Daily Archives: September 18, 2016

Scientists believe that at least 10 percent of people inherit one or more of the genes that could eventually lead to psoriasis. However, only 2 percent to 3 percent of the population develops the disease. Researchers believe that for a person to develop psoriasis, that person must have a combination of the genes that cause psoriasis and be exposed to specific external factors known as triggers.

Genes control everything about a person, from height to eye color. When genes are working normally, the body and its cells function normally. When a misstep occurs in the way a gene works, a genetic disease such as psoriasis may result.

Research into the genetics of psoriasis didnt begin until the early 1970s. Recently, it has exploded in scope, thanks to improvements in medical and genetic technology, and increased funding.

In 2006, the Foundation began collecting DNA samples for the National Psoriasis Victor Henschel BioBank. The BioBank is slated to be the worlds largest collection of psoriasis-related DNA in the world available to qualified researchers. The first BioBank DNA samples were released to researchers in 2010.

Scientists have now identified about 25 genetic variants that make a person more likely to develop psoriatic disease. At the University of Michigan, Dr. J.T. Elder and his team of researchers have identified several areas on the human genome where more than one gene may be involved in psoriasis and psoriatic arthritis.

At the University of California-San Francisco, Dr. Wilson Liao is using new genetic sequencing technology to find rare "trigger genes" that may be the leading causes of psoriasis in certain individuals.

Working with DNA samples from a large family that includes many people with psoriasis, Anne Bowcock, Ph.D., a professor of genetics at Washington University School of Medicine in St. Louis, has identified a gene mutation known as CARD14 that when triggered leads to plaque psoriasis.

At the University of Utah, Drs. Gerald Krueger and Kristina Callis Duffin have carefully catalogued the psoriasis of more than 1,200 patients. By comparing the genes of each individual to the way psoriasis shows up on his or her body, the team hopes to understand which genes are involved in specific types of disease.

Using a NPF Discovery grant, British researcher Francesca Capon found that a mutation to the gene called IL36RN might be involved in the three forms of pustular psoriasis.

Psoriasis triggers are not universal. What may cause one person's psoriasis to become active, may not affect another. Established psoriasis triggers include:

Stress can cause psoriasis to flare for the first time or aggravate existing psoriasis. Relaxation and stress reduction may help prevent stress from impacting psoriasis.

Psoriasis can appear in areas of the skin that have been injured or traumatized. This is called the Koebner [KEB-ner] phenomenon. Vaccinations, sunburns and scratches can all trigger a Koebner response. The Koebner phenomenon can be treated if it is caught early enough.

Certain medications are associated with triggering psoriasis, including:

Anything that can affect the immune system can affect psoriasis. In particular, streptococcus infection (strep throat) is associated with guttate psoriasis. Strep throat often is triggers the first onset of guttate psoriasis in children. You may experience a flare-up following an earache, bronchitis, tonsillitis or a respiratory infection, too.

It's not unusual for someone to have an active psoriasis flare with no strep throat symptoms. Talk with your doctor about getting a strep throat test if your psoriasis flares.

Although scientifically unproven, some people with psoriasis suspect that allergies, diet and weather trigger their psoriasis.

NPF's Patient Navigation Center is the world's first, personalized support center for psoriatic disease. Our Patient Navigatorscan answer your questions about flare-ups,help you better manage your symptoms and support your journey to a healthy life with psoriasis.

For free and confidential assistance, contact our Patient Navigators

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Psoriasis causes and known triggers | National Psoriasis ...

IMPORTANT SAFETY INFORMATION

What is the most important information I should know about ENBREL?

ENBREL is a medicine that affects your immune system. ENBREL can lower the ability of your immune system to fight infections. Serious infections have happened in patients taking ENBREL. These infections include tuberculosis (TB) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. Some patients have died from these infections. Your doctor should test you for TB before you take ENBREL and monitor you closely for TB before, during, and after ENBREL treatment, even if you have tested negative for TB.

There have been some cases of unusual cancers reported in children and teenage patients who started using tumor necrosis factor (TNF) blockers before 18 years of age. Also, for children, teenagers, and adults taking TNF blockers, including ENBREL, the chances of getting lymphoma or other cancers may increase. Patients with RA or psoriasis may be more likely to get lymphoma.

