And So, It Begins: How to Spot the Early Stages of Psoriasis

From greatist.com

If you’re living with psoriasis, then you know the struggle can be real. But people who aren’t already living the flare-up lifestyle may not always be aware of what to look out for if psoriasis occurs.

We’ve got all you need to know on how to spot psoriasis — and its many subtypes — in the early stages, so you can set yourself on the path to treatment, pronto.

What are the early stages of psoriasis?

The condition often shows up similar to a rash.

Psoriasis on people with lighter skin types includes patches of skin that look red, dry, and inflamed. But people with darker skin types experience skin patches that are purple, grey, or darker brown. They also experience dry and inflamed areas of skin.

You may also experience itching or irritation at first, accompanied by the rough, scaly patches of skin.

Early-stage psoriasis signs and symptoms

Symptoms can start at any age, but the first signs of psoriasis often occur between the ages of 15 and 25, according to the National Psoriasis Foundation.

When psoriasis first appears, you start to notice symptoms of inflammation on your skin. This can include: 

• itching, stinging, or burning
• red to silver patches of skin on people with lighter skin types
• purple, greyish, or darker brown patches of skin on people with darker skin types
• silvery-white scales, known as “plaques”
• dry, cracked, or bleeding patches of skin
• thick, rough patches of skin
• joint swelling
• ridged or pitted nails 

As the condition progresses, symptoms can start to worsen or become more noticeable.

Symptoms can vary based on the type of psoriasis (we’ll get to the seven main subtypes in a sec), the amount of psoriasis, and the area that’s affected.

While psoriasis can show up anywhere on your body. It most commonly develops on your:

• elbows
• knees
• legs
• scalp
• lower back
• hands or feet
• face

Beginning stages of different types of psoriasis

The features, feels, and early symptoms of psoriasis might often depend on what type you have.

Plaque psoriasis

Plaque psoriasis is the most common type, affecting 80 to 90 percent of people with the condition.

This form of psoriasis usually first appears as thick, raised patches of skin — aka plaques. These plaques can be red, purple, or silver and often vary in size. Over time, they may start to feel dry and scaly, which can cause them to itch like crazy.

Guttate psoriasis

Guttate psoriasis appears as tiny bumps that may pop up suddenly on your skin. These bumps, or spots, are usually red or pink and have a scaly texture.

Guttate psoriasis often begins to show up on your arms, legs, or torso, but the condition can develop in other areas.

Guttate spots are known to clear up on their own and sometimes never make a return appearance. No one really knows why this happens, making guttate psoriasis one of the more mysterious psoriasis types. 

Inverse psoriasis

While other forms of psoriasis are raised and rough to the touch, inverse psoriasis causes flat, raw-looking rashes in folds of the skin. These reddish or purple rashes are usually smooth to the touch, but that doesn’t make them any less uncomfortable.

Inverse psoriasis usually develops in areas where skin is constantly rubbing on skin (like the armpits, under boob area, and even the genitals). This can cause increasing levels of soreness or discomfort over time — especially when sweat gets trapped in these folds.

Pustular psoriasis

When it comes to pustular psoriasis, you’ll usually see puss-filled bumps often appearing on your hands and feet. These small, inflamed bumps can typically be confused for acne when they first appear.

But you’ll def be able to tell the difference as the condition progresses. The skin underneath the pus-filled bumps will become red and swollen. The area can also become itchy and sore.

As the bumps dry out, they’re usually replaced with scaly, brown dots.

Erythrodermic psoriasis

If you start to experience symptoms of erythrodermic psoriasis, call the doctor.

This rare, severe form of psoriasis can cause large chunks of skin to shed, leading to debilitating pain. It can also cause an elevated heart rate, dehydration, fever, chills, and muscle weakness. Erythrodermic psoriasis can also lead to hypothermia, making it difficult to stay warm.

Erythrodermic psoriasis spreads fast, causing visible inflammation in nearly 90 percent of your body. This condition can resemble a burn at first, with the skin becoming red, dry, and tender to the touch. You may experience intense itching as the rash spreads.

