Spotlight on Psoriasis

Preventing Patches of Itchy, Sore Skin

You may have heard of psoriasis, but do you know what it is? Psoriasis is a long-term, or chronic, skin disorder that affects more than 6.7 million U.S. adults. Symptoms can vary, but it’s usually recognized by itchy or sore patches of thick, red skin with silvery scales. There’s currently no cure, but treatment often helps.

Psoriasis occurs when skin cells quickly rise to the surface of the skin and build up into thick patches, or plaques. Ordinarily, skin cells mature as they rise from their origins below the surface of the skin. In psoriasis, these cells pile up before they’ve had a chance to properly mature.

Psoriasis actually begins in the immune systemThe body’s defense against germs and foreign substances., which normally protects the body against infection and disease. In psoriasis, the immune system becomes misdirected and overactive. This can cause redness and swelling (inflammation) and lead to the rapid buildup of skin cells.

Plaques are most often found on the elbows, knees, or scalp. But they can also affect the face, fingernails, toenails, soft tissues of the genitals, or any skin-covered region.

“Patients can have a lot of symptoms like itching, cracking, and bleeding that can disrupt their sleep and their social relationships,” says Dr. Joel Gelfand, a skin specialist (dermatologist) at the University of Pennsylvania. People with moderate to severe psoriasis may feel self-conscious or have a poor self-image, which can lead to depression or social isolation.

Some people with psoriasis also experience joint inflammation that produces arthritis-like pain. This condition is called psoriatic arthritis. Gelfand and other NIH-supported researchers have found that psoriasis—especially severe psoriasis—is linked to certain other disorders as well, such as heart conditions, obesity, high blood pressure, and diabetes.

Psoriasis can occur at any age, but it typically first appears in young adulthood. Many people with psoriasis have a family history of the disorder. Researchers have been able to identify certain genesStretches of DNA, a substance you inherit from your parents, that define characteristics such as eye color and your risk for certain diseases. linked to the disease, but they still don’t fully understand the disease process. They do know that it isn’t contagious. You can’t “catch” psoriasis by touching someone who has it.

Psoriasis can be hard to diagnose, because it can look like other skin diseases. Your doctor might need to look at a small skin sample under a microscope. It’s often best to make an appointment with a primary care doctor or a dermatologist to get an accurate diagnosis.

There are many approaches for treating psoriasis. Safe and proven treatment options include creams, light therapy, and medications given as pills or a shot.

“Treatment decisions in psoriasis need to be highly individualized and tailored toward the patient’s clinical condition and underlying health status, as well as their preferences and goals,” Gelfand says. Be sure to ask your doctor about the best treatment options for you.

Psoriasis symptoms may briefly worsen, or flare. These flares can arise when people are stressed or experience a traumatic event like the death of a family member or friend. Smoking, heavy alcohol use, and being overweight can also aggravate psoriasis. See the “Wise Choices” box for tips on avoiding flares.

Gelfand and other NIH-funded researchers have been working to develop better therapies. “It’s a great time to be hopeful and optimistic about this disease,” Gelfand says. “Most of the therapies coming out now seem to be well-tolerated and have impressive effectiveness.”