Before starting ENBREL, tell your doctor if you:

What are the possible side effects of ENBREL?

ENBREL can cause serious side effects including: New infections or worsening of infections you already have; hepatitis B can become active if you already have had it; nervous system problems, such as multiple sclerosis, seizures, or inflammation of the nerves of the eyes; blood problems (some fatal); new or worsening heart failure; new or worsening psoriasis; allergic reactions; autoimmune reactions, including a lupus-like syndrome and autoimmune hepatitis.

Common side effects include: Injection site reactions, upper respiratory infections (sinus infections), and headache.

In a medical study of patients with JIA, side effects were generally similar in frequency and type as those seen in adult patients. The kinds of infections reported were generally mild and similar to those usually seen in children.

These are not all the side effects with ENBREL. Tell your doctor about any side effect that bothers you or does not go away.

If you have any questions about this information, be sure to discuss them with your doctor. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatch, or call 1-800-FDA-1088.

Please see Prescribing Information and Medication Guide.

INDICATIONS

Moderate to Severe Rheumatoid Arthritis (RA)

ENBREL is indicated for reducing signs and symptoms, keeping joint damage from getting worse, and improving physical function in patients with moderately to severely active rheumatoid arthritis. ENBREL can be taken with methotrexate or used alone.

Moderately to Severely Active Polyarticular Juvenile Idiopathic Arthritis (JIA)

ENBREL is indicated for reducing signs and symptoms of moderately to severely active polyarticular juvenile idiopathic arthritis (JIA) in children ages 2 years and older.

Psoriatic Arthritis

ENBREL is indicated for reducing signs and symptoms, keeping joint damage from getting worse, and improving physical function in patients with psoriatic arthritis. ENBREL can be used with or without methotrexate.

Ankylosing Spondylitis (AS)

ENBREL is indicated for reducing signs and symptoms in patients with active ankylosing spondylitis.

Moderate to Severe Plaque Psoriasis

ENBREL is indicated for the treatment of adult patients (18 years or older) with chronic moderate to severe plaque psoriasis who are candidates for systemic therapy or phototherapy.

IMPORTANT SAFETY INFORMATION: What is the most important information I should know about Enbrel (etanercept)?

ENBREL is a medicine that affects your immune system. ENBREL can lower the ability of your immune system to fight infections. Serious infections have happened in patients taking ENBREL. These infections include tuberculosis(TB) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. Some patients have died from these infections. Your doctor should test you for TB before you take ENBREL and monitor you closely for TB before, during, and after ENBREL treatment, even if you have tested negative for TB.

There have been some cases of unusual cancers reported in children and teenage patients who started using tumor necrosis factor (TNF) blockers before 18 years of age. Also, for children, teenagers, and adults taking TNF blockers, including ENBREL, the chances of getting lymphoma or other cancers may increase. Patients with RA or psoriasis may be more likely to get lymphoma.

Before starting ENBREL, tell your doctor if you:

What are the possible side effects of ENBREL?

ENBREL can cause serious side effects including: New infections or worsening of infections you already have; hepatitis B can become active if you already have had it; nervous system problems, such as multiple sclerosis, seizures, or inflammation of the nerves of the eyes; blood problems (some fatal); new or worsening heart failure; new or worsening psoriasis; allergic reactions; autoimmune reactions, including a lupus-like syndrome and autoimmune hepatitis.

Common side effects include: Injection site reactions, upper respiratory infections (sinus infections), and headache.

In a medical study of patients with JIA, side effects were generally similar in frequency and type as those seen in adult patients. The kinds of infections reported were generally mild and similar to those usually seen in children.

These are not all the side effects with ENBREL. Tell your doctor about any side effect that bothers you or does not go away.

If you have any questions about this information, be sure to discuss them with your doctor. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatch, or call 1-800-FDA-1088.

Please see Prescribing Information and Medication Guide.

