, from small areas to areas so large as to become a debilitating problem.

In most cases psoriasis affects the elbows, the knees, the scalp, the lower back, the face, the palms of the hands and the soles of the feet, but it can affect the skin in any area of ​​the body; it can also affect the nails of the hands and feet, and the soft tissues of the oral cavity and the genital area.

The most frequent form in adolescent age is instead guttate psoriasis, characterized by the presence of small desquamated patches on:

  • scalp,
  • trunk,
  • limbs (arms and legs).
  • The lesions do not cause permanent scarring.

People with psoriasis can also suffer from further disorders, including pain and itching, difficulty in joint movement and emotional stress.

Psoriasis Severity

Psoriasis can be classified based on skin manifestations such as:

  • mild (less than 3% of the body surface),
  • moderate (between 3 and 10%),
  • serious (more than 10%).

A correct evaluation in this sense is important, a process that is obviously the responsibility of the dermatologist because treatment options generally depend on this; as an example, approximately, the entire hand (palm and fingers) is approximately 1 percent of the body surface.

The assessment also takes into account the impact that the disease has on the patient’s life, which can be severe even if limited to a small area such as the palms of the hands or the soles of the feet.

People at risk

  • People who have a family history of psoriasis. Nearly 40% of patients have one or more members of their family who are also affected. If one of the parents is affected, the risk for the child to suffer from this condition varies from 5 to 10%.
  • Obese people. Obesity-associated with an increased risk of psoriases, like type 2 diabetes and metabolic syndrome.
  • People infected with HIV.

Risk factors Of Psoriasis

Several factors can trigger plaque formation in people who already have psoriasis.

  • A drug reaction, including lithium prescribed to treat bipolar disorder, beta-blockers for hypertension, and anti-malarial medications   ;
  • A high level of stress;
  • Scratching, cutting or insect sting
  • A sunburn ;
  • Cold and dry climates;
  • Exposure to chemicals
  • Alcohol consumption ;
  • Smoking. It worsens the symptoms and is a risk factor for this disease;
  • An infection of the throat or respiratory tract (in the case of psoriasis drops).

Diagnosis of Psoriasis

Doctors usually diagnose the disease after a careful skin analysis, but diagnosis can be difficult because psoriasis often resembles other conditions that affect the skin. In some patients, it may be necessary to use a biopsy, which is a sample of skin that will be examined by a microscope pathologist.

This approach allows to determine the exact type of psoriasis and to exclude other skin disorders such as

  • seborrheic dermatitis,
  • lichen planus,
  • lichen simplex
  • pityriasis rosea.

It is often appropriate to refer to a dermatologist (the specialist in the diagnosis and treatment of skin conditions), especially if the attendant was uncertain about the diagnosis or if the condition was serious.

In the case of suspected psoriatic arthritis, a complication of psoriasis affecting the joints, refer to a rheumatologist (a doctor specializing in arthritis), who will prescribe blood tests to rule out other conditions, such as rheumatoid arthritis, and possibly radiographs of the affected joints.

Prevention of psoriasis

There is no known way to prevent psoriasis. However, it is possible to reduce the frequency and intensity of relapses. In addition to careful monitoring of the prescribed treatment, it is possible to observe what triggers the onset of symptoms. This approach requires time and patience.

Here are some general tips:

  • During long exposure to the sun, it is advisable to apply an effective sunscreen (SPF 15 minimum).
  • Alcohol consumption must be greatly diminished or even eliminated altogether.
  • Do not smoke. Several studies have clearly shown that the severity of psoriasis is related to the number of cigarettes smoked.
  • Some sufferers have their disease diminish considerably after losing a little weight. Consider changing lifestyle habits accordingly if necessary.
  • Find solutions to better manage stress. Stress is known to play a role in the onset or exacerbation of psoriasis outbursts. Anecdotally, it has been observed that the severity of symptoms of a patient followed for 20 weeks was clearly connected to disturbing events in his life and his psychological distress. On this subject, consult our file Stress and anxiety.
  • Sufferers may eventually undertake psychotherapy to become aware of the events or mental states that cause certain psoriasis outbreaks.

