Category Archives: Psoriasis

Q: One of the two people from Pangasinan who were reported by a radio-TV network to be afflicted with a flesh-eating disease was actually suffering from psoriasis according to the Department of Health. What is psoriasis? Is it contagious? elena623@gmail.com

A: Psoriasis is an autoimmune disease that primarily affects the skin. It afflicts two to four percent of the population, mainly adults. Although rather common, the disease is little understood by the public.

The typical skin lesions of psoriasis consist of red and well-demarcated patches that are often covered by silvery scales. The lesions can occur anywhere, but usually the skin areas that are affected are those on the elbows, knees, lower back, and buttocks. It is, however, not unusual for lesions to develop on the scalp, genitalia, and even the face. Occasionally, the nails also get involvedthey thicken and deform. As a rule, psoriasis affects only the skin although occasionally, it complicates and produces swelling and pain in some joints (psoriatic arthritis).

In psoriasis, the area of skin involved can vary from a few small spots to nearly complete body coverage. When only small areas are involved, there is usually no accompanying sign or symptom, except for occasional itchiness and soreness. Extensive body coverage, however, is invariably accompanied by itchiness, tenderness, and/or bleeding. The physical discomforts associated with psoriasis are generally tolerable, but the skin rashes are unsightly and often cause embarrassment and psychological distress.

Psoriasis is not an infection, thus it is not contagious. It is caused by a malfunction of the bodys immune system that results in the proliferation and abnormal maturation of the cells of the skin, that is accompanied by inflammation and abnormalities of the blood vessels. Psoriasis runs in families and researchers have already identified genes that are linked to the disease.

Once it has appeared, psoriasis persists for life, although in most people, appearance of the skin lesions(called a flare-up) is followed by a prolonged period of remission that last for months to years. Flare ups can be precipitated by intake of drugs like lithium and beta-blockers (used in hypertension), stress, alcohol, injury or physical irritation of the skin and upper respiratory tract infection, but some occur spontaneously. Sunburn exacerbates psoriasis, although moderate exposure to sun is beneficial.

There is no cure for psoriasis yet, but it is controllable. A variety of treatment regimens that relieve the active skin lesions are available, but none is consistently effective in inducing long-term remissions. Furthermore, a regimen that works in one person may have little effect in another. Often, a regimen that works is found only after a series of trial and error attempts.

In general, initial treatment of psoriasis involves application of a topical medicine, which could be a steroid preparation, retinoid (synthetic vitamin A), dithranol, calcipotriol (a vitamin D analog), anthralin, or coal tar.

For extensive psoriasis and those unresponsive to topical treatment, exposure of the affected areas to ultraviolet (UV) light with or without topical or oral Psoralen is employed.

Flare ups that are refractory to topical and UV therapy necessitate use of systemic drugsnonbiologics and biologicsthat are given by injection or IV infusion. Nonbiologics drugs such as cyclosporine and methotrexate suppress the immune system in general while biologics such as infliximab, adalimumab, and golimumab are protein-based drugs derived from living cells cultured in a laboratory that target specific agents of the immune system that contribute to psoriasis.

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