INDICATIONS

Moderate to Severe Rheumatoid Arthritis (RA)

ENBREL is indicated for reducing signs and symptoms, keeping joint damage from getting worse, and improving physical function in patients with moderately to severely active rheumatoid arthritis. ENBREL can be taken with methotrexate or used alone.

Moderately to Severely Active Polyarticular Juvenile Idiopathic Arthritis (JIA)

ENBREL is indicated for reducing signs and symptoms of moderately to severely active polyarticular juvenile idiopathic arthritis (JIA) in children ages 2 years and older.

Psoriatic Arthritis

ENBREL is indicated for reducing signs and symptoms, keeping joint damage from getting worse, and improving physical function in patients with psoriatic arthritis. ENBREL can be used with or without methotrexate.

Ankylosing Spondylitis(AS)

ENBREL is indicated for reducing signs and symptoms in patients with active ankylosing spondylitis.

Moderate to Severe Plaque Psoriasis

ENBREL is indicated for the treatment of adult patients (18 years or older) with chronic moderate to severe plaque psoriasis who are candidates for systemic therapy or phototherapy.

At Enbrel.com, you can learn about Enbrel (etanercept), a self-injected biologic medicine used to treat inflammatory diseases with long-term effects. You can find information about moderate to severe rheumatoid arthritis(RA), moderate to severe plaque psoriasis, psoriatic arthritis, moderately to severely active polyarticular juvenile idiopathic arthritis(JIA), and ankylosing spondylitis(AS). You can learn about symptoms, treatment, how Enbrel (etanercept) works for each condition, results for each condition, results for each condition, and safety information.

Enbrel.com supports you and your loved ones from diagnosis to treatment. You can find resources like injection demonstrations, patient testimonial videos, questions to ask your doctor, and even help with finding a rheumatologist or dermatologist near you.

Enbrel.com also provices ongoing assistance with ENBREL SupportTM, a patient support program to help with out-of-pocket costs and connect you with registered nurses and ENBREL Nurse Partners. The resources available will help you get started. Resources include the ENBREL Starter Kit, injection and medicine refill reminders, free needle disposal containers, travel packs, and ongoing education.

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What Is Plaque Psoriasis? - Enbrel (etanercept)

Home Topics AZ Psoriasis

Author:Hon A/Prof Amanda Oakley, Hamilton, New Zealand. Revised and updated, August 2014.

Psoriasis is a chronic inflammatory skin condition characterised by clearly defined, red and scaly plaques (thickened skin). It is classified into several subtypes.

Psoriasis affects 24% of males and females. It can start at any age including childhood, with peaks of onset at 1525 years and 5060 years. It tends to persist lifelong, fluctuating in extent and severity. It is particularly common in Caucasians, but may affect people of any race. About one third of patients with psoriasis have family members with psoriasis.

Psoriasis is multifactorial. It is classified as an immune-mediated inflammatory disease (IMID).

Genetic factors are important. An individual's genetic profile influences their type of psoriasis and its response to treatment.

Genome-wide association studies report that HLA-Cw6 is associated with early onset psoriasis and guttate psoriasis. This major histocompatibility complex is not associated with arthritis, nail dystrophy or late onset psoriasis.

Theories about the causes of psoriasis need to explain why the skin is red, inflamed and thickened. It is clear that immune factors and inflammatory cytokines (messenger proteins) such is IL1 and TNF are responsible for the clinical features of psoriasis. Current theories are exploring the TH17 pathway and release of the cytokine IL17A.

Psoriasis usually presents with symmetrically distributed, red, scaly plaques with well-defined edges. The scale is typically silvery white, except in skin folds where the plaques often appear shiny and they may have a moist peeling surface. The most common sites are scalp, elbows and knees, but any part of the skin can be involved. The plaques are usually very persistent without treatment.

Itch is mostly mild but may be severe in some patients, leading to scratching and lichenification (thickened leathery skin with increased skin markings). Painful skin cracks or fissures may occur.

When psoriatic plaques clear up, they may leave brown or pale marks that can be expected to fade over several months.

Certain features of psoriasis can be categorised to help determine appropriate investigations and treatment pathways. Overlap may occur.

Generalised pustulosis and localised palmoplantar pustulosis are no longer classified within the psoriasis spectrum.

