| Newsletter Fall 2005
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Living With Psoriasis
Those of us of a certain age recognize “the heartbreak of psoriasis” from long-ago television commercials. While the ad may be old, the significance of the message remains solid. Psoriasis is a miserable disease.
Dermatologist Daniel Dietzman, MD, works with people who suffer from psoriasis. “The psychological and emotional impact of the disease is a big concern. Since it’s on the skin it’s a very visible condition. Many people are very self-conscious of it. They won’t go out in public. It can be very disturbing to people.”
Psoriasis is a skin disease characterized by red, thick, scaly patches. Normally, skin cells grow deep in the skin and slowly rise to the surface. With psoriasis, skin cells grow about eight times faster than normal, but the rate that old skin cells slough off remains unchanged. The result - old skin cells build up on the skin’s surface forming red, scaly patches. To add insult to injury, not only are these patches unsightly, but they constantly shed flaky skin.
An estimated 5.8 and 7.5 million people in the United States have psoriasis, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Men and women get psoriasis at about the same rate.
Psoriasis occurs when the body’s autoimmune system, which usually protects against infection, doesn’t function properly. Another disorder of the autoimmune system is arthritis, and about 15 percent of psoriasis-sufferers also get psoriatic arthritis.
Psoriasis may first appear as small red bumps that soon morph into larger lesions. The plaques, as they’re called, most frequently appear on elbows, knees, legs, scalp, back, face, palms, and the bottom of feet. They can also develop on fingernails and toenails.
So what causes psoriasis? Researchers think that certain white blood cells, called T-Cells play an important role. T-Cells circulate throughout the body as part of the body’s defense, like a military general rallying the troops against invading enemies, such as bacteria and viruses. But something goes wrong in people with psoriasis. Their T-Cells overact and move to the skin, as if to heal a wound or ward off infection. They promote the rapid growth of skin cells, triggering inflammation and the development of lesions.
Scientists believe there is may be a genetic component to psoriasis. About one third of people with the disease have psoriasis in their family history.
“It goes throughout population and races,” says Dr. Dietzman. “We don’t really understand how. It can run in families, and it can have different expressions. Your great uncle could have a patch the size of a quarter, and you could have it all over your whole body. We think some people are born with a predisposition to develop it.”
There is no single test to diagnose psoriasis, but dermatologists are trained to recognize the appearance of the disease.
“There are a number of treatments,” says Dietzman. “We try to control it to the patient’s level of satisfaction. We want to make sure the side effects of the treatment aren’t worse than the condition itself.”
Treatment of the disease includes medications applied topically to the skin, ultraviolet light therapy, and a variety of medications taken orally or by injections
“What’s been used for years, and is still beneficial, are topical steroids. They still work well on limited patches, but their effects wear off over time. So there’s medication that we add to make the stero
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