When I was young, I didn't know what the rashes on my dads' skin were. When I asked, I was told not to bother my dad, it was 'Daddy's disease' and we shouldn't ask him about it. Like it was shameful or something. Then it stared happing to me. I was getting rashes on my scalp, and on my arms. My dad wasn't a lot of help, his response was, 'well I had it, and sorry, you have it too.' I had to get answers elsewhere.
After consulting with doctors and scouring the internet, I came to the conclusion that not enough attention was being paid, not to the disease (although more could go that way) but to the people with the disease, the sufferers.
'The Heartbreak of Psoriasis'
How many times as a kid did you hear the TV ad phrase, 'Do you suffer
from the heartbreak of psoriasis'? and didn't know what it was they were talking about? well, now you know, or you wouldn't be visiting us on this site. Psoriasis is a condition that has existed, and has been written about under various names, for centuries. The condition we now call psoriasis has been described on Egyptian tablets, bible verses and mediaeval script. With all this knowledge of the age and the condition, you would think we would know more about the actual disorder.
Unfortunately, little was known about the origin of the disease for hundreds of years, and many psoriasis sufferers were thought at the time to have leprosy, of some form of a curse. Because so little was known about contraction and treatment, psoriasis patients were often separated from the general population for fear of their contaminating others. It wasn't until the early 1800's that psoriasis was determined to be a condition separate from leprosy. Soon after, the name psoriasis was given to the condition, stemming from the Greek word meaning "to itch."
After researchers began to study psoriasis as its own entity, they soon discovered that within the disease, there are multiple subsets.
• Plaque, or the most common type of psoriasis, is characterized by large patches of scaly, itchy thickened skin, or plaques, often covering large portions of the body. See image above.
• Affected by friction and sweat, flexural psoriasis most often presents itself as skin that is smooth but inflamed in the folds of skin under the arms, breasts, or around the genitals.
• The appearance of numerous, small, pear-shaped spots over the entire body following a streptococcal throat infection may be caused by guttate psoriasis.
• Postular (or pustular) psoriasis can either be concentrated in one area, such as the hands or feet, or spread over the body. The patches where it occurs are covered with small, pus-filled bumps that are often tender and painful.
• Thickening beneath either the toenails or fingernails, accompanied with change in the nails' appearance, such as lines or pitting of the nail, may be caused by nail psoriasis.
• Some who have psoriasis may also suffer from psoriatic arthritis, a condition that causes inflammation in the joints, most often those of the fingers and toes, but also afflicting other joints in the body or even the spine.
• Erythrodermic psoriasis is extremely dangerous, as most of the skin of persons with this condition is covered with painful itchy plaques, and the body is unable to regulate temperature and may be unable to protect itself from disease. This sometimes fatal form of psoriasis may be caused by volatile plaque psoriasis, especially if systemic treatment has been suddenly interrupted.
Treatments for Psoriasis
With so many different types of psoriasis and centuries of doctors studying them, there are a number of treatments available with most of the advancements made in the past century. As sufferers we know none of these are able to completely cure psoriasis, and some cause side effects almost as bad. At the PSA, we plan to push for more funding, more notice of the disease and its affect on the sufferers.
Older psoriasis treatments
As we said before, herbal salves accompanied by sun exposure were methods used by ancient cultures to bring relief to skin disease. Another topical treatment commonly used is coal tar. Coal tar is applied to the skin in order to increase sun sensitivity. Not only is this method often very messy, but the tar can discolor the skin, and may cause inflammation of areas of skin not afflicted by psoriasis. Additionally, some studies have cited coal tar as a carcinogen.
Psoriasis treatments in the 20th Century
Here we're going to have to start getting heavily medical. If I haver any of the information incorrect, let me know.
The 20th century saw a flurry of developments in psoriasis treatment. As years progressed the list of potential therapies grew, but so did the list of harmful side effects.
In the 1920's, psoriasis treatment centered around sunlight exposure, particularly the effects of UVB rays on the disease. Most often the patient applied topical treatment or salve and was exposed to sunlight, much like in ancient times. Eventually a UVB lamp was developed to provide a consistent wavelength.
Topical and oral steroids became a popular method of treatment during the 1950's, but also presenting a host of problems. These synthetic hormone-mimics are able to limit growth and inflammation of skin cells when applied to the skin. They work quickly, but need to be used often in order to retain results. Over time steroids can cause a number of problems, including cutaneous atrophy, and occasionally stretch marks develop which leave permanent scars.
Doctors in the 1960's began using hydroxyurea to treat psoriasis patients. This substance, also used in cancer treatment, is believed to inhibit the DNA replication within skin cells. Hydroxyurea may cause birth defects and can also cause a drop in white blood cells and platelets.
In the 1970's, interest in UV treatment for psoriasis was renewed. This time, however, sufferers were asked to use a method known as PUVA, or photochemotherapy. Psoriasis sufferers were given a medicine that made their skin more susceptible to light before being exposed to irradiation by UVA. This treatment not only causes premature aging of the skin, but also amplifies the risk of skin cancer.
Methotrexate, another cancer treatment, came onto the scene for psoriasis treatment in the 1990's. Methotrexate slows the growth of skin cells, but also slows the growth of other cells, such as bone marrow and sperm cells. Another potential side effect of this treatment is the potential for liver damage.
Modern psoriasis treatments
Recently, a number of new treatments have become available for psoriasis patients. Some are based on older methods of treatment, but some, like biological therapies, are new to the field of medicine altogether.
Lasers have become a new way for psoriasis sufferers to deal with flare-ups. Much in the same way that lasers are used to alleviate the signs of aging or redness, areas of skin affected by psoriasis lesions are targeted by a beam of intense UV light. This method of treatment is suggested only to those with mild cases, and occasionally scarring may occur.
A treatment which is new for psoriasis as well as in the medical community is the administration of biological therapies. Biological therapies are injected into patients suffering from more advanced psoriasis symptoms. Biologicals target and block specific immune cells within the body. Several biological treatments are currently available, and more are in development. Currently they appear to be a relatively safe treatment method, yet studies are still being conducted to determine potential side effects.
Cyclosporin, tioguanine, and retinoid drugs are just a few of the systemic treatments offered to treat severe psoriasis cases. Cyclosporin works by suppressing the immune system, while tioguanine, which is often used to treat leukemia, prevents cell growth and division. Retinoids are very potent synthetic forms of vitamin A. Due to the high toxicity and side effects of these medications, patients must be monitored frequently for distress in the liver and kidneys, and women using this method of treatment are discouraged from becoming pregnant during treatment due to high risk of birth defects.
While psoriasis is not curable at this time, there are treatment for it. It may sound corny, but there cause for hope for the sufferer. On the rest of the site, we'll outline causes/treatments/risks and the things you can do yourself to help in your treatment.
Stats
Here are a few stats to keep in mind about psoriasis.
- Psoriasis is the most prevalent autoimmune diseases in the U.S.
- According to the National Institutes of Health (NIH), as many as 7.5 million Americans—approximately 2.2 percent of the population--have psoriasis.
- 125 million people worldwide—2 to 3 percent of the total population—have psoriasis.
- Studies show that between 10 and 30 percent of people with psoriasis also develop psoriatic arthritis.
- Psoriasis prevalence in African Americans is 1.3 percent compared to 2.5 percent of Caucasians.
More updates as more information becomes available. Please check out the rest of the site and let us know what you think!
-Robert Newcastle, President, PSA.