Psoriasis is a chronic skin disease characterized by red patches covered with white scales . Often these spots feel thickened . The rash occurs mainly on the scalp, the extensor of the knees and elbows , lower back , legs , arms , hands and feet , face and body folds (quite rare ) . A generalized form of the body is rare.
Sometimes nail changes (pitting , dystrophy ) or arthritis ( fingers , toes ) in .
Psoriasis often occurs with arthritis (10%) , Crohn 's disease and other psoriasis does not affect other potential diseases .
The disease is often for the family. People are born with psoriasis. Every person has a predisposition to developing psoriasis in his / her life. This means you will not necessarily get psoriasis, even if you have the predisposition . There is about a 10 percent chance that a child will get psoriasis if one parent has psoriasis , 50 percent chance if both parents have psoriasis.
Were estimated to live in Belgium , about 200 000 to 300 000 people with psoriasis.
• Psoriasis vulgaris : ordinary plaque psoriasis , the most common form . Red , symmetrical, well-defined , raised rashes or "plaques " of variable size , with silver gray , scaly easily removable. Especially extension sides of the elbows , knees , scalp ( psoriasis capitis preaches a continuation ) to the back .
• pustular psoriasis rare form with large puskoppen mainly on the feet and hands . Sometimes widespread throughout the body, with fever .
• arthropatica Psoriasis: Psoriasis associated with joint problems
• Psoriasis capitis : scalp psoriasis
• flexural psoriasis : psoriasis in body folds and armpits , groin , under the breasts and the skin is red and itchy , but does not flake . It would be particularly common in obese people .
• unguum Psoriasis Nail Psoriasis can occur on a nail , but also in all fingernails and feet. Often there are pits on the surface of the nail and brown discoloration and sometimes loose nail .
• ertrodermie Psoriasis : psoriasis rare form throughout the body dotted with bright redness . It occurs in the eruptions.
• Guttate psoriasis ( psoriasis fall ) : acute, widespread outbreak of small red spots up to 1 cm in diameter , especially on the trunk and extremities. It occurs mostly in children and young adults , sometimes after an infection , and usually heals spontaneously .
10 to 30 % of patients with psoriasis also develop some form of arthritis ( swollen joints ) . This is accompanied by stiffness and pain in the joints , limited joint mobility, etc. All joints may be affected .
The disease usually develops slowly , but sometimes it can get worse very quickly.
common types of psoriasis
Causes
The exact cause of psoriasis is unknown . Is suspected to be an immune disorder in which the immune system gives wrong signal causing the growth cycle of the cells of the skin accelerates. Normal skin renews itself every month. In psoriasis, an injury, however, cell division in the epidermis is produced at very high speed , so that cells move ongveer 6 times longer than normal in the direction of the outer layer of skin. Therefore keratinization or expansion occurs . The chips are actually nothing more than immature skin cells that come off prematurely.
Only people with a genetic predisposition ( susceptibility ) contract this skin disease . Psoriasis is a disease sensitive to stress above . Stress then be understood in its broadest sense . Example proven that students in the period of the course, when she married family problems ... the emergence or worsening of psoriasis. Moreover, to reduce psoriasis or even disappear when a person is happy or go on vacation .
Other triggers may include irritation or friction injury, infections with fever, the influence of hormones in women , certain medications and climate .
It is important to know that psoriasis is not contagious .
Proceedings of psoriasis
Psoriasis is not so bad and the age at which the disease manifests itself can vary in all patients . Some patients only have a place here and there , some are from head to toe . Psoriasis also has an undulating course : periods of flares are interspersed with periods of improvement ( remissions) .
Very often , the first signs of psoriasis during the teenage years , around age 25 or 50 years .
Degree of participation
• mild psoriasis shape (approximately 5% ) occurs in approximately 75 % of patients
• degradation moderate ( 5 to 20% ) to about 20% of patients.
• psoriasis Erge degradation (20 to 100%): less than 5 % of patients
Currently , doctors use the PASI ( Psoriasis Area and Severity Index) to go. Severity of the condition on the map Here the body is divided into four zones by location and display the percentage affected area .
Psoriasis treatment
The psoriasis drug combats the effects and not the disease itself. No treatment can be guaranteed and permanent healing . It is also suggested that the medication that works well for one person to another perhaps give any results .
Certain medications have many side effects that your health is seriously impaired . Good and honest consultation with your doctor is very important. Never experiment on your own.
Some treatments are mainly aimed at temporarily to 'clean up' the skin, while others are more focused on keeping the disease under control and prevent. Flares
Typically , one , depending on the severity of the disease, from lighter treatments and , if necessary , to gradually change along a different treatment. Sometimes you can get better results by combining ( 2 or more treatments at the same time ) and turn ( alternative treatments ) .