Treatments Of Psoriasis

Therapy

Psoriasis therapy depends on:

  • the severity of the disorder,
  • extension of the affected areas,
  • type of psoriasis,
  • good response to initial therapy.

The approach to the psoriasis patient is not simple and a therapy that proves to be effective for one subject may not be so for another; a trial and error approach is often necessary to find an effective therapy and it is common to have to change therapy periodically therapy.

What Is Psoriasis Caused By
Source: NCBI

The available treatments are the following, and usually undertake in this order (and it is obviously possible to associate them with one another):

  • topical drugs (applied directly to the skin),
  • phototherapy (light beam therapy),
  • systemic therapy, ie taking medication orally or by injection.

Over time, psoriasis-affected skin may develop resistance to therapy, especially if it is performed with corticosteroids ( cortisone ) for topical use.

One aspect that is too often overlooked is the importance of diet and lifestyle in general, which in psoriatic patients can have a direct impact on the extent of skin manifestations; besides being important in terms of cardiovascular and metabolic prevention.

A diet based on the Mediterranean model is able to exert a measurable effect on the severity of the disease, as well as other factors, such as the body mass index, smoking, physical activity, hypertension, diabetes, and depression.

Topical medications

The drugs applied directly to the skin are the first attempted approach and normally they are more than sufficient to manage the medium-moderate cases of psoriasis, in some cases it is, however, necessary to wait up to 6 weeks before seeing the effects.

Emollients and moisturizers

These are the mildest remedies, useful in monotherapy in the lighter cases or in association with other drugs for topical use; the goal is to keep the skin hydrated and eventually create a protective film, this allows to reduce itching and flaking.

Cortisone

Corticosteroid-based ointments (cortisone) reduce skin inflammation and are almost always effective in allowing symptoms to regress; abuse should be avoided in order not to incur even important side effects, this means using them for short cycles of therapy and possibly on a limited body surface.

Retinoids

Topical drugs based on vitamin D3 or chemical analogs can control the overproduction of skin cells and can reverse symptoms. They are often used alternatively or in association with corticosteroids, being perhaps less effective but certainly better tolerated.

Phototherapy

Phototherapy uses natural and / or artificial light to treat psoriasis symptoms; artificial light is administered through specific devices, other than sunbeds, in a hospital or outpatient setting and under the direct supervision of a dermatologist.

There are two types of UV rays that can be administered, UVA and UVB.

Phototherapy with UVB rays uses artificial light sources that can slow the production of new cells in sessions of a few minutes, but to be repeated 2-3 times a week for 6-8 weeks,

while Psoralen and UVA rays can be combined in so-called P.UVA therapy for more severe psoriasis cases.

Psoralen is a drug that can be taken orally or topically which makes the body more sensitive to UV rays however if the therapy lasts for too long, it increases the risk of skin cancer. The advantage of this approach is that it allows you to reach deeper layers of the skin and therefore guarantees greater incisiveness in the results.

Systemic therapy

For the most serious forms of psoriasis the best option is to take systemic drugs, orally or by injection, among which we find for example:

  • methotrexate (slows the production of new cells and reduces inflammation),
  • cyclosporine (an immunosuppressive drug, reduces the response of the immune system).

The term “systemic” indicates that the drug acts on the entire organism, thus ensuring greater effectiveness on disease control but, at the same time, a higher risk of side effects.

A more recent approach is offered by biological drugs, which can reduce the response of the immune system; they are very effective drugs for the most severe and obstinate forms of psoriasis; an increase in the use of these drugs expected with the imminent entry into the market of biosimilar equivalents, or those having the same efficacy profile, but with a significant saving for the National Health System.

The success and efficacy of these molecules is to be found in the high selectivity of action that allows obtaining, in most patients, a more than satisfactory tolerability; the only disadvantage is the form of administration, usually subcutaneous injections or intravenous infusion (but a new drug that seems to promise great results, even if not organic, in tablets) has recently been on the market .

In some cases a therapy based solely on biological drugs is prescribed, in other cases, they associated with topical therapies.


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