Know The Symptoms Of Psoriasis

Psoriasis is a stubborn, chronic, and as yet incurable disease of the skin. Some eight million people suffer from psoriasis in the United States alone. And they spend more than $1 billion a year ($2,000 every minute!) to treat this poorly understood ailment.

Psoriasis-the word comes from the Greek psora which means itch-was considered a form of leprosy in biblical times. But this "disease of healthy people" doesn't threaten or shorten lives. It is neither an infection nor an allergy. It probably is not due to any vitamin or mineral deficiency. It doesn't leave scars or make you lose your hair. And, except in severe cases, it doesn't interfere with physical activities. (In fact, it may not even itch). To the psoriasis sufferer, however, it can be an emotionally disabling and trau­matic disorder.

Psoriasis is characterized by patches of raised, red skin cov­ered by silvery-white scales. It can occur at any age, but commonly begins in young adulthood. It usually recurs at unpredictable intervals and may be worse in the winter. It is often precipitated or aggravated by physical or emotional stress, upper respiratory infections, strep throat, alcoholic beverages, obesity, certain oral medications (lithium and anti-malarial drugs are but a few), and skin injuries such as scratches, cuts, and burns, including sunburn.

Psoriasis is not contagious. It does seem to run in families­ about one-third of psoriatic patients have a family history of the condition-although the pattern of heredity is not clear. It is also associated with a form of arthritis which affects the joints of the fingers.

No one knows the cause of psoriasis, but we do know how it comes about. Normal skin cells have a life span of about twenty­ eight days. This is the time it takes for a cell to be born, move to the outer surface of the skin, and flake off.

In psoriasis, due to some abnormality in the mechanism which makes the skin grow and replace itself, this orderly process goes awry. The skin cells turn over at a rate ten times faster than the normal cells, causing a build-up of scales in thick, red, and sharply-bordered patches. These patches may be small, the size of a matchhead or smaller, or extremely large, covering the entire body. If these patches appear in the body's creases and folds. They may cause itching and pain. Although psoriasis can affect any part of the skin, the patches usually occur on the elbows, knees, and scalp.

Psoriasis comes in many shapes and forms. It can, for example, limit itself to the fingernails and toenails as small pits or stippling or loosening of the nails from their beds. In some unfortunate people, it affects the genital area and can limit sexual activity. In extreme cases it is widespread, with total body redness and scaling, causing severe embarrassment which, in turn, can lead to psychological problems: the true "heartbreak" of psoriasis.

If you have psoriasis, there are some remedies you can try yourself. But for serious or stubborn cases, I recommend you see your dermatologist. There are many treatments, both old and new, that require a doctor's know-how.

The method of treatment depends on the extent and severity of the symptoms. An old standby is one of the various types of tar preparations which have been used with good results by thousands of psoriasis sufferers. Other methods are sunlight and ultraviolet radiation. There are also cortisone-like medications that are ap­plied or injected into the patches as well as various oral remedies which, while often effective, may have potentially serious side effects. One of these is methotrexate, a drug that has been used for many years to treat difficult and extensive cases of psoriasis. Treatment with methotrexate is complicated by nausea, mouth ulcers, headaches, and harmful effects on the liver.

The latest powerful oral medication for severe and stubborn psoriasis is a pill called etretinate (Tegison). It is extremely effective for the severe, generalized forms of psoriasis, but there are many serious, adverse side effects. If you plan to enter into this therapy, make sure your dermatologist explains it to you.Every new treatment for psoriasis becomes headline news.

Most of these "miracle treatments" quickly fall into disfavor or are discarded when another "breakthrough" is heralded. One of the popular treatments, PUVA therapy, is aimed at slowing down excess cell reproduction. The patient swallows a harmless drug called methoxsalen and then is exposed to longwave ultraviolet light. The proponents of this therapy swear by it, and today it has become a fashionable treatment for people with extensive psoria­sis. There is some indication, however, that the PUVA treatment' can lead to severe skin damage appearing many years later. Another reported treatment, called climatotherapy, consists of bathing in the Dead Sea!

But let's face it. While many of these treatments can help relieve the itching and scaling, there is no known "cure" for psoriasis. The cure will come about only when we know the exact nature and mechanism of the disease.

And while you must face the possibility that psoriasis will be a permanent guest in your life, let me offer some general guidelines to help you overcome the difficulties that accompany your condi­tion:

* Avoid emotional stress and tension.

* Try not to worry about what you consider the unsightly appearance of your rash. (It looks a lot worse to you than it does to other people.)

* If it itches, try not to scratch.

* Avoid those widely advertised" quick cures."

* While diet plays only a small role in psoriasis, I recommend that you limit your intake of red meat, poultry, eggs, dairy products, and alcoholic beverages for a few weeks to see if it helps. I know that doesn't leave much, but a temporary diet of fish and vegetables is a small price to pay for the chance of relief.

* Cooperate with your dermatologist.

* Don't be discouraged if progress is slow.

* And take comfort in knowing that with the variety of medications and treatments available, this potentially trau­matic and hopeless disorder has a good chance of being controlled.