There are three main categories of treatments :
A. Local or topical treatments
Ointments, creams , lotions based on bitumen (obsolete ) , anthralin (obsolete ) , cortisone and vitamin D3
• tar (coal tar or mineral or vegetable origin ) is a product (obsolete ) used in shampoos and various ointments, usually in combination with other substances . Advantage increases sensitivity to the sun. Moreover, clothes and colors can give the skin irritation ..
• Vitamin D3
Calcitriol and calcipotriol are synthetic forms of vitamin D3 which inhibit the production of skin cells . It is an effective work product , but slow . Is normally used in combination with other treatments . Not used on the face or in children.
Disadvantages : calcipotriene can irritate the skin , especially at the beginning of treatment. The agent must be applied two times a day. Destinations to
• Anthralin
Anthralin is an old product which is used for mild to moderate psoriasis , sometimes in combination with light therapy. This conditions the skin and clothes and can give skin irritation . Contact with eyes and mucous membranes should be avoided.
• Salicylic acid
Products containing salicylic acid - sometimes in combination with other products - facilitate release of white flakes , so that the effects of other drugs is enhanced .
Should not be used over a large area of the body, or in children.
• Cortisone and its derivatives
Cortisone derivatives are basic treatment , often in combination with salicylic acid , coal tar or anthralin . They provide an inhibition on and decrease the thickness of the plates. Often success with strong corticosteroids for the skin to get. Almost completely quiet
Cortisone is a natural hormone produced by the adrenal glands , but also synthetically. There are different kinds . Their use depends on the severity of the psoriasis , the site of the lesions and the patient's age . Since these drugs can cause serious side effects should always be used followed by the doctor and that can be used . Only for limited periods
In psoriasis oral corticosteroids should not be taken by the risk of escalation and spread of the disease.
B. Light therapy
• PUVA ( pill + exposure)
This is a treatment in which ultraviolet light is combined with a drug ( psoralen ) , which makes the skin more sensitive to UV -A. Because UV light, the affected cell growth and inflammation of the skin.
Pua has in most patients with psoriasis a beneficial effect, however, is only temporary. Due to side effects ( accelerated skin aging , skin cancer , eye damage ... ) , this therapy is used only in the most severe forms of psoriasis and for a limited period . Not for use during pregnancy.
• UVB: narrow and broad spectrum
In this treatment, the skin is exposed to a specific wavelength of ultraviolet light , ie UVB . It is a relatively safe method , without the risks of PUVA therapy , used to treat moderate to severe psoriasis . After initial intensive treatment for several weeks you can switch to a maintenance treatment.
• Laser
The new X -trac provides excimer laser for the treatment of psoriasis is a promising new patient application of laser technology in light therapy . The laser light is focused on a very high dose of some of its active plates of a few cm . Due to this high dose are only skin areas brought to heal, and the risk of damage , reduced skin . The new therapy is particularly valuable for the localized , stubborn psoriasis plaque type .
People with moderate disease of psoriasis vulgaris usually make a substantial improvement in the skin condition after only 4 to 10 Xtrac laser treatments set. In some cases we have seen a marked improvement after a single treatment. The result obtained after treatment can be maintained. More than six months
The results are therefore easier to see than conventional phototherapy . It's nice that patients with fewer treatments per year have to be. Freed from the symptoms therapy has no additional money care, creams, or any other medication .
Recently, this laser treatment also exists in Belgium. They are not reimbursed by health insurance .
C. Systemic treatment
In severe cases of psoriasis that can not be brought under control of local resources or light therapy , dermatologists suggest a systemic therapy . Control and monitoring of these treatments should always be carried out . By medical specialist are more and more medicines lately in the market. The most common are :
• methotrexate
Metrotrexaat used in cancer treatment . Prevents the multiplication of cells . Is an effective product , but due to side effects , is used only for severe forms of psoriasis that are not amenable to other treatments. Can be administered orally. O through an injection
Adverse reactions of nausea , fatigue , loss of appetite damage , anemia , liver and kidney, etc. should never be given to pregnant women . When used by young women need to ensure effective contraception . Can not be combined with various drugs such as aspirin and other anti-inflammatory drugs , diuretics and most antibiotics.
• Retinoids
Retinoids are synthetic derivatives of vitamin A. The only product on the Belgian market for the treatment of psoriasis is acitretin . Only use in the most severe forms of psoriasis and under strict medical supervision.
Possible side effects include headache , dry mouth , muscle , liver and nierbaschadiging . It is very toxic to the fetus . Pregnant women should not use it. Always be combined with a preservative, up to 2 years after the use of the product . Can not be combined with vitamin A and alcohol and most antibiotics .
• cyclosporine
This is also an immunosuppressive agent used to prevent organ transplant rejection after counter. It is used for severe forms of psoriasis that do not respond to other treatments.
Due to side effects ( high pressure , kidney damage, blood) can be used. Only for limited periods need regular monitoring of blood pressure. Never in combination with anti- inhibitors , aspirin , most antibiotics , diuretics , etc.
