MEDICAL SURFARI: EASING THE SYMPTOMS OF PSORIASIS

Psoriasis is Greek for "an itching", and it is a non-contagious but incurable, chronic condition that causes the skin to become inflamed, red, and thick with silvery scales, most often on the scalp, elbows, knees, and lower back.

Many of the nearly four to five million people in the United States who have this condition have very mild cases and, in fact, may go through life without even knowing they have it. Psoriasis can be unsightly and uncomfortable, and it may cause a good deal of emotional distress for some with severe cases; however, these symptoms can be effectively treated.

The exact cause of psoriasis is not known, but psoriasis does tend to run in families, and it seems that hereditary factors are important. This does not mean that every child of a parent with psoriasis will develop this condition, but it may mean that somewhere down the line psoriasis will appear in the same family. This condition is not caused by allergies, infections, dietary deficiencies or excesses, or nervous tension, and it is not contagious or spreadable from one part of the body to another.

Although, a healthy balanced diet is important for good health, and some people find that their psoriasis is worse if they are overweight, consequently weight loss may help in controlling this. Others have noted that alcohol of any type will flare their psoriasis. Some people find that stress and tension seems to make their psoriasis worse. Some medications and some types of infections, especially streptococcal infections may make psoriasis worse. Rubbing, scratching and sunburn, or other forms of skin injury or irritation, may cause psoriasis to flare. There is no blood test for psoriasis, as the diagnosis is almost always made by direct observation and examination of the skin by a physician. Rarely a skin biopsy is necessary if the skin does not appear typical or characteristic for psoriasis.

There are many different types of psoriasis, and each form differs in how bad it is, how long it lasts, where it is, and in the shape and pattern of the scales. Although it may take on different forms, one of its distinguishing characteristics is its variability, as it predictably changes over time going throughout cycles of flaring and improving, even into remission. Since psoriasis is caused by an over production of skin cells that mature briskly over three of four days, instead of the usual 28 to 30 days, the skin may thicken and become reddened, bumpy, and covered by silvery scales. The goal in treating this condition is to reduce inflammation to slow down rapid skin cell division. Moisturizing creams and lotions may improve the dry scaling and help control itching. Treatment is based on a patient's health, age, lifestyle, and severity of the psoriasis, and it may range from topical compounds applied to the skin lesions to the use of natural sunlight or ultraviolet light therapy. Rarely, in very severe cases that do not respond to other treatments, oral medications that arrest cell division may be given.

Psoriasis can range from a nuisance problem to the one that is physically and socially limiting. But, in either case, with your physician's help, the symptoms of psoriasis can be managed and improved.

World Wide Web Resources

National Psoriasis Foundation

www.psoriasis.org/whatis.html

The National Psoriasis Foundation provides facts about various aspects of psoriasis, including causes, types of psoriasis and treatments.

American Academy of Dermatology

www.aad.org/aadpamphrework/Psoriasis.html

Accurate information of psoriasis, including treatment options, is available from the American Academy of Dermatology.

DermWeb

www.derm.ubc.ca/skincare/psoriasis/psorhand.html

This site provides basic information on psoriasis, but also gives the advantages and disadvantages of current treatments.

Dr. Scott Gibbs is a Cape Girardeau neurosurgeon and editor-in-chief of Mosby's Medical Surfari. You may e-mail questions to him at drgibbs@semissourian.com or write in care of the Southeast Missourian, P.O. Box 699, Cape Girardeau, Mo., 63701.