Psoriasis is a widespread dermatological pathology that afflicts millions of people and causes discomfort, embarrassment and shame that can also degenerate into depression in severe cases .
Psoriasis is a chronic inflammatory skin disease, not infectious or contagious, usually chronic and relapsing. There are several types of psoriasis, with partially different symptoms. Although the disorder can appear in any area of the body , it generally occurs in the elbows, knees, scalp and lumbar part of the back , as well as in the palms of the hands and soles of the feet. Its onset can occur at any age, although it is more frequent between 15 and 35 years of age. It rarely occurs in infants and very young children.
How lesions are formed
The typical patches, or plaques , of psoriasis are the result of an inflammatory process that stimulates the proliferation of the skin . The natural exchange of skin cells (keratinocytes) is extremely accelerated: instead of maturing and reaching the surface of the skin in about 25 days, keratocytes do it in just 7 days. This pathological mechanism tends to maintain itself over time . The course of psoriasis is characterized by periods, even long ones, free from skin manifestations alternating with relapses , that is the recurrence of the typical lesions.
Science has not yet been able to give an adequate answer on the causes triggering this skin pathology, even if we know that the immune system and genetics, together with environmental factors, play an important role in its development.
We can therefore say that this pathology is a genetic autoimmune condition . The immune system reacts abnormally causing a rapid multiplication of skin cells, which our body is unable to eliminate. This excessive production of cells is precisely what causes the typical spots of psoriasis.
Certain events can contribute to the appearance of psoriasis in predisposed people. Among these we have:
- Streptococcal infections : they are the cause of psoriasis in the guttate form, but they can also aggravate other forms of psoriasis. In these cases the infection must be treated with antibiotics
- Use of systemic corticosteroids : psoriasis sometimes appears during treatment with systemic corticosteroids, administered for other diseases. Otherwise it can also happen that the pathology is aggravated by the administration of these drugs
- Stress : it has always been considered a trigger for psoriasis, particularly in people with an aptitude to somatize on the skin.
Psoriasis is certainly ruthless: it can appear on the eyelids, ears, mouth and lips, on the folds of the skin, on the hands, feet and even on the nails . However, each of these areas is characterized by a different and different type of skin , therefore, it must be the treatment.
There are various types of psoriasis and therefore a slightly different symptomatology for each of its forms. Let’s see.
It is the most common form of psoriasis: it is characterized by erythematous plaques, covered with a silvery layer of dead skin cells . The individual plaques can also flow together and cover large body areas . The more intense the erythema and the more flaking the plaque, the more active the psoriasis. This type of plaque tends to appear more often on the scalp, knees, elbows and in the lumbar area . The lesions are often itchy and painful and it can happen that they can crack until they bleed.
The characteristic of this form is that it occurs in the form of small point lesions . Generally, children suffering from streptococcal tonsillitis suffer . In fact, it was found that about 10/15 days before the rash, patients had an episode of streptococcal pharyngotonsillitis. The streptococcal-psoriasis relationship is further confirmed by the fact that after an antibiotic treatment or after tonsillectomy , young patients undergo a spontaneous regression of this form of psoriasis. After plaque, it is the most common type of psoriasis.
It occurs in the form of red lesions located in the skin folds , for example behind the knees, in the armpits or in the groin. The skin appears smooth and shiny and often this type of psoriasis is accompanied by other psoriatic types.
As the name suggests, pustular psoriasis occurs with white pustules formed from non-infectious pus . Generally this form is localized in the palmoplantar area . It happens to be confused with other pathologies, such as dyshidrosis, contact dermatitis or irritative dermatitis. The pustular form generalized in other parts of the body is instead a serious form of psoriasis, which fortunately is rarely found .
It is a form of severe psoriasis that affects the entire skin area, which becomes erythematous and scaly . Sometimes the skin becomes exuding , thus generating a heat loss that induces a metabolic imbalance . In this case the patient must be hospitalized for therapeutic support. Generally this form is induced by coexisting drugs, stress or diseases.
It can cause bothersome itching and pain. It is a rare form and occurs in about 3% of psoriasis patients.
Generally, the dermatologist can diagnose psoriasis after an examination of the diseased skin, without resorting to laboratory tests. Sometimes, to be sure of the diagnosis, when the skin manifestation is similar to eczema, a biopsy may be required to examine the flap of skin taken: the psoriatic skin appears thicker and inflamed than that with eczema. It is possible that the doctor prescribes some blood tests to detect early the presence of other pathologies that can be associated with psoriasis.
The complications of psoriasis
It is important that patients suffering from this condition are aware of the autoimmune nature of the disorder as they are approximately twice as likely to contract another autoimmune disease . In fact , lupus, celiac disease and rheumatoid arthritis may be associated with psoriasis . An increasing number of studies suggest that this inflammation may also accelerate the development of atherosclerotic plaque , a degeneration of the arterial walls that leads to coronary heart disease . Although research is still weak, some studies confirm that the risk of contracting heart disease is much greater in people with psoriasis.
