Let’s Talk About the Types of Psoriasis

From healthcentral.com

There are multiple forms of this scaly skin condition, and which one you have will determine the treatment you receive.

With 125 million people in the world who have psoriasis, chances are you know someone who has the condition. But what you may not know is that there are several types of the chronic skin disease. They tend to get lumped in with the most common one: plaque psoriasis, which accounts for a whopping 80% of all cases. But there are six others that look, act, and may even be treated differently than the rest. Knowing which one you have can help you get better, faster.

What Is Psoriasis, Again?

Red, scaly, painful patches or bumps on your skin are the telltale signs of this inflammatory skin condition. It happens when your skin cells turn over at a way-too-fast rate (10 times faster than normal), causing a pile up of cells on the skin’s surface that form those angry, red patches, or plaques. Why this happens isn’t so clear, but researchers believe psoriasis is caused by a mix of genetics, an overactive immune system, and triggers such as bacterial infection, skin trauma, smoking, medications, and obesity, just to name a few.
As we mentioned above, there are seven different types of psoriasis:

• plaque psoriasis
• scalp psoriasis
• nail psoriasis
• guttate psoriasis
• inverse psoriasis
• pustular psoriasis
• erythrodermic psoriasis

There’s also psoriatic arthritis, a combo of psoriasis and arthritis. Here’s what you need to know about the causes and treatments for each one.

What You Should Know About Plaque Psoriasis

This is the type you’re probably thinking of when someone mentions psoriasis. It’s characterized by clearly demarcated, raised, red, scaly patches called plaques that appear most commonly on your elbows, knees, scalp, and back (but they can pop up anywhere on the body).
Because it accounts for 80% of all cases, plaque psoriasis tends to get the most press. It’s the type addressed in most psoriasis drug commercials, and celebs including reality star Kim Kardashian and singer Cyndi Lauper have both been vocal about being plagued with plaques.

What Causes Plaque Psoriasis?

The cause for all cases of psoriasis stems from a combo of genetics, immune dysfunction, and triggers. People who have psoriasis are also more likely to have other inflammatory diseases such as Crohn’s disease, heart disease, or diabetes, suggesting some link between the underlying inflammation.
A study in Archives of Dermatology that looked at over 100,000 patients with psoriasis found those with severe psoriasis had a 46% greater chance of having diabetes than those without the skin disease.

How Do You Treat Plaque Psoriasis?

There are several treatments that target plaques. Your physician will decide which one is right for you based on your general health, any underlying conditions, and the severity of your plaque psoriasis. Your options include:

• Topical ointments and creams such as cortisone cream, oral or injectable corticosteroids
• Light therapy (phototherapy)
• Systemic drugs such as Gengraf and Sandimmune (cyclosporine) and Rasuvo and Rheumatrex (methotrexate)
• Biologic medications, which are made from living organisms and work by slowing down your overactive immune system

Research suggests that biologics for psoriasis might help with those other inflammatory diseases linked to the skin condition, too. A study in Cardiovascular Research found that treating psoriasis with biologics helps reduce the plaque build-up in the arteries, which leads to heart attacks and strokes.
However, once your skin plaques disappear, you’re not necessarily in the clear. Exposure to your triggers can bring on a new bout of plaque psoriasis. Only 10% of people are lucky enough to have what’s called “spontaneous remission,” when your skin clears up forever and you never have a flare up again.

What You Should Know About Scalp Psoriasis

If you’re scratching your head over an itchy scalp condition that won’t clear up with a traditional dandruff shampoo, you may have scalp psoriasis. This type can go hand-in-hand with plaque psoriasis (see above), or even appear in those who don’t have any history of the skin disorder at all.

It’s often confused with dandruff, because, well, it itches and causes flakes, only these flakes are typically silvery-white and scaly. You might also have painful red scales or silver plaques on your head. In severe cases, scalp psoriasis appears as thickened, crusty patches of skin not only on the hairline, but also on the forehead, back of the neck and near the ears.

What Causes Scalp Psoriasis?

Unlike dandruff, scalp psoriasis doesn’t come and go with the weather, hormonal fluctuations, or changes in hair products. The cause is the same as other types of psoriasis: an overactive immune system, genetics, and triggers such as stress and certain medications. But in this case, the plaques that show up may only show up on your scalp.

How Do You Treat Scalp Psoriasis?

Mild cases can be nipped in the bud or improved with salicylic-, coal-tar-, or clobestasol propionate-containing (a topical steroid) shampoos. More severe cases may require systemic or biologic drugs, oral treatments, light therapy, or a combination of treatments. Unfortunately, you may lose some hair with some of these treatments, which is usually temporary.

What You Should Know About Nail Psoriasis

If you’ve “nailed it” with psoriasis, then you know all too well that this type brings pitted, discoloured, thickened, and even deformed fingernails and/or toenails. In severe cases, the nail plate can lift from the nail bed and you may see some gunk or even blood in between.

What Causes Nail Psoriasis?