Most cases of erythrodermic psoriasis occur in people who already have another form of psoriasis. Talk with your dermatologist ASAP if you notice your condition becoming worse or not responding to treatment, as this condition can be life threatening.

Nail psoriasis

Nail psoriasis affects… well, your nails (obvi). Nail psoriasis is pretty common, impacting about 50 percent of people who already have another type of psoriasis.

At first, you may notice discoloration of your nails (usually yellow, white, or brownish hues), as well as pitting in your nails themselves. As the condition develops, larger dents in the nail may form, and the nail may become rough and crumbly.

Skin cells can also build up underneath your nails, causing the nail to lift and detach from the skin of your finger or toe.

Psoriatic arthritis (PsA)

Psoriatic arthritis (PsA) gets under your skin — literally. This subtype affects the joints and most often occurs in people who already have psoriasis. It can develop at any age, most commonly appearing between ages 30 and 50. 

Early signs of PsA can include swollen or tender joints, swelling on the knee or back of the leg, and pain on or around your heel. You may also notice stiffness, specifically in the mornings (because getting out of a cosy bed isn’t hard enough sometimes!).

It’s important to seek treatment for PsA. Ignoring the condition might lead to difficulty moving and even physical disability. 

When to call your doctor

There is currently no cure for psoriasis, but there *are* ways to treat and manage its symptoms.

While some cases of psoriasis are minimal, others can be more severe. No matter what level you’re at, seeking treatment can prevent recurring flares or worsening symptoms.

Talk with your doctor or dermatologist if you have questions or think you might have psoriasis. They can provide you with a diagnosis and discuss treatment options.

You should also talk with your doc ASAP if you experience:

• worsening or spreading symptoms
• swelling or discomfort
• joint pain or other probs
• your treatment no longer working

Your doctor may suggest one or more types of treatment, including:

• corticosteroids
• retinoids
• vitamin D analogues
• salicylic acid
• coal tar
• calcineurin inhibitors
• light therapy
• steroids
• biologics
• immunosuppressants (cyclosporine)

Depending on your specific diagnosis, your doc also may recommend lifestyle changes, such as stress management techniques or a nutritious diet.

Other conditions that might look like early-stage psoriasis

Psoriasis isn’t the only condition that can cause dry, flaky skin or itchy rashes. These same symptoms can be signs of many other conditions.

This can include:

• Eczema. A skin condition that causes itchy, red, inflamed skin that can become dry and scaly. You also might have purple, dark brown, or grey patches.
• Keratosis pilaris. A skin condition that causes rough patches of red or brown bumps.
• Hives. Tender, itchy bumps, usually triggered by allergens or irritants. 
• Acne. A common skin condition that usually occurs when gunk (like dirt, oil, and dead skin) clogs your pores. 
• Rosacea. A condition that causes your face to flush or blush easily, making the skin look red and irritated.
• Parapsoriasis. A condition that sounds like psoriasis and often looks like psoriasis, but isn’t. Parapsoriasis plaques are usually smaller and thinner.
• Ringworm. A fungal infection that forms a circular red rash. On darker skin this rash can also look grey or brown.
• Lupus. An autoimmune disorder that can cause a butterfly-shaped rash on your face.
• Skin cancer. A common type of cancer that can cause a rash or sores. 

The takeaway

In the beginning stages of psoriasis, red, purple, or silver scaly patches — or plaques — develop on your skin. These can be itchy or even painful. However, there are many types of psoriasis and symptoms can vary based on which one you have.

There isn’t a cure for psoriasis yet, but there are ways to treat and manage symptoms.

Talk with your doctor if you think you have psoriasis or notice a change or worsening of an existing case. They can work with you on a treatment plan tailored to your needs, such as using a prescription topical or making lifestyle changes. These changes might include managing your stress levels or eating a more balanced diet.

https://greatist.com/psoriasis/early-stage-beginning-of-psoriasis

 

Vitamin D Supplements Might Cut Your Odds for Autoimmune Diseases

From consumer.healthday.com

THURSDAY, Jan. 27, 2022 (HealthDay News) -- Taking vitamin D supplements may help stave off psoriasis, rheumatoid arthritis, lupus and other autoimmune diseases, a new study suggests.

