"My daughter is in her 20s and has just been diagnosed with psoriasis. Can you give me some information about this?" - Anne
Psoriasis is a chronic, autoimmune condition, typified by dry, scaly, red patches of skin. It is less common than eczema, but still affects around 2-3 per cent of New Zealanders. It causes significant physical and psychological distress, and in severe cases can be quite debilitating.
Psoriasis can occur at any age, but is typically diagnosed either in the teen years, or later on in middle age. It affects males and females equally, and there is a genetic link, with a third of patients also having an affected relative.
Psoriasis is an autoimmune condition, which means that for some reason the body's immune system attacks and destroys healthy body tissue, in this case primarily the skin cells. It can be associated with other autoimmune conditions such as diabetes, and up to 25 per cent of patients with psoriasis will also suffer from a related form of arthritis.
Although you can't avoid "getting" psoriasis, there are known factors that will aggravate the condition and make your symptoms worse. These include:
* Smoking
* High alcohol intake
* A diet high in sugar
* Certain medications, including beta blockers and lithium
* Stress.
In fact the link with emotional stress is so strong that on some occasions people will have no symptoms at all until a stressful event triggers a flare-up, and once their stress is under control their psoriasis may all but disappear.
There are several different types of psoriasis, and the symptoms can vary depending on which type you have. However, in classical cases of psoriasis the following may occur:
* Distinct raised patches of overgrown, red, dry, scaly skin; these can get quite flaky and cause severe itching. They can occur anywhere, but typically are found on the elbows, knees, scalp and in the "flexures" such as underneath the breasts, in the armpits and groin
* The amount of skin affected varies hugely – in mild cases, there may just be one or two small plaques, but in severe cases most of the body can be involved
* In nail psoriasis, finger and toenails can become pitted and fragile
* For people who develop arthritis with their psoriasis, the symptoms include pain, swelling and stiffness in joints and surrounding tissues
* Many people with psoriasis, especially those with severe forms, will have low self-esteem, and anxiety around their body image – in more extreme cases, this can lead to depression.
In terms of treatment options, it will depend a little on what type of psoriasis your daughter has, and how severe it is. Milder forms respond to topical treatments including:
* Emollients – regular use of a thick emollient or moisturiser, such as fatty cream or cetomacrogol, can be a really good way to prevent cracking and irritation of the skin. Substances like urea or salicyclic acid are known as "keratolytics" – they break down the scaly plaques and can be added to these moisturisers to make them more effective.
* Tar products – using either coal or pine tar products, especially in the bath or shower can be an effective way to reduce the itching and discomfort.
* Corticosteroid ointments – steroids can be very useful in managing the symptoms of psoriasis, but need to be used sparingly as they can cause long-term damage to the skin; milder steroids such as hydrocortisone can be used on the face, but stronger versions (such as betnovate or dermol) are only suitable for use elsewhere on the body, and in short courses to reduce the potential harm.
* Vitamin D analogues – calcipotriol or Daivonex works by reducing the thickness of the scale, although the redness tends to remain; they need to be used sparingly as they can be toxic if the weekly total dose is exceeded.
* For scalp psoriasis, shampoos such as ketoconazole or steroid -based products such as betnosol can be good for symptom relief.
If your daughter's psoriasis is severe or not responsive to any of these topical treatments, she may require either phototherapy (where UV light is used to reduce the psoriatic plaques) or an oral medication.
These would usually be prescribed by a dermatologist, so ask your GP for a referral to a specialist if needed. Be mindful too that your daughter may be struggling with her condition, so don't hesitate to offer extra support or ask your GP about any local groups that might be helpful.
http://www.stuff.co.nz/life-style/well-good/teach-me/82529253/what-is-psoriasis-and-what-you-can-do-about-it
No comments:
Post a Comment