We all know that a healthy immune system is good. But, do you know that an overactive immune system can cause certain conditions like Psoriasis? Read on to find out more.
By Dr Rinky Kapoor
Psoriasis is an unpredictable, non-contagious, persistent skin disorder. It happens when skin cells multiply nearly ten times faster than normal. The underlying skin cells reach the skin’s surface very fast causing raised, red thick patches that are covered with white scales. The proliferation of skin cells is triggered by inflammatory chemicals produced by specialized white blood cells called T-lymphocytes.
Psoriasis occurs on the knees, elbows and scalp, and occasionally affects the torso, nails, palms and soles of the feet. It may involve only a localised area or the whole body. In later stages, it can affect the bones and joints, and the internal organs.
Patients are first diagnosed in their early adult years. Worldwide, the prevalence of psoriasis ranges from 0.5 to 11.4 per cent in adults and 0 to 1.4 per cent in children. People with psoriasis are more likely to have diabetes, high blood lipids, cardiovascular disease, and a variety of other inflammatory diseases.
Psoriasis occurs mainly due to an autoimmune dysfunction of the skin cells due to a combination of elements that includes genetic, environmental, infectious and stress factors. Defects in immune regulation and the control of inflammation are thought to play major roles. Certain medications like beta-blockers which are given to treat high blood pressure have also been linked to psoriasis.
Psoriasis has a variable course, periodically improving and worsening. In rare cases, it may spontaneously clear for years and stay in remission. Many people note a worsening of their symptoms during winter.
The symptoms include plaques of red skin covered by loose sliver coloured scales that are sometimes itchy and painful, sometimes cracking and bleeding. Fingernails can be prone to discolouration and pitting of nails that might also crumble or detach from the nail bed.
Psoriasis symptoms can be treated with topical ointments, light therapy and oral medications. Nowadays, biological therapy has revolutionised the treatment of psoriasis though it is currently very expensive. Psoriasis is a chronic condition and can outbreak suddenly, repeatedly but can be helped by reducing stress, monitoring diet and reducing sun exposure. If the patient notices any specific psoriasis triggers it would be better to avoid them.
The best treatment is individually determined by the treating doctor and depends, in part, on the type of disease, the severity, and amount of skin involved.
For mild disease that involves only small areas of the body (less than 10 per cent of the total skin surface), topical treatments such as creams, lotions, and sprays, are used. For moderate to severe disease that involves much larger areas of the body (10 per cent or more of the total skin surface) one may require ultraviolet light treatments or systemic treatments such as pills or injections.
Topical treatments include:
Light therapy, also called phototherapy, is one of the oldest treatment modalities for psoriasis. There are several types:
Most patients with psoriasis seem to be overweight. Generally, a diet composed of polyunsaturated oils like olive oil and fish oil, cold water fish, seeds, nuts, omega-3 fatty acids, vitamin D, milk thistle, aloe vera, Oregon grape, and evening primrose oil is beneficial for psoriasis.
The more hydrated the skin the lesser the irritation and chances of flare of disease. Sensitive skin moisturizers are great at preventing plaques from forming. Avoid harsh antiseptic and fragranced soaps and perfumes that may irritate the skin. A lukewarm bath with Epsom salt, mineral oil, milk, or olive oil can soothe the itching. Moisturising immediately after a bath helps. Oatmeal baths are also well known for soothing itch. Alcohol and smoking are triggers for many people who have psoriasis.
Recent studies show an association between psoriasis and other medical conditions, including obesity, diabetes, and heart disease. So, a healthy lifestyle, diet and exercise and management of stress are known to prevent the disease to some extent as also flares.
The author is Consultant Dermatologist, Cosmetic Dermatologist & Dermato-Surgeon, The Esthetic Clinics.
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