What is Psoriasis?

Psoriasis is a chronic scaling disease of the skin. It may range from just a few spots anywhere on the body to large areas of involvement. It is not contagious or spread able from one part of the body to another or from one person to another.
There is no blood test for psoriasis. The diagnosis is made by observation and examination of the skin. Sometimes microscopic examination of the skin (biopsy) is helpful where the changes are not typical or characteristic.
The exact cause of psoriasis is unknown, but hereditary and genetic factors are important. Psoriasis runs in families. This does not mean, however, that every child of a parent with psoriasis will develop psoriasis, but it is common that somewhere down the line psoriasis will appear in families. Psoriasis is not caused by allergies, infections, dietary deficiencies or excesses, or nervous tension.
How serious is Psoriasis?
Psoriasis does not affect he overall general health. If it is widespread it can certainly cause a great deal of skin discomfort and emotional embarrassment, and can affect job and leisure time activities...
How serious is Psoriasis?
Fortunately most people who have psoriasis only have a small amount and while it certainly can be a nuisance, it does not alter the lifestyle.
In about 10 percent of people with psoriasis there can develop a form of arthritis called psoriatic arthritis. It will take proper medical examination to confirm this diagnosis. Although not always, psoriatic arthritis is more often seen in people with widespread psoriasis than those who have a small amount. The psoriatic arthritis can affect people of all ages.
Is there a Cure for Psoriasis?
There is no present cure for psoriasis, but there are a number of drugs and treatments that can relieve and control psoriasis, often for long periods of time. Psoriasis on its own can come and go often with long periods of remission. In most cases, however, psoriasis is persistent. It can come and go without any obvious reason. Psoriasis does not necessarily become worse with age. Psoriasis can occur at any age from infancy to the elderly. Psoriasis will often remain in small localized areas and never spread.
Here you will find useful advise in order to cope with your Psoriasis in a responsible manner, changing your attitude and the way you fight the disease will help you in your every day life
1. Do keep a positive attitude towards your condition. It will clear up, you just have to find the treatment that's best for you. Remember your Psoriasis is uniquely your own and what works for some might not work for others. If you work with your Doctor it may take time but together you will find a treatment out there that is good for you alone.
2. Do remember that there are many remedies advertised in newspapers, pamphlets, word of mouth and door to door, but unless they can give you absolute proof that this is a "cure" don't touch it as it can make your psoriasis worse. Always consult your dermatologist before starting a cure let him monitor it for you. Sometimes those cures work for some people but sometime they do not.
3. Do avoid stress as much as possible, both mental and physical.
4. Do find out all you can about your condition from a. your physician, b. Your dermatologist, c. the library, d. a Psoriasis Foundation.
5. Do remember that Psoriasis is not a disease. You cannot catch it nor can you
give it. It is a hereditary genetic skin condition.
6. Do learn how to properly apply your external medications.
8. Do not let your skin become scratched or injured in any way even a mosquito bite can cause a flare up. When you have an itch you tend to scratch. DONT!
9. Do not expose your skin to harsh chemicals, wear rubber gloves. Harsh chemicals include dish detergents. Always wear cotton gloves under the rubber glove and only leave them on for twenty minutes at a time.
10. Do not forget Psoriasis is a genetically transmitted illness. In other words, if your grandmother had it, then for sure someone else in your family either has it or will have it. It will benefit you in the long run to find out as much information as possible about your condition.
11. Do not wash your clothes in heavy detergents, such as TIDE, unless your use very little. read the instructions on soap containers carefully, and use less soap than called for.
These do's and don’ts won't cure your Psoriasis, but will help you to cope with it. They do help and can be of assistance to you in your fight with this skin condition...
Unfortunately diet will not cure your Psoriasis but, however, the healthier the diet the better; especially a diet that includes regular exercise will be a good complement for psoriasis treatments.
GOOD DIET:
General: Rosemary, oregano, thyme, marjoram, laurel, ginger, basil, red peppers, cardamon,saffron, capers, onions, garlic, parsley, chives, tomato pulp, fruit vinegars, homemade mayonnaise.
Alcoholic Beverages: Cider, fruit wine, beer, whiskey, gin, rum, vodka, fruit brandies
Nut, oils, shortenings: Almonds, coconut, pistachios, cashews, sunflower oil, olive oil, corn oil, soybean oil, butter, sunflower margarine.
Foods: Fruits than contain grapes and grape juices, fresh vegetables, fish pastes, fish, bread, yogurt, butter and almond cakes, coconut based products. almond nougat.
Citrus fruits: Fruit pulps, fresh juices
BAD DIET:
Spices and condiments: Pepper, cloves, cumin, anise, cinnamon,paprika, mustard, pimento, nutmeg, commercial mayonnaise, ketchup, tabasco sauce, bouillon cubes and gravies, wine, vinegar, herb vinegar, candied orange, lemon peel, curry, commercial condiments, pastry aromas.
Alcoholic Beverages: All red and white wines, sparkling wines, champagnes, brandy, cognac, sherry,cinzano, vermouth, port, samos, all egg and nut based liqueurs, grand marnier,Cointreau.
Nuts: Hazelnuts, walnuts, walnut pastry aroma, peanuts, peanut oil, peanut butter.
Food: Prepared meats, sausages, pre-spiced meats, most cold cuts and pates. spice cakes, pickles, pickled spices and peppers, nut-based pastries, chocolate-based products.
Citrus Fruits: Fruit peels, orange marmalade,prepared juices, grapefruit, limes, lemon, lemonade, bitter lemons
How is Psoriasis Treated?
Treatment is determined by the location, severity and history of psoriasis in each individual. There is no one way of treatment, for each person with psoriasis may respond differently.
One main objective of treatment is to slow down the more rapid than usual growth rate of the skin cells. The rapid growth rate of skin cells causes the red, scaly psoriasis patches. The underlying cause of this increased skin growth is not yet known.
For patients with minimal psoriasis, therapy is limited to topical medications that are drugs applied to the skin. For patients with moderate to widespread psoriasis, topical treatments are often combined with ultraviolet light therapy. Either sunlight or artificial ultraviolet light therapy can be used.
If topical and ultraviolet light therapy are not effective, or are not practical, systemic or oral medications can be used. These may be combined with ultraviolet light therapy, the so-called photo chemotherapy or PUVA therapy. In severe cases and unresponsive cases of psoriasis, there are oral medications that slow down the growth rate of skin which are helpful. These drugs can have significant side effects and have to be used with the proper safeguard and caution. Even these strong drugs do not cure psoriasis but only help to control the disease.
Topical Treatment
Treatments applied directly to the skin are sometimes effective in clearing psoriasis. Doctors find that some patients respond well to sunlight, corticosteroid ointments, medicines derived from vitamin D3, vitamin A (retinoid), coal tar, or anthralin. Other topical measures, such as bath solutions and moisturizers, may be soothing but are seldom strong enough to clear lesions over the long term and may need to be combined with more potent remedies.