Previous research has hinted at this connection, but the new study is the first randomized controlled trial to look at what happens when people are given vitamin D supplements and followed to see if they develop an autoimmune disease, the study authors said. Randomized controlled trials are considered the gold standard in clinical research.

In the new study, people who took 2,000 international units per day (IU/day) of vitamin D, with or without one gram of fish oil, for slightly more than five years reduced their risk of developing an autoimmune disease by 22% when compared to their counterparts who took placebo ("dummy") pills.

"It looks like giving vitamin D will prevent autoimmune disease, which is really exciting," said study author Dr. Karen Costenbader, a rheumatologist at Brigham and Women's Hospital in Boston.

There's no shortage of mechanisms to explain this finding. "Vitamin D binds to receptors on immune system cells to turn on an array of genes involved in immune system function," she said.

Autoimmune diseases occur when your immune system engages in destructive "friendly fire" against its own body parts.

Vitamin D is called the "sunshine vitamin" because our bodies produce it when exposed to sunlight. It is hard to get as much as we need from food, so most people will need supplements. The Institute of Medicine recommends people aged 1 to 70 take 600 IU/day and that adults older than 70 aim for 800 IU/day. Other medical groups set the bar even higher.

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The new study, dubbed the Vitamin D and Omega-3 Trial (VITAL), included close to 26,000 adults (aged 67, on average). These folks were not vitamin D deficient and weren't considered high risk for developing autoimmune diseases.

Participants were randomly assigned to receive either 2,000 IU/day of vitamin D with a 1 gram omega-3 fatty acid supplement; vitamin D with a placebo; omega-3 fatty acid with a placebo; or placebo alone. The participants then answered questionnaires about new diagnoses of autoimmune diseases, and doctors reviewed their records to confirm these diagnoses.

People who took vitamin D or vitamin D and omega-3 fatty acids had a lower rate of autoimmune disease than people who took a placebo or omega-3 fatty acids alone after slightly more than five years of follow-up, and these effects were more pronounced after two years.

Omega-3 fatty acids alone didn't significantly lower the incidence of autoimmune disease. Many autoimmune diseases are marked by inflammation, and fish oil is known to help cool inflammation.

Costenbader and colleagues plan to continue to follow participants for a few more years. "We want to see who benefits the most in terms of which autoimmune diseases were prevented and whether vitamin D works as well or better in people who are at high risk for autoimmune disease," she noted.

This is important as there are more than 80 autoimmune diseases, she explained.

Vitamin D and fish oil are safe, Costenbader said. "I suggest vitamin D 2,000 IU/day and 1 g/day of marine omega-3 fatty acids (fish oil) — the same doses used in VITAL," she added.

You can get all of the vitamin D you need by spending 15 minutes in the sun every day. But "this is tricky as a lot of sun exposure leads to skin cancer," she said.

Still, Costenbader cautioned not everyone should jump on the vitamin D supplement bandwagon. "There are some people who need to avoid vitamin D because they have a history of kidney stones or other diseases," she said. "Check with your doctor before you start taking supplements."

VITAL was designed to see if vitamin D could reduce the risk of developing cancer, heart disease and stroke. The risk for developing autoimmune disease was another endpoint in this trial.

The report was published online Jan. 26 in the BMJ.

Dr. Michael Holick has devoted his career to studying vitamin D. He's a professor of medicine, physiology, biophysics and molecular medicine at Boston University School of Medicine.

"There's a lot of evidence suggesting that vitamin D would help to reduce the risk for autoimmune disease, and this study confirms that vitamin D status, even if you are vitamin D sufficient, is associated with decreased risk for developing autoimmune diseases," said Holick, who has no ties to the new research.

This makes sense, he said: "Vitamin D is a major modulator of immune function at every level."

There's no downside to increasing your vitamin D intake, and there's a whole lot of upside, he said. Studies have linked vitamin D deficiency to a host of diseases and conditions including heart disease, diabetes, the brittle bone disease osteoporosis, certain types of cancer and depression.

More information

The Academy of Nutrition and Dietetics has more on the benefits of vitamin D.

https://consumer.healthday.com/vitamin-d-2656468913.html 

11 Early Signs of Psoriatic Arthritis

From healthline.com

What is psoriatic arthritis?