Patients with psoriasis are more likely than other people to have other health conditions listed here.

Psoriasis is diagnosed by its clinical features. If necessary, diagnosis is supported by typical skin biopsy findings.

Medical assessment entails a careful history, examination, questioning about effect of psoriasis on daily life, and evaluation of comorbid factors.

Validated tools used to evaluate psoriasis include:

The severity of psoriasis is classified as mild in 60% of patients, moderate in 30% and severe in 10%.

Evaluation of comorbidities may include:

Patients with psoriasis should ensure they are well informed about their skin condition and its treatment. There are benefits from not smoking, avoiding excessive alcohol and maintaining optimal weight.

Mild psoriasis is generally treated with topical agents alone. Which treatment is selected may depend on body site, extent and severity of the psoriasis.

Most psoriasis centres offer phototherapy with ultraviolet (UV) radiation, often in combination with topical or systemic agents. Types of phototherapy include

Moderate to severe psoriasis warrants treatment with a systemic agent and/or phototherapy. The most common treatments are:

Other medicines occasionally used for psoriasis include:

Systemic corticosteroids are best avoided due to risk of severe withdrawal flare of psoriasis and adverse effects.

Biologics or targeted therapies are reserved for conventional treatment-resistant severe psoriasis, mainly because of expense, as side effects compare favourably with other systemic agents. These include:

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Psoriasis | DermNet New Zealand

What Is Psoriasis?

Psoriasis is a genetically programmed inflammatory disease that primarily affects the skin in about 3% of individuals in the United States. Psoriasis is characterized by skin cells that multiply up to 10 times faster than normal. When these cells reach the surface and die, raised, red plaques covered with white scales form. Psoriasis begins as a small scaling papule. When multiple papules coalesce, they form scaling plaques. These plaques tend to occur in the scalp, elbows, and knees.

Although psoriatic plaques can be limited to only a few small areas, the condition can involve widespread areas of skin anywhere on the body. Psoriasis symptoms vary depending on the type of psoriasis you have. Common psoriasis symptoms can include the following:

Plaque psoriasis is the most common type of psoriasis and it gets its name from the plaques that build up on the skin. There tend to be well-defined patches of red raised skin that can appear on any area of the skin, but the knees, elbows, scalp, trunk, and nails are the most common locations. There is also a flaky, white build up on top of the plaques, called scales. Possible plaque psoriasis symptoms include skin pain, itching, and cracking.

There are plenty of over-the-counter products that are effective in the treatment of plaque psoriasis. 1% hydrocortisone cream is a topical steroid that can suppress mild disease and preparations containing tar are effective in treating plaque psoriasis.

Scalp psoriasis is a common skin disorder that makes raised, reddish, often scaly patches. Scalp psoriasis can affect your whole scalp, or just pop up as one patch. This type of psoriasis can even spread to the forehead, the back of the neck, or behind the ears. Scalp psoriasis symptoms may include only slight, fine scaling. Moderate to severe scalp psoriasis symptoms may include dandruff-like flaking, dry scalp, and hair loss. Scalp psoriasis does not directly cause hair loss, but stress and excess scratching or picking of the scalp may result in hair loss.

Scalp psoriasis can be treated with medicated shampoos, creams, gels, oils, ointments, and soaps. Salicylic acid and coal tar are two medications in over-the-counter products that help treat scalp psoriasis. Steroid injections and phototherapy may help treat mild scalp psoriasis. Biologics are the latest class of medications that can also help treat severe scalp psoriasis.

Guttate psoriasis looks like small, pink dots or drops on the skin. The word guttate is from the Latin word gutta, meaning drop. There tends to be fine scales with guttate psoriasis that is finer than the scales in plaque psoriasis. Guttate psoriasis is typically triggered by streptococcal (strep throat) and the outbreak will usually occur two to three weeks after having strep throat.

Guttate psoriasis tends to go away after a few weeks without treatment. Moisturizers can be used to soften the skin. If there is a history of psoriasis, a doctor may take a throat culture to determine if strep throat is present. If the throat culture shows that streptococcal is present, a doctor may prescribe antibiotics.

