Krankheitsbild Psoriasis
What is Psoriasis?
Psoriasis is a widely spread, noncontagious, chronic and inflammatory skin disease that causes well-defined, red, scaly patches. Every area of the body can be affected, but the elbows, the knees and the scalp are the most frequently attacked.
The nails are attacked to 50% of the patients, while the joints (Arthritis psoriatica) are attacked to 20% of the cases. This disease is characterised by defined and accentuated skin lesions that are covered with lose overlying silvery-white dandruff.
Typically, the dandruff doesn’t cover the red centre completely and leaves a red margin that got the size of around one Micrometre.
The symptoms manifest itchiness, acute pain and slightly bleeding of the affected areas. In bad cases, even the general condition of the patient can be affected. The process of the Psoriasis is unpredictable because the symptoms can fade away and spontaneously re-emerge.
Who is affected?
2 to 3% of all people worldwide suffer from psoriasis. Men and women are affected almost equally. In western countries Psoriasis is a widely spread skin disease while in Africa or Asia it is found very seldom. Psoriasis can appear to every age. Usually, it is said that the earlier the disease appears, the harder is the following process. There are two different types:
TYPE 1: The disease appears when the patient is between 10 and 25 years old, there is a positive family history, a hard process of long duration.
TYPE 2: The disease appears when the patient is between 50 and 70 years old, there is a negative family history, easy process.
The psoriatic skin
Psoriatic skin lesions are often the result of
- an abnormal epidermal change,
- an abnormal keratinization, as well as
- an increase of the inflammatory mediators.
Which factors can cause psoriasis ?
Genetic influence
In the matter of Psoriasis, there is a strong genetic component, especially when the disease appears at young ages. Around one third of the psoriatics have one of the parents affected by this disease. However, there is no argument for a simple pattern of a dominant hereditary transmission. There are also patients without a genetic exposure and consequently there have to be both immunological and environmental factors responsible for the cause of the disease.
Immunological factors
Psoriatic patients have an abnormal cell immunity. The skin has a high number of immune cells and other natural substances, which enhance an inflammatory reaction as well as factors which stimulate the growth and excrescence of the cell.
Environmental factors
The following environmental factors are considered to be activators for Psoriasis:
- Spreptococcal, staphylococcal and viral infection (i.e. amygdalitis, varicella, measles, zoster)
- Physical trauma: i.e. mechanical irritation caused by wearing a watch or tight clothes.
- Therapy: lithium, ACE-Blocker, Lipid-lowering medication (gemfibrozil), interrupting the administration of Corticosteroids
- Emotional stress: shock, grief, depression, fear
- Weather: weather changes, switching the climate as a result of a trip.
Types of psoriasis
There are three different types of Psoriasis:
- sudden appearance of psoriasis, often after an infection
- chronic Psoriasis with just a few centres and increased scuffing
- and the rare, pustular type with yellow crustification of the dandruff and the tendency of a bad evolution.