Psoriatic arthritis (PsA) is a type of inflammatory arthritis. It affects some people with psoriasis, a condition that causes red, scaly patches to form on the skin.

PsA affects roughly 30 percentTrusted Source of people with psoriasis, and it’s most commonTrusted Source in people between the ages of 35 to 45. There’s no connection between the severity of psoriasis and the severity of PsA.

PsA typically develops after the onset of psoriasis, but some people develop joint pain before they notice any skin-related symptoms.

Here are 11 symptoms to watch for if you think you might have PsA.

1. Joint pain or stiffness

PsA causes inflammation in the joints, which can cause pain, tenderness, and stiffness. You might feel this in just one joint or in several.

PsA usually affects:

• knees
• fingers
• toes
• ankles
• lower back

Symptoms of pain and stiffness may disappear at times and then return and worsen at other times. When symptoms subside for a time, it’s known as remission. When they worsen, it’s called a flare-up. 

2. Joint swelling or warmth

The joints connect bones within the body, including in the feet, ankles, knees, hips, wrists, and more. They’re surrounded by soft tissues that cushion the bones on either side. When fluid accumulates in the tissues, swelling can occur.

Joint swelling may be accompanied by:

• stiffness
• pain
• irregular shape of digits in chronic cases

Swelling in the joints due to inflammation is a common sign of PsA. Inflamed tissue produces heat, so your joints may also feel warm to the touch.

Treatment for inflamed joints due to PsA may include medications, physical therapy, or other methods to help relieve discomfort.

3. Pitted nails

Changes to your nails, such as pitting, may be an early sign of PsA. Pitted nails appear bumpy or dented.

Nail pitting is more commonTrusted Source in those who have PsA and those who are over age 40.

Symptoms of pitted nails include:

• depressions in the fingernails or toenails
• changes in nail colour (discolouration)
• changes to nail shape (deformation)
• thickening of the nails

Evidence shows that psoriatic changes in the nails are a predictor of joint disease and arthritis. Psoriasis itself can also affect the nails, making them look like they have a fungal infection. 

About 50 percent of people with psoriasis and around 80 percent of people with PsA develop nail changes, sometimes known as nail psoriasis. 

4. Nail separation

Nails that fall off or separateTrusted Source from your nail bed may also be a sign of PsA. This is called onycholysis. 

Onycholysis can happen with or without pitting, though the presence of transverse grooves, or grooves that run horizontally across the nail, appears to be strongly correlated with PsA.

If you experience onycholysis, your nail will begin to peel off the nail bed. Depending on the cause, it may also become yellow, greenish, purple, white, or grey. Onycholysis is not usually painful.

It’s important to keep your nails short if you’re experiencing separation, but don’t over-clip them. Simply clip off the affected portion as the new nail comes in.

Onycholysis can go away if the underlying cause is treated.

Photo by DermNet New Zealand

5. Lower back pain

PsA can lead to a condition called spondylitis. This causes swelling in the joints, especially in the spine.

According to the Spondylitis Association of America, 20 percent of people with PsA will develop psoriatic spondylitis.

Common symptoms of spondylitis include:

• lower back pain (lumbar and lumbosacral)
• muscle pain
• eye inflammation
• hip pain
• fatigue

In some cases, the sacroiliac (SI) joints of the pelvis actually fuse together.

Spondylitis treatment usually targets pain and inflammation to help reduce symptoms. Some possible treatments include:

• nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, or naproxen
• disease-modifying antirheumatic drugs (DMARDs)
• tumour necrosis alpha (TNF-alpha) blockers
• steroid injections or eye drops 
• physical therapy
• when extreme, surgery for the back or hip

Your doctor may also recommend lifestyle measures, such as:

• regular exercise to reduce pain, swelling, and immobility
• hot and cold therapies for pain
• an anti-inflammatory diet 
• if you smoke, quitting

6. Swollen fingers or toes

PsA may begin in smaller joints, such as those of the fingers or toes, and progress from there.

Spondylitis may be accompanied by dactylitis, or swelling of the toe or finger joints. This is sometimes called “sausage fingers.”

