Find ways to live with psoriasis

Published: Thursday, January 3, 2008 at 6:01 a.m.
Last Modified: Wednesday, January 2, 2008 at 5:16 p.m.

As a sufferer of a chronic condition (one that will not go away), I have great admiration for the coping ability of others who are making a life for themselves despite their chronic condition.

For the most part, although these conditions are not contagious (cannot be passed to another by contact), they also have no cure. The best-case scenario is the management of the condition. Such management includes not only the treatments supplied by the medical field, but our individual everyday coping skills.

According to the National Psoriasis Association, psoriasis is one of these conditions. It occurs at different levels of severity and may cause quite a bit of discomfort to the affected person.

More than 4.5 million adults in the United States have been diagnosed with psoriasis, and approximately 150,000 new cases are diagnosed each year. An estimated 20 percent have moderate to severe psoriasis.

This condition may be one that you have wondered about. Do you remember seeing a person with patches of white scaly skin on certain areas of their body, and wondering what it was?

In such cases, you are probably looking at a person with psoriasis, or something known as an "inflammatory skin condition." This type of inflammatory condition may occur as one of five types of a skin condition known as psoriasis.

Each type has its own unique signs and symptoms. Unfortunately, this condition can have more serious consequences for 10 percent to 30 percent of the people who develop it.

These persons may get what is known as "psoriatic arthritis," which affects the joints and causes inflammation. The most common type of this condition, known as plaque psoriasis, occurs in 80 percent of those with this condition. This type of psoriasis appears as patches of raised, reddish skin covered by silvery-white scales. These patches may appear on the elbows, knees, lower back and scalp, although they can appear anywhere on the body.

The other types of psoriasis are characterized by their symptoms and where they appear on the body. When we look at the second type, we see small, red spots on the skin.

The third type is seen as white pustules (raised areas) surrounded by red skin, and the fourth type is known as inverse psoriasis and appears as smooth, red patches that form in the folds of the skin. The fifth type may appear all over the body as widespread redness, severe itching and pain.

But, no matter what type of psoriasis that exists, the sufferer usually has some level of discomfort. The symptoms may include itching and skin that cracks and bleed. In severe cases, the itching and discomfort may keep a person awake at night, and the pain can make everyday tasks difficult.

I thought it was interesting to know that some people who have a family history of psoriasis never develop the condition. Research reported by the National Psoriasis Association indicate that there needs to be something that triggers the occurrence. Some of those things listed as "triggers" by the researchers are stress, skin injuries, strep infections, certain medications and sunburn.

Perhaps the most challenging symptom is the level of discomfort. This, according to the NPA, is not the same for everyone. Each person must be responsible for reporting their discomfort to their health care provider, because the level of discomfort usually dictates the type of treatment recommended.

Given the fact that for some folks the psoriasis is so mild they are not aware they have the condition, in other cases, symptoms may develop that are so severe, hospitalization is required. The majority of sufferers fall somewhere between these two extremes. Those with the symptoms of psoriasis must learn to deal with their condition.

This is one of those conditions that occur equally in men and women. Although ethnically, the condition seems to occur more in Caucasians and slightly less in African Americans, the genetic link associated with psoriasis indicate at least 1/3 of people who develop psoriasis have at least one family member with the condition.

According to the NPA, psoriasis may be one of the oldest recorded skin conditions. It was probably first described around 35 AD, with evidence of its existence at an even earlier date.

It is interesting to note that although this is a very old condition, the answer to what causes the condition is still not fully understood. What scientists have decided is that psoriasis may be caused by faulty signals from our immune system, with the contention that psoriasis develops when the immune system tells the body to overreact and accelerate the growth of skin cells.

You have to know that normally, the skin cells mature and are shed from the skin's surface every 28 to 30 days. When psoriasis develops, the skin cells mature in 3 to 6 days and move to the skin's surface. Instead of being shed, the skin cells pile up, causing the visible patches.

There is no age that makes you unlikely for the development of this condition. About 1 in 10 people develop psoriasis during childhood, and psoriasis can begin in infancy. The earlier the psoriasis appears, the more likely it is to be widespread and recurring.

Quality of life is obviously the name of the game here. Anytime we have to live with a chronic condition, concessions have to be made. Depending on the severity of the condition and its effect on our everyday lifestyle, the physical and emotional challenge can be overwhelming. Itching, scratching, soreness and cracked and bleeding skin may be both hard to deal with and to cover up.

If you are one of the sufferers or know someone with the condition, be sure that you acknowledge the frustration and embarrassment that may exist. Finding ways to cope through your health care provider will help you or your loved one deal with both the physical and the emotional components of this condition.

Remember, you must have your itch checked out by your physician. Psoriasis is just one of the inflammatory conditions that can affect the skin.

Vivian Filer is a retired professor of nursing, Santa Fe Community College. Write to her in care of the Gainesville Guardian, "Health Files," 2700 SW 13th St., Gainesville, Fla. 32608. You can also e-mail your questions, with "Health Files" in the subject line, to

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