Psoriasis is a chronic skin disease in which skin cells multiply too quickly due to false signals in the immune system. It is distinguished by sharply circumscribed pink-red plaques, which are mother-of-pearl-like white-gray scales that give a typical appearance in the compression/impact areas of the skin. It may continue for years, but it is very mild in 75% of patients. Psoriasis progresses with exacerbations seen in 1-3 of every 100 people. It is seen equally in both sexes, it can occur at any age, but it starts a little earlier in women. It occurs most frequently in the 20-year-old age group. Psoriasis begins before the age of 40 with a rate of 75%, the age of 50-60 is an important period for psoriasis.
What are the Causes of Psoriasis?
Although the exact cause is unknown, environmental factors in genetically susceptible individuals It is thought to occur when the immune system unusually affects epithelial cells. Environmental factors such as microbial diseases (throat infection, etc.), drugs, stress, mechanical irritation (rubbing, scratching) or sunburn may have an increasing effect.
Although there is a genetic predisposition, it is not seen in every member of the family. Environmental factors may increase the incidence of the disease.
Psoriasis is estimated to affect 125 million people worldwide. One third of the cases have psoriasis in their first-degree relatives. If a single parent has psoriasis, the risk for the child is 14%, and if a double parent has psoriasis, it is 41%.
Psoriasis occurs more rarely in children. It occurs before the age of 10 in 10% of the pediatric patients and before the age of 2 in 2% of them. It is thinner and lighter crusted, more itchy. It settles on the face, scalp and folds. It can affect the gland area and armpit. /h2>
The most typical symptoms of psoriasis are sharply circumscribed, vivid red-colored lesions with mother-of-pearl crusts, which give the disease its name, especially in places such as knees and elbows. These lesions also have scalp i, nails, genital area can also occur. It does not cause baldness, but if the disease is severe, it can increase hair loss.
Psoriasis can only affect the nail. The most common findings are pinhead-sized pits, thickening of the nail, discharge, and yellow discoloration. Sometimes swelling and redness may develop around the nails. Therefore, it is also important to detect and treat accompanying diseases during the follow-up and treatment of patients.
Also, the disease rarely affects the joints. Swelling and pain occur in the joints in 30% of the cases. Psoriatic arthritis needs effective treatment because it causes joint damage and chronic pain. Joint pain with increased warmth, redness and swelling in the joint, morning stiffness with back pain and lasting for an hour or more, and limitation of movement of the joints are the main symptoms of psoriatic arthritis. is not. If it is not typical, a skin biopsy may be required to distinguish it from other skin diseases that may be confused.
Blood analysis may be required to investigate the factors that may increase its severity and to use safe drugs before some treatments. People with severe psoriasis can be followed up in terms of metabolic diseases, diabetes, cardiovascular diseases. Obesity and bowel disease may sometimes accompany it.
From Which Diseases Psoriasis Should Be Differentiated?
- Rapes and eczema: Most commonly, typically on the knee and elbow, on the scalp, on the waist sharply circumscribed oval-shaped plaques with pink red white pearlescent scaling are formed. Sometimes, similar lesions occur without scaling in areas such as the groin, armpits and under the breasts in the folds, and should be differentiated with diaper rash and eczema.
- Fungal disease: It can only be seen on the soles of the palms of the feet, it can be confused with fungal disease.
- Upper respiratory tract infection Rashes due to skin rashes: Small red flaking plaques in the form of drops on the trunk, arms and legs may appear suddenly after upper respiratory tract infection in children and adolescents, and regress more quickly with appropriate treatment.
- Other rash diseases: Palms in a certain area Psoriasis can be seen in the form of a pimple-like rash on the red soles of the feet or in the form of acne-like rashes on a widespread red plaque all over the body. Less commonly, it may be widespread throughout the body.
- Nail disorders: Tiny pits, separation, yellowish staining, and thickening of the nail plate may be seen on the nails. visible. Most commonly, the hand finger joint and lumbar region are involved. If there is low back pain, morning stiffness, swelling and redness in the joint area, joint psoriasis is investigated.
How to Treat Psoriasis?
Psoriasis is a lifelong disease. . It can be kept under control with precautions and appropriate treatment.
Psoriasis can cause social and psychological problems in the person. Therefore, it is very important to recognize the disease and to avoid triggers. Early diagnosis will make it easier to control the disease. If the lesions involve more than 10% of the skin, phototherapy or systemic treatment is absolutely necessary. Being content with creams only creates difficulties in disease control and is not helpful in preventing diseases that may accompany. The same treatment is not used for every patient. Treatment is planned with a certain algorithm.
The extent of the disease, the age of the patient, compliance with the treatment, the previous drugs are important in the choice of treatment. In a limited area, creams and moisturizers are used. If there is more widespread disease, phototherapy, drugs containing synthetic vitamin A, some cancer drugs and biological treatments are used in patients with joint disease or resistant patients at a later stage, even though they do not have cancer. important developments treatment expectations increased from 50% to 90%. With treatment, skin symptoms can disappear completely without leaving a trace. With appropriate treatments, periods of well-being, which are almost asymptomatic, can be experienced. In addition to medical treatment, it is important to eat a healthy diet for life in chronic diseases. Apart from this, there is no special diet directly related to the disease. Unnecessary food bans should be avoided. In addition, quitting smoking, reducing alcohol consumption and regular exercise are essential.
Frequently Asked Questions in Psoriasis
1) Is psoriasis contagious?
Psoriasis is definitely not contagious and does not constitute an obstacle to maintaining a normal life. It is not possible to get psoriasis by touching a psoriasis patient, using common items, swimming in the same pool or having close relationships.
2) Does stress increase psoriasis?
As with all immune system diseases, stress is among the triggers of psoriasis. A vicious circle can be mentioned between psoriasis and stress. There are other triggers such as some drugs, infections, extreme ultraviolet, hormonal changes. With the suggestions of such people, patients may turn to herbal treatments instead of drugs. Moreover, the patient's pocket sometimes costs more for herbal treatment than the medicine. Please do not apply all the information about the treatment without consulting your dermatologist and get information about the treatment options. Any method that is far from scientific evidence should not be used in the treatment of the disease. On the contrary, these methods can sometimes worsen the situation. Do not forget that; Controlling the disease is only possible with a good communication with your doctor.
3) Are the drugs used in the treatment of psoriasis strong?
In mild cases, it is possible to apply drugs in the form of creams externally. If the lesions of Psoriasis are more than 5% of the body If it has spread to the skin, different treatment options other than cream may be required. If the treatment is delayed, the risk of different diseases such as joint, heart, metabolic syndrome and obesity may increase over time.
There are very new treatments aimed at correcting the immune mechanism. There is no reason to be hopeless. In the treatment of psoriasis, the compliance of the patients and the care they will show are also very important. For example, patients generally stop using the drug when the lesions subside. However, it is very important to use the drug regularly.
4) Can psoriasis patients go out to the sun?
Excessive sun is harmful for these patients. It is possible to go out to the controlled sun at certain times in the morning and evening. Too much of it triggers the disease negatively.
5) Is psoriasis related to nutrition?
The structure in psoriasis is very interesting; It's not just a skin disease. The disease starts in the skin, but there is a risk of obesity. In these patients, the secretion of a chemical called TNF (tumor necrosis factor) is high. TNF is also secreted in the adipose tissue and causes the lesion to become active.
Psoriasis patients should have a healthy lifestyle. As it applies to all of us, exercise and proper nutrition are important for these patients.
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