Psoriasis is a common skin disease that
affects the life cycle of skin cells. Normally, new
cells take about a month to move from the lowest skin
layer where they're produced, to the outermost layer
where they die and flake off. With psoriasis, the
entire life cycle takes only days. As a result, cells
build up rapidly, forming thick silvery scales and
itchy, dry, red patches that are sometimes painful.
Psoriasis is a persistent, long-lasting (chronic)
disease. You may have periods when your psoriasis
symptoms improve or go into remission alternating with
times your psoriasis becomes worse.
For some people, psoriasis is just a nuisance. For
others, it's disabling, especially when associated with
arthritis. No cure exists, but psoriasis treatments may
offer significant relief. And self-care measures, such
as using a nonprescription cortisone cream and exposing
your skin to small amounts of ultraviolet light, can
improve your psoriasis symptoms.
Signs and symptoms
Psoriasis symptoms can vary from person to person but
may include one or more of the following:
Red patches of skin covered with silvery scales.
Small scaling spots (commonly seen in children)
Dry, cracked skin that may bleed
Itching, burning or soreness
Thickened, pitted or ridged nails
Swollen and stiff joints
Psoriasis patches can range from a few spots of
dandruff-like scaling to major eruptions that cover
large areas. Mild cases of psoriasis may be a nuisance.
But more severe cases can be painful, disfiguring and
Most types of psoriasis go through cycles, flaring for
a few weeks or months, then subsiding for a time or
even going into complete remission. In most cases,
however, the disease eventually returns.
Several types of psoriasis exist. These include:
The most common form, plaque psoriasis causes dry, red
skin lesions (plaques) covered with silvery scales. The
plaques itch or feel sore and may occur anywhere on
your body, including your genitals and the soft tissue
inside your mouth. You may have just a few plaques or
many, and in severe cases, the skin around your joints
may crack and bleed.
Psoriasis can affect fingernails and toenails, causing
pitting, abnormal nail growth and discoloration.
Psoriatic nails may become loose and separate from the
nail bed (onycholysis). Severe cases may cause the nail
Psoriasis on the scalp appears as red, itchy areas with
silvery-white scales. You may notice flakes of dead
skin in your hair or on your shoulders, especially
after scratching your scalp.
This primarily affects people younger than 30 and is
usually triggered by a bacterial infection such as
strep throat. It's marked by small, water-drop-shaped
sores on your trunk, arms, legs and scalp. The sores
are covered by a fine scale and aren't as thick as
typical plaques are. You may have a single outbreak
that goes away on its own, or you may have repeated
episodes, especially if you have ongoing respiratory
Mainly affecting the skin in the armpits, groin, under
the breasts and around the genitals, inverse psoriasis
causes smooth patches of red, inflamed skin. It's more
common in overweight people and is worsened by friction
This rare form of psoriasis can occur in widespread
patches (generalized pustular psoriasis) or in smaller
areas on your hands, feet or fingertips. It generally
develops quickly, with pus-filled blisters appearing
just hours after your skin becomes red and tender. The
blisters dry within a day or two but may reappear every
few days or weeks. Generalized pustular psoriasis can
also cause fever, chills, severe itching, weight loss
The least common type of psoriasis, erythrodermic
psoriasis can cover your entire body with a red,
peeling rash that can itch or burn intensely. It may be
triggered by severe sunburn, by corticosteroids and
other medications, or by another type of psoriasis
that's poorly controlled.
In addition to inflamed, scaly skin, psoriatic
arthritis causes pitted, discolored nails and the
swollen, painful joints that are typical of arthritis.
It can also lead to inflammatory eye conditions such as
conjunctivitis. Symptoms range from mild to severe.
Although the disease usually isn't as crippling as
other forms of arthritis, it can cause stiffness and
progressive joint damage that in the most serious cases
may lead to permanent deformity.
The cause of psoriasis is related to the immune system,
and more specifically, a type of white blood cell
called a T lymphocyte or T cell. Normally, T cells
travel throughout the body to detect and fight off
foreign substances, such as viruses or bacteria. In
people with psoriasis, however, the T cells attack
healthy skin cells by mistake as if to heal a wound or
to fight an infection.
Overactive T cells trigger other immune responses that
cause an increased production of both healthy skin
cells and more T cells. What results is an ongoing
cycle in which new skin cells move to the outermost
layer of skin too quickly — in days rather than weeks.
Dead skin and white blood cells can't slough off
quickly enough and build up in thick, scaly patches on
the skin's surface. This usually doesn't stop unless
treatment interrupts the cycle.
Just what causes T cells to malfunction in people with
psoriasis isn't entirely clear, although researchers
think genetic and environmental factors both play a
Psoriasis typically starts or worsens because of a
trigger that you may be able to identify and avoid.
Factors that may trigger psoriasis include:
Infections, such as strep throat or thrush.
Injury to the skin, such as a cut or scrape, bug bite,
or a severe sunburn.
Heavy alcohol consumption
Certain medications, including lithium, which is
prescribed for bipolar disorder, high blood pressure
medications such as beta blockers, antimalarial drugs
Depending on the type and location of the psoriasis and
how widespread the disease is, psoriasis can cause
complications. These include:
Severe itching, which can lead to thickened skin and
bacterial skin infections.
Fluid and electrolyte imbalance in the case of severe
In addition, psoriatic arthritis can be debilitating
and painful, making it difficult to go about your daily
routine. Despite medications, psoriatic arthritis can
cause erosion in your joints.
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