Many patients with psoriasis have abnormal nails. Psoriatic nails often have a horizontal white or yellow margin at the tip of the nail called distal onycholysis because the nail is lifted away from the skin. There can often be small pits in the nail plate, and the nail is often yellow and crumbly.

The same treatment for skin psoriasis is beneficial for nail psoriasis. However, since nails grow slow, it may take a while for improvements to be evident. Nail psoriasis can be treated with phototherapy, systemic therapy (medications that spread throughout the body), and steroids (cream or injection). If medications do not improve the condition of nail psoriasis, a doctor may surgically remove the nail.

Psoriasis can be associated with a destructive arthritis called psoriatic arthritis. Damage can be serious enough to permanently damage the affected joints. Prevention of joint damage in such cases is very important.

Psoriatic arthritis is a chronic disease characterized by a form of inflammation of the skin and joints. About 15%-25% of patients with psoriasis also develop an inflammation of their joints. Psoriatic arthritis is a systemic rheumatic disease that can not only cause inflammation of the skin, but in the eyes, heart, kidneys, and lungs as well. Currently, the cause of psoriatic arthritis is unknown, but a combination of genetic, immune, and environmental facts is likely involved.

Typically, a patient will have psoriasis months or years before they develop psoriatic arthritis. Psoriatic arthritis usually involves the knees, ankles, and joints in the feet. There may also be a loss of range of motion of the involved joints as well as joint stiffness. Psoriatic arthritis can also cause inflammation of the spine and the sacrum, which causes pain and stiffness in the low back, buttocks, neck, and upper back.

Treatment for psoriatic arthritis generally involves anti-inflammatory medications and exercise. It is important to stretch or take a hot shower before exercise in order to relax the muscles. Ice application after exercise can help minimize soreness and inflammation. Nonsteroidal anti-inflammatory drugs may also reduce joint inflammation, pain, and stiffness.

It is now clear that there is a genetic basis for psoriasis. This hereditary predisposition is necessary before the disease can be triggered by environmental factors. White blood cells called T-cells mediate the development of the psoriatic plaques that are present in the skin. When someone has psoriasis, their body is unable to offer protection from invaders. Instead, inflammation is promoted and skin cells are on overdrive. When cell growth is increased, old skin cells pile up instead of flaking off, causing psoriasis to occur. Currently, most experts conclude that environmental, genetic and immunologic factors interact to cause the disease.

If you have the genetic basis of psoriasis, a trigger can cause psoriasis to flare up. The following are triggers that may set off ones psoriasis:

No, psoriasis is not contagious. People used to believe that psoriasis was the same as leprosy, but that is not the case. You cannot get psoriasis by touching, kissing, or having sex with someone who has psoriasis. People get psoriasis because of their genes, not their hygiene, diet, lifestyle, or any other habits.

Psoriasis is often diagnosed or at least suspected on the basis of its appearance and distribution. However, psoriasis may resemble eczema or other skin diseases and further tests may be required. It may be necessary to remove a small piece of skin (a biopsy) and have it examined by a pathologist to confirm the diagnosis. If there are joint symptoms, X-rays and other laboratory tests may be in order. Psoriasis cannot be cured, but like many other medical conditions, it is controllable with treatment. Your doctor may have you seen by a consultant such as a dermatologist, rheumatologist or immunologist to help diagnose and treat your form of psoriasis.

Since psoriasis mainly affects the skin, topical treatments are very useful because they are relatively safe, fairly effective, and can be applied directly to the affected skin. They take the form of lotions, foams, creams, ointments, gels, and shampoos. They include topical steroids, tar preparations, and calcium- modulating drugs. The precise drug used and the form in which it is delivered depends on the areas involved. In widespread disease in patients with more than 10% of the body surface involved, it may not be practical to use topical medication alone.

For more extensive psoriasis, a useful option is ultraviolet (UV) light exposure. UV light can treat large areas of skin with few side effects, if performed in the physicians office. It should be kept in mind that all UV light causes mutational events, which can lead to skin cancer. At this time, the most popular type of UV light for psoriasis is called narrow-band UVB. Only a small portion of the UV light spectrum is used, which seems to be particularly beneficial for psoriasis and may be less carcinogenic. This UVB is quite different from the UVA, the wavelength available in tanning salons, which is not effective in psoriasis. Phototherapy can be used alone or with medications when treating psoriasis.