Of all the people who have some type of psoriasis, up to 50% will also have nail psoriasis. Like scalp psoriasis, it often comes along with plaque psoriasis, but it can also accompany other types or appear all on its own, too. Those with psoriatic arthritis will have an 80% chance of having nail psoriasis, too.

The same underlying causes as plaque psoriasis are at play here, too, revving up your skin cell production. Nails are considered part of the skin (they’re literally made up of skin cells), which is why they are also affected by the disease.

How Do You Treat Nail Psoriasis?

Typically, mild cases are treated with topical ointments rubbed into the nails such as:

• corticosteroids
• calcipotriol
• a vitamin D derivative
• a topical retinoid such as tazarotene

More severe cases might require:

• phototherapy
• an immune suppressing oral medication
• a biologic injection or intravenous infusion

What You Should Know About Guttate Psoriasis

This type doesn’t bring large plaques, but instead little red bumps smaller than a fingertip. You can wind up with hundreds of them scattered on your arms, legs, and torso.
About 10% of all psoriasis cases are the guttate type. You can have a mild case with just a few spots in one area, a moderate case that covers up to 10% of your body, or a severe breakout that leaves most, or even all, of your body covered in bumps.

What Causes Guttate Psoriasis?

This type often stems from a bacterial infection such as strep throat, an upper respiratory infection, or tonsillitis. There is also a genetic component. If a family member has had guttate psoriasis, you’re more likely to get it, too.

How Do You Treat Guttate Psoriasis?

Because guttate psoriasis is commonly triggered by infections, once you treat the infection, the psoriasis usually goes away, too. If the skin condition lingers, or you have a severe case, your physician may want to treat your symptoms with topical steroids and/or phototherapy, artificial UVB light that halts the inflammatory process.

What You Should Know About Inverse Psoriasis

This type affects fewer than 10% of people with psoriasis. It’s called “inverse” psoriasis because it appears in unusual places such as the groin, armpits, bellybutton, genitals, under the breasts and behind the knees. Often, it’s accompanied by one of the other types of psoriasis listed here.

What Causes Inverse Psoriasis?

The same underlying culprits can lead to this type, only it’s brought on by sweat and friction. That’s why it’s commonly found in areas where there is skin-to-skin rubbing and moisture. Weight seems to be a factor, too. If you’re overweight, you’re more likely to have skin folds, prime spots for inverse psoriasis.

How Do You Treat Inverse Psoriasis?

The gold standard is typically topical steroids and ointments in those vulnerable spots where moisture and friction are likely. If those don’t work, phototherapy, and systemic treatments are an option.

What You Should Know About Pustular Psoriasis

As the name implies, this type causes pus-filled bumps. These white spots can appear anywhere on your body, but most commonly the hands and feet. The bumps come on suddenly and look infected, but they’re not.

The real danger here is damage to the skin’s barrier, the outermost protective layer of your skin. That means your skin can’t retain water or nutrients, while also allowing bacteria and other irritants to get a fast pass into your body. As a result, in some cases, pustular psoriasis can be deadly, so make an appointment with your doctor asap, if you develop it.
There are a few sub-types of pustular psoriasis:

• Von Zumbusch: This form features pustules that appear and then dry up, leaving skin with a glazed look.
• Palmoplantar pustules: This version shows up on the palms of your hands and the soles of your feet.
• Acropustulosis: This type is characterized by pustules that burst and ooze. In severe cases, this type can cause bone or nail deformity.

What Causes Pustular Psoriasis?

At the risk of sounding like a broken record, genes are to blame. But researchers have dug deeper and discovered a specific gene mutation that may be responsible for pustular psoriasis.

A study in the American Journal of Human Genetics ID’d the gene AP1S3. If you have this particular genetic predisposition, the triggers for pustular psoriasis are often infection, stress, hormonal changes such as pregnancy, and exposure to chemicals. Also, certain drugs such as OTC pain relievers and anti-inflammatory drugs, penicillin, and some antidepressants such as lithium can trigger a flare. Stopping a course of steroids too fast can bring on a flare of pustular psoriasis, too.

How Do You Treat Pustular Psoriasis?

Your doctor may prescribe a topical retinol or an immune-suppressing biologic such as Remicade (infliximab) to calm inflammation and stop the bumps. In severe cases, you may get a combo of a biologic and an oral immune-calming med such as Trexall (methotrexate) to get it under control.

What You Should Know About Erythrodermic Psoriasis

The rarest of all psoriasis types, erythrodermic psoriasis affects only 2% of those with psoriasis. This type causes redness from head to toe, as if your skin has been burned. Even worse, it’s possible that your skin could peel off in sheets.
As with the pustular type, erythrodermic psoriasis severely compromises the skin’s protective barrier, so swift medical attention is a must. You can also develop fever, chills, swollen, painful joints, and rapid heart rate.

What Causes Erythrodermic Psoriasis?

This type can be triggered by a bad sunburn, an infection, drug reaction, stopping a medication too abruptly, steroid use, stress, and alcoholism.

