Psoriasis: What Is It?

Psoriasis:  A Painful and Annoying Skin Disorder

Psoriasis is a condition of the skin caused by a malfunction of the immune system.  Doctors and scientists are unsure exactly what causes this malfunction.  In people that suffer from psoriasis and psoriatic arthritis the immune system attacks the growth layer of the skin.  Psoriasis occurs symetrically on the body.  For example, if you have a plaque on one hand it will be in the same place on the other hand.

This attack of the immune system on the skin causes the growth layer to grow at a rate 2 to 3 times faster than normal.  You would think this would cause excess skin folds, but it does not.  What happens is the epidermis, the lower layer, grows too fast for the dermis, the outer layer, to slough off normally.  Typically this happens on a cycle of 21 to 28 days.  Psoriatic plaques cause the skin to grow in 7 to 14 days causing scaly patches that can become dry and cracked. Without proper care the cracks can become infected.  In some cases this excess growth can cause pustules on the skin that are very painful.

Psoriasis is not a contagious disease.  Genetic predisposition is a large factor in the manifestation of the disorder.  A person can live for most of their lives not knowing that they are prone to this skin disorder until they undergo a period of extreme stress – going away to college, getting married, starting a new job, stress at work, moving, divorce, death of a loved one or even pregnancy have been known to trigger this condition.

Are There Treatment Options?

Thankfully, yes. There are topical treatments available that can soothe and sometimes even put a psoriatic plaque into remission.  Many of these contain cortizone or a steroidal component.  Emulsions with vitamins E and A are also helpful to soften the plaque.

As with any disease or disorder there are nutritional factors.  Deficiencies in nutrients can put the body in a state of stress.  Dr. Jarret Morrow’s Arthitis Research Updates blog actually had a relevant article about folic acid supplementation for sufferer’s of psoriasis.  Here is a direct quote from his blog:

“A recent study published in the Journal of Dermatological Treatment discussed the role of folic acid supplementation in patients with psoriasis.

Background:
“Relative deficiency of folic acid may occur in conditions such as pregnancy and hyperproliferative or chronic inflammatory disorders.”

Conclusion: “Folic acid supplementation appears as a reasonable therapeutic option in patients affected by chronic inflammatory skin diseases, such as moderate to severe psoriasis; in particular, those with concomitant hyperhomocysteinemia, low plasma folate and additional cardiovascular risk factors.”

Reference:
Gisondi P, Fantuzzi F, Malerba M, Girolomoni G. Folic acid in general medicine and dermatology. J Dermatolog Treat. 2007;18(3):138-46.”

Another treatment option is phototherapy.  Phototherapy is treatment with specific parts of the light spectrum.  There are treatments with UVA, Broad Band UVB and most recently Narrow Band UVB.  UVA and a small part of the Broad Band spectrum are what are most typically found in the bulbs of tanning machines.  Pure Broad Band UVB and Narrow Band UVB if used improperly will yield severe burns.  UVA can be tolerated for longer periods of time because it is very weak, but will cause adverse effects of sking aging and possibly cancer in the long term.  Most likely a light sensitizer either topical, oral or by IV will need to be used with UVA light treatments to speed the progress.  If a systemic treatment is used in conjunction then most likely you will need to use skin and eye protection when exposed to normal sunlight.  Both broad band and narrow band uvb treatments start with merely seconds for most skin types.  Over time treatments as long as 20 minutes can be tolerated for patients being treated with narrow band uvb.  As with any exposure to UV rays there is a potential for melanoma.  In comparison with the side effects of systemic treatments like Enbrel and Amevive or Methotrexate the treatment for the side effect is quick and fairly benign.

Systemic treatments like those mentioned above are considered immunomodulators.  They suppress the immune systems response.  They keep the plaques from appearing and maintain the remission of the disorder, but also make you more vulnerable to infection by other means – viruses and bacteria.  The biggest problem with these types of treatments is their effect on the liver, kidneys and lymphatic system.

Depending on the severity of your condition, please, consider your options carefully.  Not all doctors or dermatologists are aware of or familiar with the phototherapy treatment option.  There are companies such as National Biological from Twinsburg, OH, Daavlin from Bryan, OH and Waldman from Germany that specialize in the development of phototherapy devices.  Their staffs are well versed in the treatment options available for sufferers of skin disorders like psoriasis, vitiligo, eczema and other types of dermatitis and certain types of skin cancers.  They have phototherapy schedules that have been developed by doctors specifically for use with their machines and can make that information available to your dermatologist should you choose that treatment route.

Disclaimer:

I am neither a doctor or nutritionist.  The information I present here has been gathered through communication with doctors, dermatologists and patients of psoriasis and research done during my time as an employee of a phototherapy machine manufacturer.  It is highly advisable that you do your own research as well.  There are support organizations available like the National Psoriasis Foundation that have online presences that you can search for treatment information and also moral support.