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Psoriasis: More education and awareness needed

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While most commonly seen on joints, such as knees and elbows, psoriasis can develop on the scalp, lower back, hands, feet, neck, face, and, in rarer instances, nails and mouth. (Photo: Envato Elements)
Some chronic illnesses may not be obvious, as most affect internal systems of the body, but in  the case of skin diseases, the situation differs. This is the case of psoriasis, which affects approximately 3 percent with the world population. It is a relatively uncommon condition, and people suffering from it may face hardships, not only because of the disease itself, but also because of society. اضافة اعلان

The National Psoriasis Foundation dubbed August Psoriasis Awareness Month in order to spread awareness about the condition and support those living with it.

What is psoriasis?
Normally, skin grows and dies in a steady process over the course of a month. But this chronic dermatologic autoimmune condition leads the body to mistake normal, healthy skin cells for invaders. This causes the skin to multiply at a rate 10 times greater than usual. The overproduction leads to buildup and stops the skin from falling off naturally. Thick, red patches with white scales that are prone to cracking and subsequent bleeding form on the skin. While most commonly seen on joints, such as knees and elbows, psoriasis can develop on the scalp, lower back, hands, feet, neck, face, and, in rarer instances, nails and mouth. It is an incurable, life-long condition, but proper management can control symptoms and manifestations, and reduce the number of flare-ups.

Types
Psoriasis typically makes an appearance in young adulthood and usually affects a few areas. There are currently five recognized types of psoriasis:

The most common type, present in an estimated 80 to 90 percent of all cases, plaque psoriasis shows on lighter skin tones as red patches with white scales, while on darker skin tones as purple or gray-colored patches. The areas most affected are the elbows, the knees, and the scalp.

Guttate psoriasis occurs most commonly in childhood and manifests as small pink or purple bumps, which rarely become thick. They generally affect the torso, arms, and legs.

Pustular psoriasis is characterized by white, pus-filled blisters with large areas of red, inflamed skin. Although affected regions are larger than those produced by plaque psoriasis, they are often localized to smaller places on the body, such as the hands and feet.

Inverse psoriasis causes large, bright areas of red, shiny, inflamed skin. This type of psoriasis is found on areas where skin rubs together, such as the armpits, places surrounding the genitals, and folds of skin.

Erythrodermic psoriasis is rare and extremely serious. Large portions of the body are affected. Its appearance is similar to a sunburn. Once scales develop, they begin to slough off in sheets, exposing delicate skin underneath. It is common for those with this condition to develop a fever and become very ill, which can become life-threatening without immediate treatment.

Causes
While an exact cause is unknown, it is believed that three main factors increase the risk of developing psoriasis: genetics, the immune system, and environmental causes.
Psoriasis commonly occurs in cycles, meaning that an individual will experience periods of intense symptoms that can last for days or weeks, known as flare-ups, and then clear up.
Decades of research revealed particular genetic abnormalities that will  not necessarily trigger the disease, but suggest a high degree of heredity.

Since psoriasis is an autoimmune disease, there is an inherent abnormality in the body’s ability to recognize foreign invaders. The immune system is a complex network with many pathways and any overexpression can result in the body inappropriately attacking itself.

Several environmental factors, as well as infections, stress, alcohol consumption, obesity, smoking, and specific medications can increase the risk.

Psoriasis is not contagious, but rather an internal disease that manifests externally.

Effects on the body
The symptoms of psoriasis differ from person to person and depend on the type and severity. In conjunction with the physical manifestations, it is common to experience itching, soreness, and burning sensations around affected areas. Psoriasis commonly occurs in cycles, meaning that an individual will experience periods of intense symptoms that can last for days or weeks, known as flare-ups, and then clear up. Certain environmental triggers, such as infection, can result in flare-ups. In some cases, especially with proper management, there may be no active signs or symptoms, in which case the disease may be considered in remission, but relapse is still possible.

Unfortunately, psoriasis is also associated with an increased risk of more serious difficulties, primarily cardiovascular complications. This can include an increased risk of heart attack, high blood pressure, and strokes. Psoriasis is also associated with diabetes, inflammatory bowel disease, fatty liver disease, and chronic kidney disease.

Societal stigma
A 2018 study conducted by the National Psoriasis Foundation found that 73 to 99 percent of people with psoriasis experienced some degree of stigmatization. The majority of the general population (62 percent) has poor education relating to psoriasis. In fact, 17 percent of respondents believed psoriasis was contagious and 7 percent believed it is related to poor hygiene. Roughly 50 percent said that they exhibit discriminatory behavior towards those with psoriasis, with 29 percent reporting that they would not shake hands with someone who is affected by the condition and eight percent feel reluctant to become friends. This stigmatization is felt by those who have psoriasis, and it was reported that 20 percent have faced rejection in public settings such as gyms, swimming pools, and salons.

Along with the stigma, those with psoriasis commonly report fear of rejection as well as feelings of guilt or shame. The result is a poorer quality of life along with many associated mental health conditions such as depression and anxiety.

More education and awareness should be spread about psoriasis in order to create a society that supports those suffering, instead of worsening their situation.


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