How Do You Treat Erythrodermic Psoriasis?

Your doctor will likely start with an immune suppressant. To soothe your sore skin, you may be prescribed topical steroids, itch-suppressing medications, or prescription pain treatments.

What You Should Know About Psoriatic Arthritis?

An estimated 30% of people with psoriasis also have or will develop psoriatic arthritis, or PsA, a chronic autoimmune condition that affects 2-3% of the population. While psoriasis affects the skin, psoriatic arthritis affects the joints and some parts of the body where ligaments and tendons are attached to the bone, particularly in the fingers, toes, wrists, knees and spine. The result is stiffness, swelling, pain and, if not caught early, irreversible damage, which is why early diagnosis and treatment are important.

What Causes Psoriatic Arthritis?

PsA is an autoimmune disease. That means your immune system gets its messages mixed up and attacks healthy tissue, in this case, of your skin and joints. You’re also more likely to develop PsA if you have a family history of it (40% of people who have it also have a family member who has it, too), you already have psoriasis, and you’re between the ages of 30 and 50.

How Do You Treat PsA?

If you have this condition, you’ll want to see a rheumatologist, a doctor who specializes in arthritis. Treatments can range OTC non-steroidal anti-inflammatory drugs (NSAIDs) such as Advil (ibuprofen) to disease-modifying anti-rheumatic drugs (DMARDs), including methotrexate, that work by slowing your immune system and your body’s inflammatory response. If those don’t work, biologics may be considered.

https://www.healthcentral.com/condition/types-of-psoriasis

Psoriasis and Diet: What's the Link?

From healthcentral.com

A new study says foods commonly eaten in the U.S. may play a bigger role in the skin disease than previously thought

Scientists have long known that obesity and psoriasis go hand-in-hand. Like chips and salsa or gin and tonic, if you have one disease, you’re likely to have the other. The reason is that a high BMI can lead to inflammation in the body, which increases the risk for developing the challenging skin condition known as psoriasis—or worsening existing symptoms if you already have it. Now, a new study published in the Journal of Investigative Dermatology suggests there may be another mechanism at work: Fat cells themselves may not be the culprits, say researchers, but rather specific types of foods are to blame.

In the study, conducted at the University of California, two groups of mice were fed different diets. Once group got a typical mouse meal; the other one was given a characteristic “Western diet” (basically, the mouse equivalent of a moderate-to-high fat, processed-sugar diet that mimicked what humans would eat on the same meal plan). The mice kept it up for four weeks, after which scientists took stock of their skin, and found that the creatures who’d been chowing on the rodent version of burgers, fries, and shakes showed visible inflammatory changes including redness, scales, and thickened skin—the same hallmark symptoms consistent with human psoriasis—even if the mice hadn’t appreciably gained weight.

“This is important because many people think that it’s obesity alone that leads to the increased risk for psoriasis,” says senior study author Sam T. Hwang, M.D., Ph.D., department chair and professor of dermatology at the University of California Davis School of Medicine. “What this shows is that dietary changes can have a radical impact on the skin—so it’s not just weight that makes a difference for developing psoriasis, but the types of foods you eat.”

These so-called “Western” foods are typically high in saturated fat (butter, red meat, cheese and other dairy products made from whole milk, for example), plant-based oils (such as palm oil, coconut oil, and canola oil) and processed ingredients, like those in many baked goods. The foods also contain high levels of simple sugars, found in fruit juices, soda, candy, and even some whole fruits like apples, bananas, and watermelon.

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A Gut Reaction

So, what is it about these foods, common in American diets, that causes inflammation in the first place? Researchers believe they alter the composition of the microbiome, those billions of bacteria living in your gut that help maintain general health and the health of your immune system. Changing the balance of these bacteria through diet may ultimately lead to an inflammatory response related to psoriasis.

To break it down even further (we know, it’s complicated), “high-fat foods cause bile acids from your gall bladder and liver to go into the gut to help with digestion,” says Ronald Prussick, M.D., an assistant clinical professor of dermatology at George Washington University and medical director of the Washington Dermatology Centre. “These acids then cause bad bacteria to form, leading to inflammation inside the body.”

What this all means: The study proposes that what you eat can alter the gut microbiome, causing changes in bile acid levels, which can affect inflammation.

This theory was tested in the study when the researchers administered cholestyramine, a drug used to lower cholesterol (high levels of which are found in fast foods and other “western” fare), to the mice and found that it helped reduce the risk of skin inflammation. “Cholestyramine was shown to bind to bile acids in the intestine and release through the stool, allowing for inflammation to be lowered in the mice,” Dr. Hwang says.

Food for Thought

Doctors have long maintained that there is no single food that can treat or cure psoriasis, and that’s still true. But if you have the skin condition or are at risk for the disease (which is frequently genetically determined), limiting or eliminating foods high in saturated fats and simple sugars can lessen the chances for inflammation—and therefore possibly psoriasis, Dr. Hwang says.