Excimer lasers or pulsed dye lasers are used in laser therapy. A pulsed dye laser will create a concentrated beam of yellow light. When this light hits the skin, it converts to heat. The heat then destroys the extra blood vessels in the skin that contribute to psoriasis. Excimer lasers will deliver ultraviolet light to localized areas of the skin that help treat psoriasis. These lasers produce UV light in wavelengths similar to narrow-band UVB. Laser therapy uses intense doses of laser light to help control areas of mild to moderate psoriasis without damaging surrounding healthy skin. These can be quite effective for small plaques of psoriasis, but since only small areas of skin can be treated at once, they are not practical for extensive disease.

There are a variety of drugs administered systemically that are useful in controlling psoriasis. As a generalization, most oral medications act by targeting portions of the immune system. The only exception currently is a drug called acitretin (Soriatane), which is structurally similar to vitamin A. Since the immune system is necessary in order to survive, systemic treatments do have a downside. Drugs like methotrexate and cyclosporine are administered orally and can affect the liver, kidney, and bone marrow. A new oral medication recently approved for treatment of psoriasis is called Otezla (apremilast). Otezla selectively targets molecules inside immune cells and adjusts (reduces) the processes of inflammation within the cell, which in turn helps treat psoriasis. This drug appears to be considerably safer that most of its predecessors but is also quite expensive.

A new class of drugs has recently been developed called biologics; they're called biologics because living cells synthesize them. Since these drugs are proteins, they cannot be administered orally and must be given by injection through the skin or by an intravenous infusion. This treatment is recommended in patients with moderate to severe psoriasis. These drugs target the immune response that leads to the rapid skin cell growth of psoriasis. This seems to have increased their safety profile as well as their effectiveness when compared to older drugs. On the other hand, they are quite expensive costing up to $30,000 a year.

There are many home remedies that can be used in the treatment of psoriasis. It is very important to keep the skin moist to avoid dryness. Petroleum jelly, shortening, or olive oil can be used as a moisturizer. Take fewer showers and baths to avoid stripping the skin of its natural oils. Adding salts, oil, or finely ground oatmeal to the bath can soothe the skin. Heliotherapy (medicinal sunbathing) can be effective in controlling psoriasis. There is also evidence that increased body mass is associated with psoriasis and that heavier individuals are more difficult to treat.

At the edge of Israel's Dead Sea, there are a group of resorts that cater to psoriasis patients by offering a combination of graded solar exposure and the application of crude coal tar along with a spa-like experience. The Dead Sea is the lowest point on earth, more than 400 meters below sea level. Once the suns rays pass through the haze, the harmful ultraviolet rays are filtered out and the remaining rays are highly effective in treating psoriasis. For those with the time and the money, this is a reasonable alternative to standard medical treatment.

Although there is no doubt that psoriasis is a potent inducer of stress, the evidence that stress causes psoriasis is sparse. However, stress can make psoriasis worse, and psoriasis can make one stressed. Dealing with stress with or without psoriasis is a challenge for most people living in the 21st century. The following are tips to reduce stress:

Not only are the physical effects of psoriasis frustrating, but the emotional effects of psoriasis can be much worse. Psoriasis may cause your relationships to change and people may treat you differently. Unfortunately, this may lead to stress, which then leads to worsening psoriasis. A doctor may prescribe antidepressant medications if psoriasis is diminishing your quality of life. Support groups can also help you cope with psoriasis by talking to other people who are suffering from the same disease.

Fall and winter may bring shorter days, colder temperatures, and dry air. These can all lead to worsening psoriasis symptoms. The suns ultraviolet light hinders the rapid growth of skin cells that is characteristic of psoriasis. Therefore, spending less time in the sun may cause psoriasis symptoms to flare. The dry weather may remove moisture in your skin so it is important to use moisturizer and/or a humidifier at home.