Dactylitis is estimated to affect up to 50 percent of patients with PsA, and is uncommon in other types of arthritis, except gout or pseudogout. 

When caused by PsA, dactylitis may affect individual digits differently. For example, your left hand may be swollen while your right is not.

Unlike other types of arthritis, PsA tends to make your entire finger or toe appear swollen, rather than just the joint.

Photography by DermNet New Zealand

7. Eye inflammation

People with PsA may experience eye problems, such as inflammation and redness. Symptoms of eye inflammation include:

• red eyes
• itchy eyes
• dry eyes or feeling of grit or sand in the eyes
• difficulty focusing or blurred vision
• pain or sensitivity, especially to bright light
• floaters, or small specks, lines, or other shapes in your field of vision

You may also experience uveitis, or inflammation of the middle layer of the eye called the uvea. Between 7 and 25 percent of people with PsA develop uveitis.

Symptoms of uveitis include:

• eye pain
• eye redness
• lid swelling
• blurry vision
• floaters in your field of vision
• sensitivity to light or photophobia 
• enlargement of the conjunctival vessels or hyperemia 
• unexplained visual changes

If you notice these symptoms, it’s important to seek medical care right away. Early diagnosis is important in preventing complications like:

• glaucoma
• cataracts
• optic nerve damage
• permanent vision loss

Treatments include oral medications or eye drops to reduce pain and inflammation.

8. Foot pain

Pain in the feet or ankles may be an indication of PsA.

People with PsA often develop enthesitis, or pain in the places where tendons attach to bones. This tends to appear as pain, swelling, and tenderness. The most common locations for enthesitis include the:

• Achilles tendon
• foot
• knee
• pelvis
• elbow
• shoulder

Symptoms include:

• impaired joint movement
• joint stiffness, especially after not using the joint for an extended period
• joint swelling
• a grating sensation in the joint with movement

Treatment options include:

• NSAIDs
• exercise
• reduced use of the joint
• medications like DMARDs and sulfasalazine (Azulfidine)
• steroid injections
• surgery

9. Elbow pain

Enthesitis can also involve the elbow, causing something similar to tennis elbow. Symptoms of enthesitis affecting the elbow include pain, tenderness, and trouble moving your elbow.

Symptoms include:

• elbow pain that gradually worsens
• pain from the outside of the elbow to the forearm and wrist
• a weak grip
• increased pain when shaking hands or squeezing an object
• pain when lifting something, using tools, or opening jars

Treatments can include:

• rest
• ice packs
• ultrasound therapy
• steroid injections
• shockwave therapy
• platelet-rich plasma (PRP) injections
• physical therapy and exercises

Always check with your doctor before beginning a new treatment or exercise program.

10. Reduced range of motion

One possible sign of PsA is a reduced range of motion in your joints. You might find it harder to extend your arms, bend your knees, or bend forward.

You may also have problems using your fingers effectively. This can lead to problems for people who work with their hands in any way, including typing and drawing.

When the joint becomes permanently fixed or unable to move beyond a certain point, it’s known as a contracture deformity. This can lead to complications such as:

• Dupuytren's contracture, a thickening of the tissue layer beneath the skin in the hands and wrist
• Volkmann’s contracture, or lack of blood flow to the forearm that causes muscle shortening

Prevention involves range of motion exercises prescribed by a doctor or done with a physical therapist.

11. Fatigue

Fatigue is a common symptom in people with PsA. You may begin to have difficulty making it through the day without taking a nap.

According to a 2007 studyTrusted Source, up to 50 percent of people with skin conditions report having moderate to severe fatigue, while 25 percent experience severe levels of fatigue.

In the case of PsA, fatigue may be due to symptoms or complications like:

• inflammation
• chronic pain
• anaemia
• reduced physical fitness
• increased weight or obesity
• fibromyalgia
• underlying sleeping issues
• diabetes
• anxiety and depression

The bottom line

Not everyone with psoriasis develops PsA, but it’s important to be aware of its symptoms if you have psoriasis.