What to eat instead? A Mediterranean-type diet, characteristically rich in healthy fats and omega-3 fatty acids, is known to help fight inflammation. It includes foods such as olive oil, avocados, nuts, seeds, fish like salmon and lake trout, and some meat or dairy from grass-fed animals, as well as fresh vegetables and fruits low on the glycaemic index, like berries. “Switching to a healthier diet can increase the chances of treating psoriasis more effectively,” says Dr. Prussick.

Additionally, Dr. Prussick suggests cooking on lower heat by stewing, poaching, boiling, and steaming foods rather than grilling, frying, or toasting them. “Heat causes sugars in foods to bind to proteins, known as advanced glycation end products (AGEs), which causes more inflammation,” he says. He also recommends cooking with acids such as vinegar or lemon juice, which can reduce AGEs by 50%.

https://www.healthcentral.com/article/psoriasis-and-diet

The 5 Best Diets for Psoriatic Arthritis

From healthcentral.com

No boring bites here. These diets are full of flavour, and they come with one awesome benefit—fewer psoriatic arthritis flares!

It’s no secret that what you eat can impact your health. And if you have a chronic disease, diet plays a huge role in keeping symptoms at bay.

“This is especially true for people who have too much inflammation in their body, which is what happens with psoriatic arthritis,” says Robin Foroutan, R.D.N., an integrative medicine dietitian and spokesperson for the Academy of Nutrition and Dietetics.

It is estimated that about one in five patients with psoriasis will develop psoriatic arthritis, an autoimmune condition that can lead to inflammation that damages your skin and your joints.
“Many different foods, especially foods high in antioxidants, can help the body balance inflammation, and that’s why diet is so important,” says Foroutan.

On the flip side, “some foods are pro-inflammatory in and of themselves, meaning they trigger an inflammatory cascade,” says Foroutan. “For someone with PsA, that’s like pouring gasoline on a wildfire.”

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Are You Pro Anti-Inflammatory Diet? According to the National Psoriasis Foundation, an anti-inflammatory diet composed of lean proteins, whole grains, and fresh produce is often recommended for those with psoriatic arthritis.

“Many diets will claim that they are anti-inflammatory. However, certain diets score better when it comes to research and efficacy–these diets include the Mediterranean Diet, the Dash Diet, and a Vegetarian Diet,” says Angel Planells, R.D.N., Seattle-based registered dietitian nutritionist and spokesperson for the Academy of Nutrition & Dietetics. “These diets have a higher intake of health protective nutrients (fruits, vegetables, nuts, seeds, healthy fats, lean protein).”

“On the most basic level, sugar, white refined grains, processed red meat and any food that provides minimal to no nutrient density should be avoided,” says Kristin Kirkpatrick, R.D.N., registered dietitian nutritionist and lead dietitian at Wellness Nutrition Services at Cleveland Clinic Wellness & Preventive Medicine. “What should be adhered to are colourful foods representing high phytonutrient/antioxidant levels often found in plants, such as fruits, vegetables and whole grains.”
The good news is that studies have found there are actually a bunch of diet plans that can help you eat to beat inflammation. Here’s a rundown on five of the top picks, plus their pros and cons, and who might want to consider them.

Mediterranean Diet

Basics: The Mediterranean Diet consists of mostly vegetables, fruits, and whole grains, moderate amounts of dairy, fish, and meat (with minimal amount of red meat), and minimal processed foods and sugar. Healthy fats, especially extra virgin olive oil, also get a big check mark in this diet.

Pros for PsA: The Mediterranean Diet is considered an ‘anti-inflammatory’ diet. One study found that patients with PsA who followed a Mediterranean Diet compared to those who didn’t reported lower levels of PsA disease activity.

Cons for PsA: According to Harvard University, the Mediterranean Diet could increase your risk of excess calorie intake, as portion size isn’t emphasized, which may cause weight gain.

You might like it if: You are looking to decrease the amount of processed foods you eat and increase the amount of produce.

DASH Diet

Basics: The ‘DASH’ stands for Dietary Approaches to Stop Hypertension. It was designed as a diet to lower blood pressure, and it puts major stock in vegetables, fruits, and low-fat dairy foods. Also emphasized are moderate amounts of whole grains, fish, poultry, and nuts as well as low-sodium intake.

Pros for PsA: Like the Mediterranean Diet, the DASH Diet cuts out foods known to increase PsA symptoms, including processed foods. Since it's goal is to improve heart health, this diet is another pro for those with PsA, who are at higher risk of developing heart disease.

Cons for PsA: This diet was specifically created to lower blood pressure, which may not be necessary for those with PsA (i.e. those who do not have hypertension).

You might like it if: You are looking to improve your heart health (along with your PsA symptoms).

Paleo Diet

Basics: This diet (a.k.a. the Caveman Diet) consists of primarily lean meat, fruit, fish, nuts and seeds, and cuts out the junk food and most processed foods, which can contribute to inflammation. It eliminates potentially inflammatory foods like gluten and dairy, and it allows for lots of anti-inflammatory veggies, herbs, spices, fatty fish, and high-quality meats and fats.

