Psoriasis is a common, chronic, relapsing/remitting, immune-mediated systemic disease.

1. Psoriasis
Psoriasis is a common, chronic, relapsing remitting, immune mediated systemic disease characterized by skin lesions including red, scaly patches, papules, and plaques, which usually itch.the skin lesions seen in psoriasis may vary in severity from minor localized patches to complete body coverage.
The five main types of psoriasis are plaque, guttate, inverse, pustular, and erythrodermic.Plaque psoriasis, the most common form, typically manifests as red and white scaly patches on the top layer of the skin. Skin cells rapidly accumulate at these plaque sites and create a silvery white appearance. Plaques frequently occur on the skin of the elbows and knees, but can affect any area, including the scalp, palms of hands, and soles of feet, and genitals. In contrast to eczema, psoriasis is more likely to be found on the outer side of the joint. Fingernails and toenails are frequently affected psoriatic nail dystrophy and can be seen as an isolated sign. Inflammation of the joints, known as psoriatic arthritis, affects up to 30Percent of individuals with psoriasis.
The causes of psoriasis are not fully understood. It is not purely a skin disorder and can have a negative impact on many organ systems. Psoriasis has been associated with an increased risk of certain cancers, cardiovascular disease, and other immune mediated disorders such as Crohns disease and ulcerative colitis. It is generally considered a genetic disease, thought to be triggered or influenced by environmental factors.Psoriasis develops when the immune system mistakes a normal skin cell for a pathogen, and sends out faulty signals that cause overproduction of new skin cells. It is not contagious.Oxidative stress,stress, and withdrawal of a systemic corticosteroid have each been suggested as a trigger for psoriasis.Injury to the skin can trigger local psoriatic skin changes known as the Koebner phenomenon.
No cure is available for psoriasis,but various treatments can help to control the symptoms.The effectiveness and safety of targeted immune therapies is being studied, and several have been approved or rejected for safety concerns by regulatory authorities. The disease affects 2

2. What is the treatment for psoriasis
There are many effective treatment choices for psoriasis. The best treatment is individually determined by the treating physician and depends, in part, on the type of disease, the severity, and the total body area involved.
For mild disease that involves only small areas of the body like less than 10Percent of the total skin surface, topical skin applied creams, lotions, and sprays may be very effective and safe to use. Occasionally, a small local injection of steroids directly into a tough or resistant isolated psoriatic plaque may be helpful.
For moderate to severe disease that involves much larger areas of the body like 20Percent or more of the total skin surface, topical products may not be effective or practical to apply. This may require ultraviolet light treatments or systemic total body treatments such as pills or injections medications. Internal medications usually have greater risks. Because topical therapy has no effect on psoriatic arthritis, systemic medications are generally required to stop the progression to permanent joint destruction.
It is important to keep in mind that as with any medical condition, all medications carry possible side effects. No medication is 100Percent effective for everyone, and no medication is 100Percent safe. The decision to use any medication requires thorough consideration and discussion with your physician. The risks and potential benefit of medications have to be considered for each type of psoriasis and the individual patient. Of two patients with precisely the same amount of disease, one may tolerate it with very little treatment, while the other may be almost completely become incapacitated and require treatment internally.
A proposal to minimize the toxicity of some of these medicines has been commonly called rotational therapy. The idea is to change the anti psoriasis drugs every six to 24 months in order to minimize the toxicity of one medication. Depending on the medications selected, this proposal can be an optimal option. An exception to this proposal is the use of the newer biologics medications as described below. A patient who has been using strong topical steroids over large areas of their body for prolonged periods may benefit from stopping the steroids for a while and rotating onto a different therapy, like calcitriol Vectical, light therapy, or an injectable biologic.

3. Symptoms
There are several types of psoriasis. Symptoms for each type may vary, but the major symptoms are:
Raised, bright red patches of skin camera.gif, often covered with loose, silvery scales, usually on the knees, elbows, or low back.
Tiny areas of bleeding when skin scales are picked or scraped off Auspitzs sign. Mild scaling to thick, crusted plaques on the scalp.
Itching, especially during sudden flare ups or when the psoriasis patches are in body folds, such as under the breasts or buttocks.
Discolored or pitted nails.
Other symptoms of psoriasis may include:
Similar plaques in the same area on both sides of the body for example, both knees or both elbows.
Flare ups of many raindrop shaped patches guttate psoriasis.
Joint swelling, tenderness, and pain psoriatic arthritis.
Psoriasis patches that appear after an injury, such as a cut, a burn, or too much sun. This is called Koebners phenomenon. Because this response is common, its important for people with psoriasis to avoid irritating or injuring their skin.
Several other skin conditions have symptoms similar to psoriasis. And some medicine reactions can cause symptoms such as reddened skin similar to psoriasis. Talk to your doctor about the medicines you are taking.

4. Prevention
There is no way to prevent psoriasis. But you can take steps to improve symptoms or help reduce the number of psoriasis flare ups. For more information, see Home Treatment.

5. Who gets psoriasis
People who get psoriasis usually have one or more person in their family who has psoriasis. Not everyone who has a family member with psoriasis will get psoriasis. But psoriasis is common. In the United States, about 7.5 million people have psoriasis. Most people, about 80Percent, have plaque psoriasis.
Psoriasis can begin at any age. Most people get psoriasis between 15 and 30 years of age. By age 40, most people who will get psoriasis, about 75Percent, have psoriasis. Another common time for psoriasis to begin is between 50 and 60 years of age.
Whites get psoriasis more often than other races.Infants and young children are more likely to get inverse psoriasis and guttate psoriasis.

6. What Causes Psoriasis
Psoriasis begins in the immune system, mainly with a type of white blood cell called a T cell. T cells help protect the body against infection and disease. With psoriasis, T cells are put into action by mistake. They become so active that they set off other immune responses. This leads to swelling and fast turnover of skin cells. People with psoriasis may notice that sometimes the skin gets better and sometimes it gets worse. Things that can cause the skin to get worse include:
Changes in weather that dry the skin
Certain medicines.

7. Psoriasis diagnosed
There are no special blood tests or tools to diagnose psoriasis. A dermatologist doctor who specializes in skin diseases or other health care provider usually examines the affected skin and determines if it is psoriasis.
Your doctor may take a piece of the affected skin a biopsy and examine it under the microscope. When biopsied, psoriasis skin looks thicker and inflamed when compared to skin with eczema.
Your doctor also will want to learn about your family history. About one third of people with psoriasis have a family member with the disease, according to dermatologist Dr. Paul Yamauchi with the Dermatology and Skin Care Institute in Santa Monica, Calif.

8. Psoriasis show up
Psoriasis can show up anywhere on the eyelids, ears, mouth and lips, skin folds, hands and feet, and nails. The skin at each of these sites is different and requires different treatments.
Light therapy or topical treatments are often used when psoriasis is limited to a specific part of the body. However, doctors may prescribe oral or injectable drugs if the psoriasis is widespread or greatly affects your quality of life. Effective treatments are available, no matter where your psoriasis is located.

9. How severe is my psoriasis
Psoriasis can be mild, moderate or severe. Your treatment options may depend on how severe your psoriasis is. Severity is based on how much of your body is affected by psoriasis. The surface area of the hand equals about 1 percent of the skin. However, the severity of psoriasis is also measured by how psoriasis affects a persons quality of life. For example, psoriasis can have a serious impact on ones daily activities even if it involves a small area, such as the palms of the hands or soles of the feet.

10. Guide to Psoriasis Treatment
Treating psoriasis typically requires several different approaches that may possibly include lifestyle changes, nutrition, and medication. Use this guide to get a view of your options.

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