Psoriasis (sore-EYE-ah-sis “to have the itch” is a chronic, inflammatory disease of the skin and is classified as an auto immune disorder. For individuals afflicted with it, it can be both physically and psychologically distressing. It is estimated that somewhere between 1.5-3% of the adult U.S. population has psoriasis. (1) Psoriasis can appear anywhere on the skin and is clinically characterize as mild, moderate, or severe.
The physiological mechanism behind psoriasis is as follows: A person’s immune system sends faulty signals telling the skin cells to grow too quickly. This miscommunication causes new skin cells to form rapidly, which result in the pile up of healthy cells on the skin.
However, the etiology of psoriasis is multifactorial and not completely understood. Men and women are equally affected; however, siblings and offspring of individuals affected with psoriasis are at an increased risk of developing the immune disorder. (2) One important note, psoriasis is not contagious. For the purpose of this paper we will discuss plaque psoriasis and briefly identify other grades of the skin disorder.
Western medicine offers three categories of treatment for psoriasis – topical therapy, phototherapy (light therapy) and systemic therapy.
One of the most baffling and persistent of skin disorders psoriasis is unpredictable and irritating. I It is characterized by skin cells that multiply up to ten times faster than normal. (3) As underlying cells reach the skin’s surface and die, their sheer volume creates raised, red erythematous plaques covered with white scales. According to the Mayo Clinic “Diseases and Conditions”, the cause of psoriasis is not fully known, but it is thought to be related to an immune system problem. One key cell is 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. If you have psoriasis, the T cells attack the healthy skin cells but cannot differentiate self from non-self and attack the healthy sells by mistake, as if to heal a wound or fight an infection. Overzealous T cells trigger other immune responses and the sequela can include dilation of blood vessels in the skin around the plaques and an increase in other white blood cells that can enter the outer layer of the skin. These changes result in an increased production of healthy skin cells and more T cells as well as other white blood cells. This causes rapid feedback loop which new skin cells move to the outermost layer of the skin too quickly, in days rather than weeks. The dead skin and white blood cells can’t slough off quickly enough and build up in thick, scaly patches on the surface of the skin. This usually does not stop unless treatment occurs and interrupts the cellular reproductive cycle. Western medicine is not clear what causes the T cells to malfunction in people with psoriasis. However while it is clear the there is a genetic link, it is also clear that environmental factors do play a role. (4)
Plaque psoriasis symptoms, being the most common variety of the skin disorder, are plaques of red skin often covered with loose, silver colored scales. These lesions may be itchy and painful, and they sometimes crack and bleed. At times these plaques of irritation with grow and merge into one another to cover large areas of the body. Psoriasis typically occurs on the knees, elbows, and scalp, as well as affecting the torso, palms, and soles of the feet. People who experience psoriasis know that this uncomfortable and at times deforming skin disease is difficult and discouraging to treat, as the condition comes and goes in cycles of remission and flare ups over a lifetime. While there are medications and treatment therapies that can help to clear up the patches of red, scaly thickened skin and alleviate the pruritus, that are the characteristics of psoriasis, there is no cure. Following are examples of the types of psoriasis, as stated earlier this paper will refer to plaque psoriasis which is the most common type.