Pros for PsA: There’s a version of Paleo called the AIP diet, or auto-immune paleo diet (which is an elimination-style Paleo diet), that can also be remarkably helpful for anyone with an autoimmune condition. The AIP diet requires focus on food quality and includes trial elimination of many otherwise healthy foods like eggs, beans and legumes, which are technically anti-inflammatory.

Cons for PSA: If people were to eat too much meat and not enough veggies (which is easy to do with this diet), the level of anti-inflammatory protection would go down.

You might like it if: You're up for meal planning and prepping, and you want to lose or maintain your weight.

Intermittent Fasting

Basics: This somewhat customizable diet implements different time cycles of fasting and eating. There are many different fasting methods, including the 16/8 method where you fast for 16 hours and have an 8-hour eating window. There’s also the “Eat-Stop-Eat” method where you fast for 24 hours once or twice a week.

Pros for PsA: There is some evidence that Intermittent Fasting (IF) can help regulate the immune system and reduce inflammation, especially when paired with anti-inflammatory foods like green leafy vegetables, fatty fish, and olive oil. One study published in the journal Nutrients found that after a month of fasting, patients with PsA reported lower inflammation markers.

Cons for PsA: It may prevent you from attaining as many nutrients as possible if you limit the amount of time (and consequently the amount of food) you eat using IF. And simply limiting the periods when you’re eating without adjusting your diet to include anti-inflammatory foods likely won’t result in major PsA improvements.

You might like it if: You want to practice portion control and simplify your lifestyle (since you don't have to think about when to eat, only what to eat).

Vegetarian Diet

Basics: This diet consists of plants, plants, and more plants. Obvi.

Pros for PsA: “The different colours you see in plant foods are signals that the food is high in ‘phytonutrients’, a.k.a. antioxidants,” says Foroutan. “These foods help the body balance inflammation and can help modulate an overactive immune system.” In other words, when you eat foods that are high in antioxidants, like vegetables, you prevent the production of inflammatory compounds and fight destructive ‘oxidant’ molecules that attack healthy cells, leading to inflammation.

Cons for PsA: Plant-based diets often lack foods that contain vitamin D like fatty fish, cheese, and egg yolks, which is not ideal. One study published in Arthritis Research & Therapy, found that nearly 41% of participants with psoriatic arthritis had a vitamin D deficiency.

You might like it if: You’re trying to cut back on your meat intake (which can come with a lot of inflammation-causing saturated fats), and up your consumption of veggies.

https://www.healthcentral.com/article/best-diets-psoriatic-arthritis

What To Know About COVID-19 And Psoriasis

From southfloridareporter.com

At present, it is unclear how COVID-19 may affect those with psoriasis, which is an immune-mediated condition. This mean the condition occurs as a result of abnormal immune system activity. Scientists are also unsure about how it may impact the treatment of these individuals.
Some treatments for psoriasis, which are immunosuppressive medications, may increase the risk of a COVID-19, or of severe illness due to the virus. However, the effects are still unknown.

How does COVID-19 affect people with psoriasis?

The details of how COVID-19 affects those with psoriasis remain unknown, but there is not yet evidence to suggest that it affects them differently than people without the condition.

According to the National Psoriasis Foundation (NPF), if a person is not taking an immunosuppressive medication and is free from other underlying diseases, there may be “minimal additional risk” of them contracting SARS-CoV-2 relative to the rest of the population.

However, as the virus is highly transmissible, spreads rapidly, and replicates rapidly, everyone is at risk. Even asymptomatic people can transmit the virus to others.

The NPF note that people with severe psoriasis, such as those who are on immunosuppressive therapies or have other medical conditions, probably are at higher risk of infection.

Is COVID-19 more dangerous for people with psoriasis?

As psoriasis is a chronic immune-mediated condition, some people may take immunosuppressant drugs to keep their symptoms under control.
These medications can reduce immune function, which may increase the risk of infection with SARS-CoV-2 or other infectious agents. Immunosuppressive drugs could also increase the risk of severe symptoms.

According to the Centres for Disease Control and Prevention (CDC), conditions or medications that weaken the immune system and cause people to become immunocompromised increase the risk of severe COVID-19.

The International Psoriasis Council (IPC) recommend that people with psoriasis who receive a COVID-19 diagnosis discuss discontinuing or postponing their use of immunosuppressant medications with their doctor.

However, the IPC caution that doctors should carefully weigh the benefit-to-risk ratio of immunosuppressive treatments on an individual basis.

The medical board of the NPF do not recommend that people with psoriasis stop their treatment unless they have an active infection. They suggest that those in high risk groups discuss their options with their doctor.
The CDC list the following as high risk:

• those aged 65 years and older
• people living in a nursing home or care facility
• smokers
• individuals with underlying medical conditions (especially if poorly controlled) or risk factors that include:
  • chronic lung disease
  • moderate or severe asthma
  • serious heart conditions
  • a weakened immune system, for instance, due to cancer treatment or HIV
  • severe obesity
  • diabetes
  • chronic kidney disease
  • liver disease

The World Health Organization (WHO) and other expert bodies are still learning about the effects of COVID-19 on those with co-occurring conditions.

