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What is Psoriasis? (Psoriasis)
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What is Psoriasis?

Charles Lynde, MD, FRCPC

It is unfortunate but true that many people, including some doctors, believe that skin diseases are not essential, or even trivial. While it is true that many skin diseases are not life-threatening, the emotional and social impact can be comparable to that of clinical depression and should not be taken lightly. Psoriasis is a skin disorder that causes scaling of the skin, and it can often be itchy or even painful. It can be localized, areas affecting specific points of the body, such as the nails, arms, or the backside, or it can be widespread.

Impact of Psoriasis

This condition can have many physical impacts including severe itching, as well as be a source of pain, when moving certain areas of the body. It can also later become the cause of a very serious condition called psoriatic arthritis. Psoriasis is also highly visible, and while the condition is not contagious, it can be a cause of social embarrassment or even isolation. It is common to be excluded from public areas such as swimming pools or spas, due to misunderstandings and misperceptions about the skin condition.

Psoriasis Facts

Psoriasis is often thought to be caused by anxiety or the nerves. While psoriasis can cause anxiety or nervousness due to its symptoms, it is not caused by these factors. It is an immunological problem, where the body’s defence mechanism reacts to a perceived threat. Psoriasis tends to run in families, and may have a hereditary component. It is also common for psoriasis to vary in intensity over time, and it can even disappear for extended periods of time.

Why does the skin scale?

The exact cause of psoriasis is still unknown. However, we do understand the mechanisms of psoriasis. Lymphocytes are the body’s defence mechanism against outside pathogens, and the skin is where a lot of immunological battles take place. For psoriatic patients, these lymphocytes become active perceiving a threat, where none may exist, which causes the skin to become inflamed. This causes the epidermis to grow at an accelerated pace, causing it to become thick and scaly. The lymphocytes induce a cascading effect, which induces semi-permanent changes in the skin. For some people, the lymphocytes can also cause inflammation of the joints, resulting in a serious condition called psoriatic arthritis.

What treatments are there?

Past treatments for psoriasis have included topical such as creams and ointments, which contain vitamin D, Tazarotene, and cortisone, which helps reduce scaling. Oral drugs range from vitamin A pills to methotrexate which slows down inflammation of the skin. UV lights have also been used to treat psoriasis patients.

Recently, new research has made some breakthroughs at the cellular level, which plays a role in psoriasis. Biologics is a new type of medication that attacks psoriasis at its source, rather than treat the skin condition, which is a symptom of psoriasis. These drugs block activated lymphocytes or break down the chemical processes that cause psoriasis. Alefacept has been approved for use in Canada. This blocks activation of lymphocytes by psoriasis. Entaneracept is a drug that has recently been approved for the treatment of psoriatic arthritis. This drug stops tumor necrosis, a process integral to psoriatic arthritis.

Visit psoriasisguide.ca for more information on this skin condition, and remember to visit your dermatologist for help.

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