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Thursday, November 11, 2004
Psoriasis: Incurable skin disease
By Henrylito D. Tacio
Health 101
COLUMBUS, Ohio -- Jude was only 15 years old when he observed two raised small red patches on his scalp. He never paid attention to it since the patches cleared up after a few weeks. He only started to worry when the patches grew together to form larger patches. Despite this fact, Jude still did not consult a doctor. It was only when the patches spread to other parts of his body, particularly elbows, knees, and buttocks, that he went to see a dermatologist.
The dermatologist Jude consulted prescribed a drug. At first, the drug was very helpful. But in the recent months, he started to feel the side effects of the drug like gaining weight, weakening of his bones, blurring vision, and having headaches. "Is there any solution to my problem out there?" he wondered.
Jude's problem is called psoriasis, a long-lasting, recurring disease often mistaken for leprosy. "Psoriasis occurs when skin cells quickly rise from their origin below the surface of the skin and pile up on the surface before they have a chance to mature," explains the Portland-based National Psoriasis Foundation (NPF) in the United States.
"Usually this movement (also called turnover) takes about a month, but in psoriasis it may occur in only a few days. In its typical form, psoriasis results in patches of thick, red skin covered with silvery scales. These patches, which are sometimes referred to as plaques, usually itch or feel sore. They most often occur on the elbows, knees, other parts of the legs, scalp, lower back, face, palms, and soles of the feet, but they can occur on skin anywhere on the body."
The NPF says the disease may also affect the fingernails, the toenails and the soft tissues of the genitals and inside the mouth. According to NPF, there are several forms of psoriasis. Some of these include: plaque psoriasis (skin lesions are red at the base and covered by silvery scales), guttate psoriasis (small, drop-shaped lesions appear on the trunk, limbs, and scalp), and pustular psoriasis (blisters of noninfectious pus appear on the skin).
Inverse psoriasis is smooth, red patches occurring in the folds of the skin near the genitals, under the breasts, or in the armpits. The symptoms may be worsened by friction and sweating. On the other hand, erythrodermic psoriasis is widespread reddening and scaling of the skin, which may be a reaction to severe sunburn or to taking medications. It can also be caused by a prolonged period of increased activity of psoriasis that is poorly controlled.
Then, there's psoriatic arthritis, a joint inflammation that produces symptoms of arthritis in patients who have or will develop psoriasis. "Although the patches do not cause extreme physical discomfort, they are very obvious and often embarrassing to the person," points out the second home edition of The Merck Manual of Medical Information.
Take the case of Jude. He could never go swimming in the beach or pools with his friends. When he changed clothes, he usually closed his room so that nobody
could see him. "I am afraid they would find about it," he said.
On the other hand, the psychologic distress caused by psoriasis can be severe; it may lead to significant depression and social isolation. Many people with psoriasis also have deformed, thickened, pitted nails. There are 125 million people worldwide afflicted with this non-contagious immune system disorder.
Generally, psoriasis begins most often in people aged 10 to 40, although people in all age groups are susceptible.
"Psoriasis has always been on the list of the top 20 diseases in the country," said Dr. Francisca de la Cruz-Roa, president of the Philippine Dermatology Society. "It often appears in the late teens to adulthood. It rarely occurs in children."
Psoriasis persists throughout life but many come and go. "Symptoms are often diminished during the summer when the skin is exposed to bright sunlight," says the Merck manual. "Some people may go for years between occurrences. Psoriasis may flare up for no apparent reason or as a result of a variety of circumstances."
Speaking of flare-ups, the Merck manual informs: "Flare-ups often result from conditions that irritate the skin, such as minor injuries and severe sunburn. Sometimes flare-ups follow infections, such as colds and strep throat. Flare-ups are more common during cold seasons and after stressful situations. Many drugs, such as antimalarial drugs, lithium, and beta-blockers, can also cause psoriasis to flare up."
The cause of psoriasis is still unknown but a problem with the immune system is thought to play a role. "Psoriasis is a skin disorder driven by the immune system, especially involving a type of white blood cell called a T-cell," explains the NPF.
(November 11, 2004 issue)
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