Symptoms to look out for

The WHO list the most common COVID-19 symptoms as:

• a dry cough
• fatigue
• fever

They state that other possible symptoms include:

• aches and pains
• diarrhoea
• difficulty breathing
• nasal congestion
• runny nose
• shortness of breath
• sore throat

Some people with COVID-19 also report a loss of taste or smell.
Symptoms typically develop within 2–14 days of exposure to the virus. They range from mild to severe, although the majority of people experience a relatively mild form of the disease, which will not require specialist treatment in a hospital.

Some people may be asymptomatic, meaning that they have no symptoms, despite testing positive for the virus that causes COVID-19. Asymptomatic individuals can still transmit the virus to others, though.

Extra care and precautions

People can reduce the risk of exposure to the novel coronavirus by:

• washing their hands regularly with soap and water for at least 20 seconds or using an alcohol-based hand sanitizer
• maintaining a distance of 6-feet (2-meter) or more from others, especially those who are showing symptoms
• staying home as much as possible and limiting the amount of time that they spend out in public places, including parks and grocery stores
• stocking up on food, medications, and other essential items to reduce the number of trips outside the home
• avoiding nonessential travel
• cleaning and disinfecting surfaces and items in the home daily, including faucets, door handles, toilet handles, and remote controls
• avoiding sharing cutlery, towels, and other personal items with family members
• having sick members of the household isolate themselves as much as possible until symptoms resolve
• wearing a cloth face covering or mask when in public outside the home
• sick persons should wear a mask whenever in the presence of others

Anyone who thinks that they may have become exposed to the virus should:

• monitor their symptoms closely and check their temperature daily for fever
• call their doctor immediately if symptoms develop
• seek immediate medical attention if breathing difficulties or chest pain occurs

It is advisable to call ahead before presenting at an emergency facility in case they need to put safety measures in place.

The NPF recommend that people with psoriasis discuss their treatment with their doctor. A doctor may recommend continuing medications or taking a break from them.
It is important that people only adjust or stop their treatment after consulting with their doctor.

Treatment and symptom management

So far, there is no specific treatment or vaccine for COVID-19. In those who contract the virus and develop symptoms, treatment aims to alleviate these symptoms. Treatments include:

• cough medicines
• hydration
• pain relief
• rest

People who develop severe illness will require hospitalization. In the hospital, doctors may put them on oxygen or a ventilator, or provide other specialist care.
In some cases, doctors may speak to a person about participating in a clinical trial, which is very important in helping experts learn about the disease and find effective treatments.

People with psoriasis who develop COVID-19 should speak to their doctor about their psoriasis treatment while ill.
Those taking immunosuppressive medications will often need to stop treatment temporarily until their doctor says that it is safe to resume. The doctor will advise on other types of psoriasis treatment on a case-by-case basis.

What to do if the test is positive

When someone tests positive for the novel coronavirus, their doctor will provide them with instructions for recovery. They will also explain to the individual how to self-isolate to reduce the spread of the virus to others.
People with mild symptoms can typically recover at home, while those with severe illness often require a hospital stay.

Outlook

It is difficult to determine the outlook for people with COVID-19 and psoriasis, but this generally depends on:

• the severity of the disease
• the person’s age, sex, and ethnicity
• the presence of additional underlying health conditions

Data from China showed that 80% of people who develop COVID-19 have mild-to-moderate symptoms and recover well. Of the remainder, 13.8% develop severe disease, and 6.1% become critical and require intensive care.

Prompt medical treatment may improve the outlook of people with severe disease and reduce the risk of complications, which include pneumonia and organ failure. In some cases, COVID-19 can also lead to death.

Summary

At present, experts know little about the effects of COVID-19 on people with psoriasis.
However, it seems that those who are not taking an immunosuppressive medication and do not have another co-occurring disorder have a similar risk to the rest of the population.

People taking immunosuppressive therapies who receive a COVID-19 diagnosis should consult their doctor immediately. It is likely that the doctor will advise them to stop taking these medications until they recover.

There is no specific treatment for the novel coronavirus, but individuals can reduce their risk of contracting it by maintaining physical distance from others, avoiding unnecessary public outings, and practicing good hygiene.

Individuals with psoriasis should speak to their doctor about their specific case. A doctor will address any concerns that a person has, and they may adjust their treatment plan accordingly.

https://southfloridareporter.com/what-to-know-about-covid-19-and-psoriasis/

Let's Talk About the Causes of Psoriasis

From healthcentral.com

Psoriasis can be a pain: It's often itchy and stings like whoa. It might also make you feel self-conscious because psoriasis lesions can be prominent on your arms, legs, and face. If you have it, it might help to know that you're not alone: More than 8 million Americans are in the same boat. Still, you're probably wondering, why me? Good question. Understanding the causes and triggers can help you keep this chronic condition under control—and, hopefully, stay in the clear.