* Sunlight - Daily, regular, short doses of sunlight that do not produce a sunburn clear psoriasis in many people.

· Corticosteroids - Available in different strengths, corticosteroids (cortisone) are usually applied twice a day. Short-term treatment is often effective in improving but not completely clearing psoriasis. If less than 10 percent of the skin is involved, some doctors will begin treatment with a high-potency corticosteroid ointment (for example, Diprolene®,* Tem ovate®, Ultravate®, or Psorcon®).
· Skin Cap products - Are considered by some people the most successful treatment for Psoriasis, the wide spectrum of positive effects of Skin Cap products is based on the specific properties of a new formulation
of Zinc Pyrithione

* Calcipotriene - This drug is a synthetic form of vitamin D3. (It is not the same as vitamin D supplements.) Applying calcipotriene ointment (for example, Dovonex®) twice a day controls excessive production of skin cells. Because calcipotriene can irritate the skin, however, it is not recommended for the face or genitals. After 4 months of treatment, about 60 percent of patients have a good to excellent response. The safety of using the drug for cases affecting more than 20 percent of the skin is unknown.
* Coal tar - Coal tar may be applied directly to the skin, used in a bath solution, or used on the scalp as a shampoo. It is available in different strengths, but the most potent form may be irritating. It is sometimes combined with ultraviolet B (UVB) phototherapy. Compared with steroids, coal tar has fewer side effects, but it is messy and less effective and thus is not popular with many patients. Other drawbacks include its failure to provide long-term help for most patients, its strong odor, and its tendency to stain skin or clothing.
* Anthralin - Doctors sometimes use a 15- to 30-minute application of anthralin ointment, cream, or paste to treat chronic psoriasis lesions. However, this treatment often fails to adequately clear lesions, it may irritate the skin, and it stains skin and clothing brown or purple.
* Topical retinoid - The retinoid tazarotene (Tazorac) is a fast-drying, clear gel that is applied to the surface of the skin. Although this preparation does not act as quickly as topical corticosteroids, it has fewer side effects. Because it is irritating to normal skin, it should be used with caution in skin folds. Women of childbearing age should use birth control when using tazarotene.
* Salicylic acid - Salicylic acid is used to remove scales, and is most effective when combined with topical steroids, anthralin, or coal tar.
* Bath solutions - People with psoriasis may find that bathing in water with an oil added, then applying a moisturizer, can soothe their skin. Scales can be removed and itching reduced by soaking for 15 minutes in water containing a tar solution, oiled oatmeal, Epsom salts, or Dead Sea salts.
* Moisturizers - When applied regularly over a long period, moisturizers have a cosmetic and soothing effect. Preparations that are thick and greasy usually work best because they hold water in the skin, reducing the scales and the itching.

