Psoriasis – what is it?

Although psoriasis is not infectious, anyone with a genetic predisposition can develop it. The name psoriasis comes from the Greek term psora ( itching ) and this emphasize s the prime symptom of the disease. Psoriasis was already described in ancient times, and for a long time was confused with leprosy . Psoriasis has many presentations, occurring in various forms and positions. It is often difficult to diagnose. For that reason, diagnosis should always be made by a dermatologist.

How common is psoriasis? Psoriasis is – after neurodermatitis – the most common chronic skin disease. The incidence in adults is 2–3 %. In the age group 0–18 years it is around 1 %. Under the age of 16, it accounts for more than 4 % of all skin diseases. In this age group, it is the most common chronic skin disease after neurodermatitis. Although infants can also develop psoriasis, the incidence of the disease in the first year of life is very low, at around 0.2 %. Psoriasis often occurs for the first-time during puberty, or between the ages of 40 and 50.

What are the causes of psoriasis? The triggering causes of psoriasis are still poorly understood. What is certain is that psoriasis is inherited, although it presents differently in different patients. It is also entirely possible for a child to develop psoriasis even though the parents didn’t develop it themselves. The probability of inheritance is around 60 % if both parents carry the genetic predisposition. If only one parent is a carrier, the probability is 30 %. The presence of the genetic predisposition alone is not enough to trigger the disease. There must be other, often unknown, factors, whether external (injuries, pressure) and/or internal (psychological, stress, alcohol, medication). Infectious diseases, metabolic disorders, hormonal factors and environmental influences can also have a triggering effect.

What happens in the skin during psoriasis? Psoriasis is an autoimmune- mediated inflammatory disease. The actual psoriatic process is associate d with these inflammatory-immunological factors; in addition to other causes that promote the inflammatory process in the skin (e.g. arachidonic acid metabolism). In the case of psoriasis, the body‘s defense reactions are faulty. The immune system attacks the body‘s own tissue, thus causing injuries. This results in inflammation, which constantly stimulates the body to produce new skin cells. Due to this overproduction, the skin cells migrate to the surface of the skin much more quickly. Normally, the cells in the top layer of the skin (epidermis) renew themselves within about 26 to 27 days, while in psoriasis patients this process only takes 6 to 7 days. However, because the skin cells are not yet mature , they do not detach from the surface. A thickening occurs in which the neighboring skin cells stick together. The raised and reddened areas of skin are covered with silvery-white scale s – known as plaques – which are typical of the disease. Psoriasis usually begins on the scalp . The course of the disease varies from person to person, but is usually relapsing . It can occur once or progress chronically over a long period of time. A worse skin condition is often observed in autumn and spring (lack of sun). Around 25 % of psoriasis patients often experience spontaneous healing of the skin symptoms.

How can psoriasis be diagnosed? The following symptoms are characteristic:

red patch es on the skin,

more or less adherent, dry and silvery scaling ,

areas bordered by a narrow red rim,

sometimes a narrow, somewhat pale zone surrounds the border .

The silvery scales do not easily detach from the skin in the initial phase, but can be lifted off with a fingernail. Once the scales have been removed, it is often possible to detach a thin, cohesive membrane from the underlying red patch – a punctiform haemorrhage occurs, which is also known as „bloody dew“. This lowest cell layer of the epidermis is the boundary to the connective tissue layer. If this last thin layer of skin can be detached, this is a sure sign of psoriasis.

What types of psoriasis exist? Psoriasis vulgaris – the “common” and most widespread form of psoriasis with large red patches, often covered with white, silvery scales and a narrow red border

Psoriasis geographica – large, contiguous patches of psoriasis whose contours often resemble those on a map

Psoriasis palmaris et plantaris, also known as psoriasis palmoplantaris – psoriasis that is limited to the hands and feet

Psoriasis punctata – patches of psoriasis, which are about the size of match heads and are usually distributed on the trunk of the body

Psoriasis pustulosa – psoriasis foci with small blisters filled with fluid but not pus

Psoriasis arthritis – joint psoriasis

Psoriasis inversa – psoriasis in skin folds and where skin lies on skin, e.g. under the (female) breast

Erythroderma – severely inflamed skin or psoriasis „from heel to neck“, from head to toe

How can I prevent psoriasis? There is no prevention in the classic sense, but there are ways of reducing the symptoms, for example by avoiding spicy foods, spirits, vinegar or nuts, and eating a diet that is low in meat. This is particularly recommended for lowering inflammation. The diet should therefore be low in arachidonic acid.

Is psoriasis treatable? As psoriasis is genetic, the disease cannot be cured. Thankfully, it is easily treatable:

In mild cases: Creams, ointment s, lotions etc. and sometimes with light-therapy,

In moderately severe cases: with light-therapy and possibly also with medication or external agents,

In severe cases: with medication and possibly also with external agents.

Are there accompany ing illnesses with psoriasis? Psoriasis patients are two to four times more likely to suffer from an accompanying disease (= comorbidity). These mainly include diseases of the cardiovascular system, such as high blood pressure, atherosclerosis, heart attack s and stroke s, as well as metabolic disease s, such as obesity, diabetes and lipometabolic disorders.

EXERCISE:

1. You can prevent yourself from catching psoriasis, if you have a diet low in meat. A) True B) False

2. Symptoms for psoriasis are: A) red patches B) areas are bordered by a narrow red rim C) sometimes a narrow, somewhat pale zone surrounds the border D) more or less adherent, dry and silvery scaling E) hair loss

3. A worse skin condition is often observed in autumn and winter. A) True B) False

You’ll find the answer below.

BIBLIOGRAPHY 1. www.aad.org

2. www.dict.cc

3. www.helios-gesundheit.de

4. www.mayoclinic.org

5. www.nhs.uk

6. www.unimedizin-ffm.de

7. www.webster-dictionary.org

CARMEN LOBITZ Carmen Lobitz ist freie Trainerin, Lehrerin und MTL. Sie gründete 1998 in Berlin lobitz seminare, die unter anderem Englischseminare für Health Professionals anbieten. Kontakt: mail@lobitz-seminare.de www.lobitz-seminare.de

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Lösung für Exercise:

1. B

2. A bis D

3. A

Psoriasis – what is it?

How common is psoriasis?

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Psoriasis – what is it?

How common is psoriasis?

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