What’s Psoriasis, Again? Let’s Recap

Psoriasis is an inflammatory skin condition marked by red, scaly patches of skin that can appear as small bumps or thick, raised lesions. These can crop up anywhere on the body, but the most typical spots are knees and other parts of the legs, elbows, torso, and face.

While psoriasis doesn’t discriminate by age and can appear at any time, it usually makes its debut sometime between 15 and 35 years old. And unlike some diseases that favour one gender over another, psoriasis is an equal opportunist: It strikes women and men in the same numbers.

There are seven different types of psoriasis. When you think about the condition, you’re probably picturing plaque psoriasis, the most common type. It affects 80% of those with psoriasis. Its lesions, called plaques, are red, scaly, and clearly demarcated, with peaks that can look silvery (on lighter skin) or purple (on darker skin). The other, less common types of psoriasis are:

Guttate: This is the second most common form, which shows up as small red tear-shaped bumps on upper arms, trunk, thighs, and scalp.

Inverse: This causes bright red, shiny patches in folds of skin such as your groin, underarms, under breasts, and around genitals that tends to get worse from sweating and friction.

Pustular: As the name implies, this type of psoriasis appears as pus-filled bumps, often on hands and feet. If it covers most of your body and comes with flu-like symptoms and an increased heart rate, it can be dangerous and needs medical attention, stat.

Erythrodermic: This condition presents as widespread, red skin that looks like a burn. It’s the least common of all the psoriasis types.

Psoriatic arthritis: This version of the disease occurs when you have both psoriasis and arthritis—achy, swollen joints and inflamed, itchy skin. Up to 30% of people with psoriasis have the joint condition, too.

Nail psoriasis: It looks similar to nail fungus with pitting, tenderness, yellowing, and separation of the nail bed, with gunk between your skin and nail. The majority of people with nail psoriasis have other types, too. In fact, 80% to 90% of them have plaque psoriasis.

So, What Causes Psoriasis?

With every type of psoriasis, your skin cell turnover is 10 times faster than the normal rate. Your body is pumping out skin cells too quickly, causing them to pile up on skin’s surface and form thick patches that appear as dense, scaly, red, irritated, and inflamed plaques. But the big question is why does this happen? It’s not completely clear, but the various types of psoriasis are thought to be caused by a perfect storm of an immune dysfunction, genetics, plus at least one other environmental trigger or risk factor. So, let’s break them down one by one.

An Overactive Immune System

Psoriasis is considered an autoimmune condition. This means your immune system is a bit overzealous, causing immune cells (T cells) to start attacking healthy tissue—in this case, your skin—as if it was an invader. The “attack” causes an inflammatory cascade as white blood cells go to war with skin cells, causing them to grow more quickly and thickly than they should. In turn, this results in the formation of those painful psoriatic patches.

Genetics

If a relative—parent, grandparent, sibling—has this skin condition, you’re more likely to develop it yourself. According to the National Psoriasis Foundation, if either Mom or Dad has psoriasis, you’ve got a 10% chance of having it, too. If both parents have it, your chances increase to 50%.

So, what exactly is the genetic link? Researchers have discovered about 25 gene variants that can up your chances of developing psoriasis and the overactive immune system that drives it. For example, there’s a gene called HLA-Cw6 that is strongly associated with psoriasis, especially guttate psoriasis. IL36N is another gene that’s specifically associated with pustular psoriasis, and researchers have discovered a gene called CARD14 that can cause plaque psoriasis once it’s activated by an environmental trigger.

That last part seems to be an important part of the psoriasis puzzle, especially when you consider that 10% of people are born with a psoriasis-inducing gene, but only 2% to 3% of the population develops it. Experts believe psoriasis doesn’t stem from genes alone. You need an outside factor to turn on the gene, which brings us to our next point.

Environmental Triggers and Other Risk Factors

These things aren’t considered all-out causes on their own, but if you already have the underlying genetic component or an overactive immune system, these factors may activate the condition, causing a psoriasis flare for the very first time (as well as subsequent flares in the future). These factors include:

• An infection: A common cold, strep throat, tonsillitis, earache, bronchitis, or respiratory infection can bring on your first psoriasis flare-up, usually two to six weeks after you get the infection. It’s typically a bacterial infection that brings on guttate psoriasis. In most cases, guttate clears on its own after two to three weeks, but as many as 40% of people will wind up with chronic plaque psoriasis after a guttate outbreak. (An infection is what reality star Kim Kardashian says led to her psoriasis.)
• Being overweight: People with psoriasis have a greater chance of being overweight. Experts say it’s somewhat of a chicken-or-egg scenario—they aren’t sure which causes which. But there’s some evidence to suggest that it’s the extra pounds that can have your skin seeing red. Studies have shown that a high BMI earlier in life is correlated with psoriasis later on. It could be that obesity raises the level of inflammation in your body, which then triggers the inflammatory skin disease. Also typically, the more you weigh, the worse your psoriasis.
• Your mental well-being: Stress is some powerful stuff; you know this. It’s well-documented that stress hormones can bring on inflammation, triggering a number of conditions, including psoriasis. Depression and anxiety seem to play a role, too. A study in Journal of the European Academy of Dermatology and Venereology found that severely depressed women were twice as likely to develop psoriasis. It’s often a vicious cycle: The pain and stigma that comes along with psoriasis brings on more stress, anxiety, and depression, making skin worse or bringing on recurrent flares.
• Smoking: More reason to kick butt? A study in JAMA Dermatology found that one in five cases of psoriasis may be caused by smoking, and there’s an especially high association between smoking and pustular psoriasis. Women who smoke more than 20 cigarettes a day are 2.5 more times more likely to develop psoriasis compared to non-smokers, and men are 1.7 times more at risk. You might also be scratching your skin if your parents smoked when you were a kid: A study in the American Journal of Epidemiology found that children exposed to second-hand smoke had a greater risk of developing psoriasis later in life.
• Skin trauma: Burning your neck while using your curling iron, getting ears or body parts pierced, or even a tattoo can bring on new plaques. It’s called the Koebner phenomenon, in which psoriatic patches can appear after a skin injury. Studies suggest it stems from a disruption in the skin barrier, its protective outermost layer.
• Alcohol: Beer drinkers, beware: A prospective study in the Archives of Dermatology followed female nurses for 14 years and found that those who drank just 2.3 non-light beers (or more) a week had an increased risk of developing psoriasis compared to non-drinkers. In this study, light beer, white and red wine, and liquor didn’t pose the same risk. However, alcohol in general is thought to both induce and aggravate inflammation, so it can not only bring on your first episode, but make an existing case worse.

What Makes Psoriasis Worse?

Speaking of making a bad situation worse, if you already have the chronic condition, certain things can increase its severity or trigger a recurrence, even if you’ve been in remission (the medical term for symptom-free) for a while. The most common triggers are:

• Medications: If you already have psoriasis, certain prescription meds may make it worse or bring on a flare while you’re taking them, or after you stop. These drugs include:
  • Antimalarial medications
  • Inderal (propranolol) for high blood pressure
  • Indomethacin, a nonsteroidal anti-inflammatory used for arthritis
  • Lithium (prescribed for bipolar disorder)
  • Prednisone, prescribed for various conditions that cause inflammation
  • Quinidine, a heart medication

If you have psoriasis, talk to your doctor before taking a new prescription drug to see if there is a skin-friendly alterative. It's not always an option, and unfortunately, even if you do discontinue a medication that appears to be worsening your skin condition, that doesn’t guarantee flares won’t occur in the future.

• Staying indoors: When you’re in the midst of a flare-up, it’s tempting to lock yourself in your bedroom and wait for it all to go away. But shunning the sun can make your flare last longer. There’s evidence that sunlight can help alleviate a psoriasis breakout. The sun’s UVB rays can help slow the rapid cell turnover. But because the sun can also burn skin and increase your risk of skin cancers, experts suggest still wearing sunscreen and keeping exposure time short.
• Skin scratching: Raking your itchy skin with your nails can make psoriasis worse and trigger new lesions in those who already have the disease. And breaking the skin’s barrier through excessive scratching can trigger new plaques and increase your risk of infection.
• Inflammatory foods: While the research is somewhat limited, scientists believe certain foods can increase inflammation, including high-glycaemic carbs, red meat, dairy, gluten, and nightshade produce (tomatoes, eggplants, eggplants, and pepper). Moving to an anti-inflammatory diet rich in low-glycaemic carbohydrates (fruits, vegetables, whole grains) and omega fatty acids (salmon, olive oil) may alleviate some psoriasis symptoms. A study in JAMA Dermatology touts the Mediterranean diet for lessening the severity of the skin condition. And a survey of over 1200 psoriasis patients published in Dermatology and Therapy calls out the virtues of the Pagano diet (more fruits and veggies, less grains, meat, seafood, dairy, and eggs).
• Cold weather: The evidence here is mostly anecdotal, but many people say their skin acts up when the temperature dips. One study in Journal of the American Academy of Dermatology found more cases tend to clear in the summer versus the winter. Doctors think it’s a combo platter of winter factors—cold air, dry heat, and less sunlight—that aggravate the condition in some people.

It’s important to note that what sets off one person’s psoriasis might not affect another’s at all. Be your own detective to ID your specific triggers. If your psoriasis acts up before your wedding, an important job interview, or a big presentation, stress is likely a trigger for you. If it rears its ugly head while you’re taking certain medications, they could be a cause. Knowing your personal triggers so you can avoid them (if possible) may help you ward off a future flare-up—or at least lessen its severity.

https://www.healthcentral.com/condition/psoriasis-causes