Psoriasis and nutrition
The relationship between psoriasis and nutrition has been the subject of numerous scientific studies for years. A cause-effect relationship between nutrition and psoriasis has not yet been demonstrated but it is certain that an incorrect diet can induce significant worsening of the disease.
Adopting an appropriate lifestyle also becomes fundamental in the field of dermatology, where the skin becomes the litmus test of our eating habits. Unbalanced diets can lead to acute stages of psoriasis while a balanced diet also guarantees prevention from overweight and obesity, thus reducing the risk of developing other pathologies related to psoriasis . The latter include cardiovascular disease, chronic inflammatory disease, depression and metabolic syndrome.
The ideal diet
Given that psoriasis is an inflammatory disease, experts advise to include in the diet those foods that naturally contain substances with anti-inflammatory activity or all those foods rich in polyunsaturated fatty acids and omega 3. Here is a short but useful list to keep in mind when let’s go shopping:
- as regards food of animal origin, green light for salmon , sardines , herring, mackerel and tuna
- As for foods of vegetable origin, ok is for legumes , dried fruit , flax and soybean oils and for green leafy vegetables . In particular, bitter vegetables are recommended, such as radicchio, chicory, beetroot and beets. Furthermore, an important role can also be played by vegetables containing beta-carotene , such as carrots and tomatoes
- The whole grains in grain are particularly important for psoriasis sufferers because they represent a valuable source of fiber and micronutrients such as antioxidants, vitamins and minerals. They are also a good source of polyunsaturated fatty acids. The micronutrients of whole grains improve immune defenses and reduce inflammatory processes , helping to burn the skin from psoriasis.
For a diet aimed at contrasting the symptoms of psoriasis at the table, red fruits , black and green tea , foods rich in polyphenols should never be missing from our shopping list .
Foods not recommended
Alcohol can worsen the symptoms of psoriasis and can interact with some drugs that are used to treat this pathology. It is important to reduce the intake of acidic foods , such as coffee and chocolate , due to their inflammatory role, and to avoid foods that contain arachidonic acid, in particular salami and red meat, but also butter, eggs and cream. In our shopping list, fried foods, sausages and products rich in refined sugar such as industrial snacks must also appear in moderation.
It is necessary to remember that psoriasis is a pathology that does not compromise the patient’s state of health and that, therefore, could easily be left untreated. Treatment is often requested by the patient for the psychosocial distress he experiences.
Therapies for the treatment of psoriasis
The treatments provided can include the use of:
- natural products (emollients, pickling agents, reducing agents, which reduce the thickness of the psoriatic plaque)
- drugs (antraline, corticosteroids, calcipotriol, tazarotene)
- systemic therapy (cyclosporine, retinoids, tracrolimus,
mycophenolate mofetil, methotrexate)
- biological drugs.
Today psoriasis therapy can make use of new biological drugs : these are antibodies aimed at blocking one or more cell activities . Once injected into our body, these antibodies recognize by themselves the place to bind with a precision and specificity that the drugs of the past did not have.
Other treatments to keep it at bay
The ‘ Skin hydration is very important to control psoriasis, especially in the plaque: is not, in fact, only an aesthetic factor but contributes to the patient’s well-being and promotes the absorption of locally applied drugs.
It is also essential to use the right products for hygiene, avoiding aggressive detergents and preferring those that are low-foaming and with few surfactants. Exposure to the sun is also useful for keeping psoriasis symptoms under control, especially vulgar ones.
The phototherapy consists in the use of equipment capable of artificially reproduce UVA . This treatment, performed at home or by the dermatologist, brings benefits similar to those of the sun, but it must be considered that the continuous use of UVA lamps increases the risk of skin carcinomas and accelerates aging. In recent years , narrow band UVB lamps have also been used , that is, they only use the wavelength useful for psoriasis, and not the one that can cause erythema.
Psoriasis five tips to keep you at bay
1- Eat light and keep weight under control
2– No to stress: under pressure psoriasis tends to get worse
3–Yes to sun and sea: vulgar psoriasis benefits from it
4-Moisturizes the skin especially if you suffer from plaque psoriasis
5–Pay attention to hygiene: no to aggressive detergents yes to those with few
Prevention at the table: the Mediterranean diet
Many scientific studies conducted by doctors shows how patients who follow the Mediterranean diet have less chance of developing psoriasis than patients who are far from this food model. In particular, the latter consume, compared to healthy subjects, less extra virgin olive oil , less fruit, fish and nutswhile they eat more red meat. Other fundamental foods of the Mediterranean diet, which it would therefore be important not only to consume for prevention, but also to introduce psoriasis into the diet, are (in addition to fish, seasonal fruit and vegetables) unrefined cereals, as they are rich in polyphenols and antioxidants and therefore able to guarantee this diet a powerful anti-inflammatory action.