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Psoriasis: Effects Don’t Always Stop with the Skin

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www.ProHealth.com • December 29, 2009


"About one in four people with psoriasis develop a form of arthritis called psoriatic arthritis."

Psoriasis, a chronic disease that causes red, raised patches of skin, is increasingly seen as a systemic disease with links to arthritis and cardiovascular disease. The December issue of Mayo Clinic Women’s HealthSource* provides an overview of this sometimes embarrassing condition, what’s known about it, and how it’s treated. [See also the Psoriasis info subsite at MayoClinic.com.]

Highlights of the overview include:

Symptoms:
Patches of thick, red skin covered with silvery, flaky scales commonly appear on the elbows and knees, but can appear anywhere on the body.

They result from skin cells on overdrive, reproducing much faster than normal. Doctors aren’t sure why this overproduction occurs, although genetic and environmental factors likely play roles.

Psoriasis symptoms come and go and flare in response to triggers that can include infections, some medications, alcohol, smoking, stress, sunburn, skin irritation or injury.

A systemic illness:
Doctors are finding that psoriasis is more than a skin disorder. About one in four people with psoriasis develop a form of arthritis called psoriatic arthritis  that can cause pain, stiffness and swelling in the joints. [Note: Nutritional supplements that MayoClinic.com suggests “have been shown to be helpful for some people with psoriatic arthritis,” include vitamins and minerals, glucosamine & chondroitin, and fish oil.]

Studies have shown that people with psoriasis face a higher risk of heart attack, stroke and other cardiovascular problems.

The underlying link may be chronic inflammation, which plays a role in psoriasis and heart disease.

Treatment:
While psoriasis can’t be cured, a variety of topical and systemic treatment options can help control the condition. For mild-to-moderate psoriasis, topical treatments often are effective. Options include:

• Corticosteroids or retinoids to reduce inflammation;

• Vitamin D analogs to slow skin growth [synthetic forms of vitamin D3 to be applied topically, such as Dovonex, generic name calcipotriene];

• And tar, to reduce scaling, itching and inflammation.

• Calcineurin inhibitors (tacrolimus and pimecrolimus) can help reduce inflammation and skin cell buildup.

• In addition, ultraviolet light [part of sunlight, or obtained from a lamp] slows the rapid growth of skin cells. Ultraviolet light therapy may be used alone or in combination with other treatments.

Several systemic medications are used for severe forms of psoriasis, though these options pose the risk of serious side effects.

Self-help measures:

• Home-care measures can help prevent or manage symptoms. A daily bath removes scales and calms inflamed skin. Adding bath oil, colloidal oatmeal, Epsom salts or Dead Sea salts can offer additional relief.

• After bathing, applying a thick moisturizing cream or ointment, such as petroleum jelly, can be helpful. During cold, dry weather, it’s beneficial to apply moisturizer several times a day.

• Short sessions in sunlight three or more times a week can improve psoriasis, as can avoiding known triggers.

____
* Citation: Mayo Clinic Women’s HealthSource is published monthly. Revenue from subscriptions is used to support medical research at Mayo Clinic.

Source: Mayo Clinic news release, Dec 29, 2009




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