Definition
The name “psoriasis” is based on the Greek word “psora”, which stands for “scratching” or “itching”. Psoriasis is a benign, chronic, non-infectious, inflammatory skin disease. It is characterized by easily distinguishable, reddish spots, which are usually covered by whitish scales. There are two forms (psoriasis vulgaris and pustular psoriasis), each of which can also cause polyarthritis (inflammation of several joints). Psoriasis psoriasis is a skin disease that appears to have an inherited component, as it often affects several members of the family.
Occurrence in the population (epidemiology)
Psoriasis occurs in 1.5-3% of the fair-skinned population, and much less frequently in other ethnic groups. Neither sex is affected more frequently than the other. There is therefore a balanced relationship.
The age distribution also does not follow any regularity. Psoriasis occurs in both young and old people. However, there are two peaks of the disease: one is in the 2nd – 3rd decade of life, the other in the 6th decade.
Forms of Psoriasis
Psoriasis can be divided into three different forms:
- Psoriasis vulgaris (general)
- Psoriasis pustulosa (pustular)
- Psoriasis of the Nail
Therapy in the context of psoriasis always depends on the individual course and severity of the symptoms. In intervals when psoriasis is not severely developed, one should pay attention to good skin care that maintains the protective function of the skin. Various high-fat creams are available, some with special antiseptic active ingredients.
Baths with moisturizing bath additives also help in therapy, provided that you do not bathe too warm or too long. Two ointment additives have shown that they have a positive effect on psoriasis: urea and salicylic acid. They reduce scaling and help the skin to maintain its natural protective barrier.
If the outbreak of symptoms occurs in the context of a psoriasis flare, a step-by-step therapy scheme is used in the clinic. A distinction is made between mild, moderate and severe symptoms. Initially, glucocorticoid-containing ointments (cortisone) are available, which form the basis of the therapy in mild cases.
They have anti-inflammatory and anti-allergic effects by inhibiting the growth of immune cells that have gone out of line. In addition, the number of cells that cause or form dandruff (keratinocytes) is reduced. Furthermore, ointments with vitamin D3-like substances are applied to affected areas for therapy.
This reduces the function of other immune cells. Other substances used in the therapy of mild psoriasis are so-called retinoids and cignolin. New agents include calcineurin inhibitors, which are also supposed to regulate the immune system locally.
If these agents are not sufficient, further therapeutic measures are added in the case of moderate psoriasis. Phototherapy, which uses UV-A radiation or UV-B radiation, plays an important role here. These have a proven positive effect on psoriasis and are combined with ointments or baths.
As a last escalation stage in the therapy of psoriasis, there are agents available that are also used in other medical fields to suppress the immune system. Some of them have very strong effects and also side effects. They are systemic agents, used in tablet form or short infusions.
Ciclosporin or methotrexate (MTX) have been used for a long time. Newly added are antibodies that specifically block only one target, thus greatly reducing side effects. What exactly is right varies from patient to patient.
Some patients report relief of their symptoms through homeopathic remedies or acupuncture. However, there is not sufficient evidence that the effect goes beyond a placebo effect. Some patients report relief of their symptoms through homeopathic remedies or acupuncture.
However, there is not sufficient evidence that the effect goes beyond a placebo effect. Laser therapy: Thanks to a very precise and thin laser beam, laser therapy offers the possibility of treating the affected skin areas very precisely. As a result, the surrounding tissue is hardly affected at all.
The dose is adjusted according to the severity of the disease. PUVA: PUVA (Psoralen + UVA) is a special procedure that uses substances that increase the skin’s sensitivity to light.These substances are called psoralenes. They can be taken as tablets, but also applied as a cream, for example.
This increases the effect of UVA rays on the skin. Psoralene is believed to inactivate the overactive cells of the immune system, the so-called T-cells, which are responsible for psoriasis. Other light therapies: Other methods that make use of UVB and UVA radiation are narrow spectrum ultraviolet radiation and selective ultraviolet phototherapy.
Both methods use the irradiation of the skin. Under stress and great psychological strain, patients’ complaints often worsen. Therefore, the reduction of these factors can lead to an improvement of the suffering.
There is, for example, the possibility of visiting self-help groups or consulting a psychologist on the subject. Psychotherapists and psychologists can train you in dealing with stress and strain. Electrotherapy: Electrotherapy is still a rather new procedure, in which the affected skin areas are treated with very low-dose interference current.
Electrodes are attached for this purpose. The treatment takes place twice a day for several weeks. Only then can results be seen.
The patient can also carry out the therapy himself with borrowed or purchased equipment. There seems to be a connection between celiac disease and psoriasis, so avoiding foods containing gluten can alleviate the symptoms. Psoriasis is caused by the benign proliferation of the epidermis.
The skin cells migrate through the individual skin layers much faster than normal. In healthy skin, the skin cells develop deep down from cell division of so-called stem cells and migrate into the upper layers as they grow. The normal migration time is about 28 days to get from the lowest layer to the uppermost layer, the horny layer.
In the case of psoriasis, the cells only need about 4 days. The proliferation of skin cells is increased by about 20 times or more. This hasty and disturbed keratinization manifests itself in a stronger keratinization and a widening of the epidermis. An inflammation develops in the skin and more blood vessels grow in.