physical

What Is Psoriasis?
Submitted by Doug Leone, MD and Adrienne Schupbach, MD, Dermatology and Mohs Surgery Institute
soriasis is a chronic skin disease of scaling and inflammation that affects more than 5 million adults in the United States. Anyone can have psoriasis, but it primarily affects people between the ages of 15 and 35. In its typical form, psoriasis results in patches of thick, red, inflamed skin covered with silvery scales. These patches, which are sometimes referred to as plaques, usually itch or feel sore. They can occur on skin anywhere on the body, but most often occur on the elbows, knees, legs, scalp, lower back, face, palms, and soles of the feet. There is no known way to prevent psoriasis and you cannot catch psoriasis or spread it to others. Psoriasis is much more than a minor skin annoyance. Individuals with psoriasis may experience significant physical discomfort and some disability. The itching and pain can interfere with basic everyday functions like walking and sleeping. Plaques on hands and feet can prevent individuals from working at certain occupations, playing some sports, and caring for family members or a home. People with moderate to severe psoriasis may feel selfconscious about their appearance and have a poor self-image that can lead to clinical depression and social isolation. What Causes Psoriasis? No one really knows what causes psoriasis. It appears to have a genetic component and is believed to be an autoimmune condition where the immune system mistakenly attacks and destroys
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healthy body tissue. Usually, skin cells grow deep in the skin and rise to the surface about once a month. When you have psoriasis, this process takes place too fast and dead skin cells build up on the skin's surface. This process is driven by the immune system, especially involving a type of white blood cell called a T cell. Normally, T cells help protect the body against infection and disease. In the case of psoriasis, T cells are put into action by mistake and become so active that they trigger other immune responses, which lead to inflammation and to rapid turnover of skin cells. People with psoriasis may notice that there are times when their skin worsens, called flares. It may even seem to go away for a long time, but then return. Conditions that may cause flares include infections, stress, changes in climate, or certain medications. How Is Psoriasis Treated? There are several forms of psoriasis, but chronic plaque psoriasis is the most common. The goal of treatment is to control your symptoms and prevent infection. Doctors generally treat psoriasis in steps based on the severity of the disease, size of the areas involved, type of psoriasis, where the psoriasis is located, and the patients response to initial treatments. There are many approaches for treating psoriasis, so it is important to consult a dermatologist to find out what works best for you. Treatment options include:

 Topical medicines applied directly to the skin: Some patients respond well to ointment or cream forms of corticosteroids, vitamin D3, retinoids, coal tar, or anthralin. Bath solutions and lubricants may be soothing, but they are seldom strong enough to improve the condition of the skin. Therefore, they usually are combined with stronger remedies. Phototherapy light treatment: Natural ultraviolet light from the sun and controlled delivery of artificial ultraviolet light are used in treating psoriasis. It is important that light therapy is administered by a doctor. Spending a lot of time in the sun or a tanning bed can cause skin damage, increase the risk of skin cancer, and worsen symptoms. Medicines taken by mouth or injection: For more severe forms of psoriasis, dermatologists sometimes prescribe medicines that are taken internally by pill or injection. Patients taking any of the systemic medication for psoriasis must be closely monitored as these medications can have serious side effects. Combination therapy: Combining various topical, light, and systemic treatments often permits lower doses of each and can result in increased effectiveness. Over time, affected skin can become resistant to treatment, especially when topical corticosteroids are used. Also, a treatment that works very well in one person may have little effect in another. Thus, doctors often use a trial-and-error approach to find a treatment that works, and they may switch treatments periodically if a treatment does not work or if adverse reactions occur. Psoriasis is a life-long condition. However, with proper treatment, it can be controlled so that there is minimal impact on your quality of life.

Psoriasis is much more than a minor skin annoyance. Individuals with psoriasis may experience significant physical discomfort and some disability.
For more information, you may contact the Dermatology and Mohs Surgery Institute at 309-451-DERM (3376) or visit www. dermatologistbloomington.com. Dr. Leone and Dr. Schupbach, both residents of Bloomington, are board-certified dermatologists, specializing in medical and cosmetic dermatology, including the treatment of skin cancer, moles, acne, rashes, warts, and all skin disorders. Dr. Leone is one of the few Mohs trained surgeons in the area. Their new practice, located at 3024 E. Empire St. 2nd floor (in the Advocate BroMenn outpatient center), Bloomington, is now open with immediate availability.

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October 2013 Bloomington Healthy Cells Magazine Page 7