What is psoriasis?

What is psoriasis?

Psoriasis is a noncontagious common skin condition that causes rapid skin cell reproduction resulting in red, dry patches of thickened skin. The dry flakes and skin scales are thought to result from the rapid buildup of skin cells. Psoriasis commonly affects the skin of the elbows, knees, and scalp.

Some people have such mild psoriasis (small, faint dry skin patches) that they may not even suspect that they have a medical skin condition. Others have very severe psoriasis where virtually their entire body is fully covered with thick, red, scaly skin.

Psoriasis is considered a non-curable, long-term (chronic) skin condition. It has a variable course, periodically improving and worsening. Sometimes psoriasis may clear for years and stay in remission. Some people have worsening of their symptoms in the colder winter months. Many people report improvement in warmer months, climates, or with increased sunlight exposure.

Psoriasis is seen worldwide, in all races, and both sexes. Although psoriasis can be seen in people of any age, from babies to seniors, most commonly patients are first diagnosed in their early adult years.

Patients with more severe psoriasis may have social embarrassment, job stress, emotional distress, and other personal issues because of the appearance of their skin.

What causes psoriasis?

The exact cause remains unknown. There may be a combination of factors, including genetic predisposition and environmental factors. It is common for psoriasis to be found in members of the same family. The immune system is thought to play a major role. Despite research over the past 30 years looking at many triggers, the "master switch" that turns on psoriasis is still a mystery.
What does psoriasis look like? What are the symptoms?

Psoriasis typically looks like red or pink areas of thickened, raised, and dry skin. It classically affects areas over the elbows, knees, and scalp. Essentially any body area may be involved. It tends to be more common in areas of trauma, repeat rubbing, use, or abrasions.

Psoriasis has many different appearances. It may be small flattened bumps, large thick plaques of raised skin, red patches, and pink mildly dry skin to big flakes of dry skin that flake off.

There are several different types of psoriasis including psoriasis vulgaris (common type), guttate psoriasis (small, drop like spots), inverse psoriasis (in the folds like of the underarms, navel, and buttocks), and pustular psoriasis (liquid-filled yellowish small blisters). Additionally, a separate entity affecting primarily the palms and the soles is known as palmoplantar psoriasis.

Sometimes pulling of one of these small dry white flakes of skin causes a tiny blood spot on the skin. This is medically referred to as a special diagnostic sign in psoriasis called the Auspitz sign.

Genital lesions, especially on the head of the penis, are common. Psoriasis in moist areas like the navel or area between the buttocks (intergluteal folds) may look like flat red patches. These atypical appearances may be confused with other skin conditions like fungal infections, yeast infections, skin irritation, or bacterial Staph infections.

On the nails, it can look like very small pits (pinpoint depressions or white spots on the nail) or as larger yellowish-brown separations of the nail bed called "oil spots." Nail psoriasis may be confused with and incorrectly diagnosed as a fungal nail infection.

On the scalp, it may look like severe dandruff with dry flakes and red areas of skin. It may be difficult to tell the difference between scalp psoriasis and seborrhea (dandruff). However, the treatment is often very similar for both conditions.

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Obese children have psoriasis risk

Overweight or obese children have an elevated rate of psoriasis and teens with psoriasis have elevated cholesterol regardless of weight, U.S. researchers say.

Lead author Corinna Koebnick, a research scientist at Kaiser Permanente Southern California's Department of Research & Evaluation in Pasadena, Calif., says psoriasis is a chronic inflammatory disease of the skin that often starts early in life and affects more than 7 million Americans.

"This study suggests a link between obesity and psoriasis in children," Koebnick says in a statement. "But our study findings also suggest that the higher heart disease risk for patients with psoriasis starts in childhood in the form of higher cholesterol levels. We may need to monitor youth with psoriasis more closely for cardiovascular risk factors, especially if they are obese."

The study using electronic health records to study 710,949 racially and ethnically diverse children, published in the Journal of Pediatrics, found overweight children were almost 40 percent more likely than normal weight children to have psoriasis, while extremely obese children were almost 80 percent more likely than normal weight children to have psoriasis.

Among youth with psoriasis, it was four times more likely that the psoriasis would be severe or more widespread in obese youth than what was seen in normal weight children, the study says.

Additionally, teens with psoriasis had 4 percent to 16 percent higher cholesterol levels and liver enzymes, regardless of their weight, than youth without this psoriasis, Koebnick says.

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