Phototherapy
Ultraviolet (UV) light from the sun causes the activated T cells in the skin to die, a process called apoptosis. Apoptosis reduces inflammation and slows the overproduction of skin cells that causes scaling. Daily, short, no burning exposure to sunlight clears or improves psoriasis in many people. A more controlled form of artificial light treatment may be used in mild psoriasis (UVB phototherapy) or in more severe or extensive psoriasis (psoralen and ultraviolet A [PUVA] therapy).
UVB phototherapy - Some artificial sources of UVB light are similar to sunlight. Newer sources, called narrow-band UVB, emit the part of the ultraviolet spectrum band that is most helpful for psoriasis. Some physicians will start with UVB treatments instead of topical agents. UVB phototherapy is also used to treat widespread psoriasis and lesions that resist topical treatment. This type of phototherapy is normally administered in a doctor’s office by using a light panel or light box, although some patients can use UVB light boxes at home with a doctor’s guidance. Generally at least three treatments a week for 2 or 3 months are needed. UVB phototherapy may be combined with other treatments as well. One combined therapy program, referred to as the Ingram regime, involves a coal tar bath, UVB phototherapy, and application of an anthralin-salicylic acid paste, which is left on the skin for 6 to 24 hours.
PUVA - This treatment combines oral or topical administration of a medicine called psoralen with exposure to ultraviolet A (UVA) light. Psoralen makes the body more sensitive to this light. PUVA is normally used when more than 10 percent of the skin is affected or when rapid clearing is required because the disease interferes with a person’s occupation (for example, when a model’s face or a carpenter’s hands are involved). Compared with UVB treatment, PUVA treatment taken two to three times a week clears psoriasis more consistently and in fewer treatments. However, it is associated with more short-term side effects, including nausea, headache, fatigue, burning, and itching. Long-term treatment is associated with an increased risk of squamous cell and melanoma skin cancers. PUVA can be combined with some oral medications (retinoids and hydroxyurea) to increase its effectiveness. Simultaneous use of drugs that suppress the immune system, such as cyclosporine, have little beneficial effect and increase the risk of cancer. Patients who must travel long distances for PUVA treatments may, with a physician’s supervision, be taught to administer this treatment at home.
Systemic Treatment
For more severe forms of psoriasis, doctors sometimes prescribe medicines that
are taken internally.

* Methotrexate - This treatment, which can be taken by pill or injection, slows cell production by suppressing the immune system. Patients taking methotrexate must be closely monitored because it can cause liver damage and/or decrease the production of oxygen-carrying red blood cells, infection-fighting white blood cells, and clot-enhancing platelets. As a precaution, doctors do not prescribe the drug for people with long-term liver disease or anemia. Methotrexate should not be used by pregnant women, by women who are planning to get pregnant, or by their male partners.
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* Cyclosporine - Taken orally, cyclosporine (Neoral®) acts by suppressing the immune system in a way that slows the rapid turnover of skin cells. It may provide quick relief of symptoms, but it is usually effective only during the course of treatment. The best candidates for this therapy are those with severe psoriasis who have not responded to or cannot tolerate other systemic therapies. Cyclosporine may impair kidney function or cause high blood pressure (hypertension), so patients must be carefully monitored by a doctor. Also, cyclosporine is not recommended for patients who have a weak immune system, those who have had substantial exposure to UVB or PUVA in the past, or those who are pregnant or breast-feeding.
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* Hydroxyurea (Hydrea®) - Compared with methotrexate and cyclosporine, hydroxyurea is less toxic but also less effective. It is sometimes combined with PUVA or UVB. Possible side effects include anemia and a decrease in white blood cells and platelets. Like methotrexate and cyclosporine, hydroxyurea must be avoided by pregnant women or those who are planning to become pregnant.
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* Retinoids - A retinoid, such as acitretin (Soriatane®), is a compound with vitamin A-like properties that may be prescribed for severe cases of psoriasis that do not respond to other therapies. Because this treatment also may cause birth defects, women must protect themselves from pregnancy beginning 1 month before through 3 years after treatment. Most patients experience a recurrence of psoriasis after acitretin is discontinued.

* Antibiotics - Although not indicated in routine treatment, antibiotics may be employed when an infection, such as Streptococcus, triggers the outbreak of psoriasis, as in certain cases of guttate psoriasis.