Psoriasis Symptoms and Treatment

The most complex organ in the body after the brain is probably the skin. It must be waterproof, and yet let out water in the form of sweat. It must be strong to resist damage, yet flexible and sensitive to touch. Skin must repair itself rapidly when damaged, or vital body fluids may escape in a quantity sufficient to threaten life. It is easy to see, but difficult to treat, because few medications can penetrate through it. Because of the complexity of skin, many diseases can arise in our outer covering, and dermatologists are the doctors who specialize in diagnosing and treating its ailments.

One of the most annoying and distressing skin diseases, because it tends to be chronic and difficult to treat, is psoriasis. Psoriasis (the P is silent, and it is pronounced almost as 'sore-eye-asis') affects up to 2% of the population. It is unusual in children but becomes more common as age increases. One of the most frustrating aspects of this disfiguring dermatitis is the way in which it can come and go without any treatment. It almost invariably returns, and often in a worse form than previously. Because of this tendency to improve spontaneously, many forms of alternative medical treatment have claimed success in its management. The truth is that there is no cure for psoriasis,but doctors do have a number of quite successful forms of control that help most patients. It is important to realize that many diseases cannot be cured, but can be controlled. Control usually means that the sufferer must continue to take regular treatment to prevent the disease from progressing.

Psoriasis first appears as a small patch of red skin covered with fine scales. The elbows, knees and scalp are the most common sites affected, but the rash may cover any part of the body. The small spot gradually enlarges, roughens and the skin thickens. Then other spots start in other areas of the body over a period of months, until a large part of the body is affected. In the scalp, it may appear to be a bad case of dandruff until the doctor makes the diagnosis. The nails may also be affected, and they become rough and pitted.

Psoriasis has many subtypes, and it is not always easy to make the diagnosis. It may be necessary to cut out a small piece of skin for a pathologist to examine under a microscope before the diagnosis is finally confirmed. One of the more unusual features of psoriasis is that in severe cases the joints may be attacked to cause a type of arthritis.

Treatment can begin once the psoriasis has been diagnosed. This usually involves one or more of a number of creams or ointments that are used regularly on the skin. Coal tar in various forms is the mainstay of treatment, but steroid creams are also widely used. Other skin preparations include drugs called dithranol, salicylic acid and psoralen. Ultraviolet light may be used in conjunction with psoralen to promote healing. In very severe cases, steroid tablets or injections may be given, and in recent years a new drug called etretinate has become available to treat the most severe cases. Although it is a chronic and sometimes severe disease, psoriasis can usually be successfully controlled.

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