Treating PsA early can help you avoid further joint damage, so make sure to mention any new or unusual joint symptoms during your medical visits.

https://www.healthline.com/health/psoriatic-arthritis-early-signs?slot_pos=article_1&utm_source=Sailthru%20Email&utm_medium=Email&utm_campaign=psoriasis&utm_content=2022-01-25&apid=39239719&rvid=058431b717dcfa59c0cdd27cd0a9313769e8b3dd4ad59d88efd0ded7ddb4774e#What-is-psoriatic-arthritis?

Living With Psoriasis: A Sufferer Shares Her Thoughts

From longevitylive.com

Psoriasis, a common autoimmune disorder that impacts over a million South Africans, is often misunderstood to be a simple skin disorder. This couldn’t be further from the truth—psoriasis is a serious chronic disorder that negatively impacts the overall health of a person, and can present with serious co-morbidities such as heart, lung and kidney problems.

Unlike other chronic diseases, psoriasis is visible to other people. This makes the disease even more complicated and debilitating, as many patients also suffer with mental health challenges such as anxiety, depression, poor self-esteem and relationship challenges. A recent study found that one third of adults living with psoriasis said that the disease interferes with their love life. 

Life with psoriasis

Sharon* was just seven years old when she had a severe case of chicken pox that left 90% of her body inflamed with painful burning scales. After a visit to a dermatologist, Sharon was diagnosed with psoriasis and has lived with this debilitating skin disease for over thirty years. This is Sharon’s story. 

“When my symptoms of psoriasis started, there weren’t many treatment options available and over the years, I tried a myriad of creams and UVA light therapies. Unfortunately, nothing helped me achieve clear skin,” said Sharon. “My life was filled with burning, itchy and embarrassing skin, at times I felt trapped alone at home. Those rare times that I did venture out, I hid my skin under layers of clothes.”

The psychological effects of psoriasis

“My psychological pain and anguish were worse than the pain of my skin,” added Sharon. “At that time, my doctors didn’t seem to consider my emotional suffering and the impact psoriasis had on my whole life. It all became so unbearable that I went to the darkest places of my mind and considered ending my life. “

namtipStudio/shutterstock

The treatment that changed everything

“Shortly after I considered suicide, I had a heart-to-heart with my doctor, who prescribed a biologic treatment,” said Sharon. “Initially, I didn’t have much hope, until I saw the difference it made to my skin. For the first time in years, I felt comfortable to wear sleeveless clothing and go out without covering up. I was overcome by joy!”

Lifestyle changes can reduce flare-ups

In addition to the right medication, lifestyle changes can also make a difference. 

• Reduce stress ­­–– psoriasis can be exacerbated by stress, so exercising regularly, doing breathing exercises, practicing yoga and mindfulness to calm your mind, body, and emotions will help.
• Talk –– endorphins are released when you share your challenges with your loved ones. Talking also makes you feel less alone, calms anxiety and reduces the chances of depression.
• Check your diet ­­–– foods such as red meat, dairy and citrus are known to cause flare-ups. Avoid them and figure out what other foods may cause your skin to flare up. We’re all different.

Talk to a dermatologist

It’s important to get the right treatment for your condition. Psoriasis patients are urged to motivate and pressurise their medical aid to cover the cost of treatment as it is a chronic and debilitating disease. In addition, it is your constitutional right to access healthcare.

“Psoriasis impacts people in different ways, and requires individual treatment,” says Dr Noufal Raboobee, a dermatologist based in Durban South Africa. “While each patient requires a unique treatment plan, what’s critical is that they find the right treatment plan to achieve clear skin, and do so before the disease escalates and causes additional health co-morbidities. Everyone deserves to live a fulfilled life without pain and shame.”

The bottom line

If you, or a loved one is experiencing dry, painful, scaly skin that just won’t heal, or any other symptoms of psoriasis, talk to a dermatologist. You can also learn more about psoriasis by visiting the #MoreThanSkinDeep page on Facebook. Remember, psoriasis can be treated and clear skin is achievable and its your right to get the treatment you need to live a healthy, fulfilled life.

 *Name of patient has been changed for privacy reasons.

https://longevitylive.com/beauty/living-with-psoriasis-a-sufferer-shares-her-thoughts/