There are many different remedies that may ease psoriasis symptoms. The following is a partial list of alternative medicine to help treat psoriasis:

Consult your doctor before trying new medications.

There is plenty of evidence that extensive psoriasis can have a very significant negative effect on a patients self-image and emotions. This is especially true in social situations, although all aspects of life can be disturbed. Inverse psoriasis, which affects the genital skin, and scalp psoriasis can be particularly troubling. Psoriasis affecting the hands may make it impossible to interact normally with others. It is important to remember that there are ways to manage and treat psoriasis flares. It may seem as if ones quality of life has diminished, but there are many organizations that offer support to psoriasis patients. The National Psoriasis Foundation is an excellent source of accurate information as well as emotional support for afflicted patients.

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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the eMedicineHealth Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

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Slideshow Pictures: Psoriasis -- Symptoms, Causes and ...

Psoriasis is a chronic skin disorder. It causes skin cells to grow abnormally fast and to build up on top of the skin. These extra cells produce thick, shiny scales with dry, itchy red patches that are sometimes painful. The patches can be small or large and may vary in intensity over time.

About7.5 millionpeople in the United States have psoriasis. The exact cause of psoriasis isnt known. However, psoriasis is more common among those with a family history of the condition.

The symptoms of psoriasis may vary from person to person. Some of the more common symptoms include:

The symptoms of psoriasis may come and go, but theres no cure for the condition. The best way to prevent symptoms is to avoid known triggers. Psoriasis triggers vary from person to person. So its important to identify the specific factors that make your symptoms worse and that help relieve them. Here are some things you can do to prevent psoriasis flare-ups:

The daily stresses of life can have a negative impact on anyone, but they are particularly problematic for people with psoriasis. The body tends to have an inflammatory reaction to stress. This response can cause a psoriasis flare-up.

Its important to reduce the amount of stress in your life as much as possible. You can try:

Certain medications can interfere with the bodys autoimmune response and cause inflammation, which can trigger psoriasis. These medications include:

Make sure you speak with your doctor about any prescription or over-the-counter medications youre taking. Your doctor may switch you to another medication or change your dosage if they suspect your medication is causing psoriasis outbreaks. Dont stop taking your medication without talking to your doctor first, even if you believe your medication is triggering a flare-up.

Injuries to the skin can trigger psoriasis in some people. This is known as the Koebner phenomenon. Common skin injuries that trigger psoriasis include sunburns and scratches.

Taking good care of your skin can help prevent these types of injuries. When doing activities that may cause skin injury, you should always take extra precautions, including:

Call your doctor right away if you notice psoriasis symptoms after a skin injury. When its caught early, the Koebner phenomenon can be treated effectively.

Infections are known to trigger psoriasis because they put stress on the immune system, causing an inflammatory reaction. Strep throat in particular is associated with the onset of guttate psoriasis, especially in children. However, psoriasis flare-ups may occur after an earache, tonsillitis, or a respiratory or skin infection.

Its important to seek treatment right away if you suspect you have an infection. If you have a skin injury, such as a cut or wound, make sure to clean it properly and keep it covered to prevent infection. Other ways to prevent an infection include:

Being obese or overweight appears to make psoriasis symptoms worse. So its important to manage your weight by exercising and eating a healthful diet. If you have trouble with this, you may want to see a nutritionist for assistance. A nutritionist will help you figure out how much food and what particular foods you should eat every day to lose weight.

Certain foods appear to cause inflammation in the body, which can trigger psoriasis symptoms in some people. Other foods seem to help reduce inflammation and the occurrence of flare-ups.

Foods that may cause inflammation include:

Foods that may reduce inflammation include:

You may also benefit from taking vitamins or supplements if your diet is lacking certain nutrients. Make sure to consult your doctor or a nutritionist before adding vitamins or supplements to your diet. Some may interfere with the effectiveness of certain medications.

Identifying your triggers is critical for reducing or preventing symptoms of psoriasis. It may not always be possible to prevent psoriasis symptoms. But sticking to your treatment plan and avoiding triggers can help keep your symptoms to a minimum. Talk to your doctor if you need help identifying your triggers or want suggestions on how to reduce your outbreaks.

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Psoriasis Prevention