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What to know about psoriasis

A psoriasis patient uses anti-inflammatory ointment to relieve symptoms. According to government data, 163,531 people were treated for psoriasis in 2018. /Gettyimagesbank
A psoriasis patient uses anti-inflammatory ointment to relieve symptoms. According to government data, 163,531 people were treated for psoriasis in 2018. /Gettyimagesbank

By Bahk Eun-ji

Psoriasis is a chronic inflammatory skin disease with a genetic basis, but environmental triggers often make symptoms of the disease flare up.

Skin cells of psoriasis patients proliferate up to 10 times faster than normal. The main symptoms of psoriasis are red, flaky, crusty patches and slivery scales covering them. It also causes intense itching or burning sensations.

Patients who have recovered still have a high chance of recurrence over their life time.

According to data from the National Health Insurance Service (NHIS), 163,531 people were treated for psoriasis in 2018. The number of patients treated for the skin disease has been around 160,000 annually for the last five years since 2014.

"Unlike some other skin conditions such as scabies and impetigo, psoriasis is not contagious. It isn't caused by contagious bacteria or another type of infection, but it is often a lifelong condition that requires a long-term treatment," said prof. Cho Nam-joon of NHIS Ilsan Hospital.

Psoriasis is an autoimmune disease. It means people must have specific genes to develop the disease, but having the gene doesn't necessarily mean developing the disease.

"Patients do have to have those genes. However, environmental factors generally activate the condition," Cho said.

Causes

The exact cause of psoriasis is not fully known, but scientists believe that it is a kind of autoimmune disease.

While the immune system produces T cells that travel through the body to protect the body against infectious agents such as viruses or bacteria, the T cells of psoriasis patients attack healthy skin cells by mistake, as if to heal a wound or to fight the infection. Normally, skin cells are replaced every 10 to 30 days, but with psoriasis, new cells grow every three to four days. The buildup of old cells being replaced by new ones creates those silver scales.

Psoriasis triggers

Many environmental and lifestyle factors may trigger psoriasis, although not everyone with the illness has the same triggers.

The factors include: infections such as strep throat or skin infections; injury to the skin such as a bug bite or severe sunburn; stress; smoking; heavy alcohol consumption; vitamin D deficiency; and certain medications including lithium prescribed for bipolar disorder as well as high blood pressure medications such as beta blockers, antimalarial drugs and iodides.

Smoking doesn't just trigger psoriasis but could increase the severity of the disease.

Experts said smoking may cause one in five cases of psoriasis and doubles the risk of getting the condition. This may be due to the effects of nicotine on skin cells, skin inflammation, and the immune system.

Although some say that allergies and certain foods can trigger psoriasis, these claims are mostly anecdotal.

Treatment

Despite the fact that psoriasis is incurable, it responds well to many topical and systemic treatments. Even people with severe cases of psoriasis can get relief during flare-ups in most cases.

When a doctor confirms psoriasis, treatment will depend on the type and seriousness of the condition. The main options include medications and phototherapy.

People with psoriasis should use emollients to keep the skin moisturized. The emollients can help reduce the itching and irritation and may reduce the number of lesions.

Patients can rub the emollients directly into the affected skin to bring local relief without major side effects. Some doctors recommend salicylic acid ointment which soothes the skin by promoting the shedding of psoriatic scales. However, using salicylic acid may cause the body to absorb too much of the medication, leading to side effects.

Using steroid creams decreases inflammation, relieve itching, and block the overproduction of cells. But such creams are strong and can cause side effects that include burning, dryness, irritation, and thinning of the skin.

Even regular doses of sunlight can help psoriasis lesions in many people. For persistent, difficult-to-treat cases of psoriasis, many doctors recommend light therapy such as ultraviolet B light (UVB) and narrow-band UVB therapy.


A psoriasis patient uses anti-inflammatory ointment to relieve symptoms. According to government data, 163,531 people were treated for psoriasis in 2018. /Gettyimagesbank
A psoriasis patient uses anti-inflammatory ointment to relieve symptoms. According to government data, 163,531 people were treated for psoriasis in 2018. /Gettyimagesbank

By Bahk Eun-ji

Psoriasis is a chronic inflammatory skin disease with a genetic basis, but environmental triggers often make symptoms of the disease flare up.

Skin cells of psoriasis patients proliferate up to 10 times faster than normal. The main symptoms of psoriasis are red, flaky, crusty patches and slivery scales covering them. It also causes intense itching or burning sensations.

Patients who have recovered still have a high chance of recurrence over their life time.

According to data from the National Health Insurance Service (NHIS), 163,531 people were treated for psoriasis in 2018. The number of patients treated for the skin disease has been around 160,000 annually for the last five years since 2014.

"Unlike some other skin conditions such as scabies and impetigo, psoriasis is not contagious. It isn't caused by contagious bacteria or another type of infection, but it is often a lifelong condition that requires a long-term treatment," said prof. Cho Nam-joon of NHIS Ilsan Hospital.

Psoriasis is an autoimmune disease. It means people must have specific genes to develop the disease, but having the gene doesn't necessarily mean developing the disease.

"Patients do have to have those genes. However, environmental factors generally activate the condition," Cho said.

Causes

The exact cause of psoriasis is not fully known, but scientists believe that it is a kind of autoimmune disease.

While the immune system produces T cells that travel through the body to protect the body against infectious agents such as viruses or bacteria, the T cells of psoriasis patients attack healthy skin cells by mistake, as if to heal a wound or to fight the infection. Normally, skin cells are replaced every 10 to 30 days, but with psoriasis, new cells grow every three to four days. The buildup of old cells being replaced by new ones creates those silver scales.

Psoriasis triggers

Many environmental and lifestyle factors may trigger psoriasis, although not everyone with the illness has the same triggers.

The factors include: infections such as strep throat or skin infections; injury to the skin such as a bug bite or severe sunburn; stress; smoking; heavy alcohol consumption; vitamin D deficiency; and certain medications including lithium prescribed for bipolar disorder as well as high blood pressure medications such as beta blockers, antimalarial drugs and iodides.

Smoking doesn't just trigger psoriasis but could increase the severity of the disease.

Experts said smoking may cause one in five cases of psoriasis and doubles the risk of getting the condition. This may be due to the effects of nicotine on skin cells, skin inflammation, and the immune system.

Although some say that allergies and certain foods can trigger psoriasis, these claims are mostly anecdotal.

Treatment

Despite the fact that psoriasis is incurable, it responds well to many topical and systemic treatments. Even people with severe cases of psoriasis can get relief during flare-ups in most cases.

When a doctor confirms psoriasis, treatment will depend on the type and seriousness of the condition. The main options include medications and phototherapy.

People with psoriasis should use emollients to keep the skin moisturized. The emollients can help reduce the itching and irritation and may reduce the number of lesions.

Patients can rub the emollients directly into the affected skin to bring local relief without major side effects. Some doctors recommend salicylic acid ointment which soothes the skin by promoting the shedding of psoriatic scales. However, using salicylic acid may cause the body to absorb too much of the medication, leading to side effects.

Using steroid creams decreases inflammation, relieve itching, and block the overproduction of cells. But such creams are strong and can cause side effects that include burning, dryness, irritation, and thinning of the skin.

Even regular doses of sunlight can help psoriasis lesions in many people. For persistent, difficult-to-treat cases of psoriasis, many doctors recommend light therapy such as ultraviolet B light (UVB) and narrow-band UVB therapy.


Bahk Eun-ji ejb@koreatimes.co.kr


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