What is Psoriasis and Psoriatic Arthritis?

If you’ve ever had dry, cracked heels and a very itchy, allergic skin reaction at the same time, you’d probably be able to better understand what it feels like to have psoriasis (pronounced suh rye uh suhs).

As unlikely a combination as this may seem the symptoms and irritations of psoriatic disease are not just skin deep. Psoriatic disease hits our whole body and leaves us with psychological baggage.

Depending on where your symptoms appear, sudden onset of psoriasis – mostly in stressful times – can be embarrassing in public.

We’re brought up to feel skin conditions are gross and embarrassing so they may go undiagnosed for years.
Breaking the stigma of psoriatic disease is important for research purposes.

The more we know about individual symptoms and triggers of this debilitating condition, the more we can study, treat, and perhaps even cure psoriatic disease one day.

DID YOU KNOW?
October 29 is World Psoriasis Day, which aims to raise awareness, share information, improve access to treatment options available, and support psoriasis sufferers worldwide

What is psoriatic disease?

Our immune system was designed to protect us from foreign bodies, much like an army would defend a fort.

When our immune system misidentifies a healthy cell as a foreign body, antibodies automatically defend the system by attacking what they perceive as a threat to our health and well-being.

A compromised or out-of-order immune system struggles to fight off infections, bacteria, and diseases.

It can even start to turn on ourselves. Our best defense becomes our worst enemy.

With autoimmunity on the rise in the U.S., the race to find possible cures or better treatment options for silent sufferers of an autoimmune disease is hampered by the race to find a Covid-19 cure first.

Recent research suggests that a number of underlying conditions noted in confirmed Covid-19 positive cases can be classified as autoimmune diseases.

© TreatPsoriasis.com, 2020
Adapted from https://www.healthline.com/health/autoimmune-disorders

It is important to consult with your healthcare professional as soon as you feel or sense a change in your body and/or its way of working.

Many autoimmune diseases share common symptoms, and Dr. Google isn’t always the expert we want it to be!

In most instances of autoimmunity diseases, the illnesses associated with autoimmunity are generally classified as chronic conditions and require ongoing, chronic medication to treat and manage.

Lifestyle changes are also needed in order to live better alongside your symptoms and flare-ups.

Related: Read an extensive list of autoimmune diseases here

DID YOU KNOW?
Psoriasis and psoriatic arthritis are classified as autoimmune diseases

Diagnostic tests for autoimmune diseases aren’t specific, and additional tests need to be done to determine if you have an autoimmune disease.

For example, a dermatologist will be able to determine if the skin problems you are having are as a result of psoriasis (and therefore has underlying autoimmunity causes), or something else, such as a bacterial infection.

What is psoriasis?

Psoriatic disease – specifically psoriasis – is a dermatological skin condition that results in raised or swollen welt-like patches on the body.

Psoriasis patches and flare-ups often occur on exposed skin such as elbows, knees, and face.

This can cause social embarrassment in some people, especially as flare-ups tend to be worse than living with the everyday condition.

It is thought that the disease may be an indication of risk in other conditions, such as Diabetes type II (insulin resistance rather than a lack of insulin production common in type 1), fatty liver disease, or increased risk of heart attacks.

If you have psoriasis, you are not alone.

You might be surprised to see below how common it is and how it affects us all:

Figure 2: Notable psoriasis statistics, 2020

© TreatPsoriasis.com, 2020
Adapted from https://www.psoriasis.org/ and https://www.healthline.com/health/psoriasis/

Types and generalized symptoms of psoriasis

While the disease is mostly just bothersome and negatively affects our quality of life, certain types can become life-threatening.

In rare instances, these diseases evolve into more serious conditions or are managed alongside other chronic conditions.

This list of types is not exhaustive, but rather takes a brief look at the most common forms.

© TreatPsoriasis.com, 2020
Adapted from https://www.psoriasis.org/about-psoriasis

1. Plaque psoriasis

The most common form of psoriasis, this condition affects 80-90% of all people living with psoriatic skin disorders.

Plaque psoriasis is characterized by angry, red patches that are covered in dry, itchy, flaking, and dead skin cells as your body races to repair skin cells that it misdiagnosed as being diseased or damaged (in need of repair or regeneration).

This results in raised welts and lesions that constantly require attention and care to minimize scarring and lowered quality of life.

The lesions and welts often weep, crack, or bleed, made worse by scratching and tight clothing.

Read more on plaque psoriasis here.

2. Guttate psoriasis

Triggered by bacterial infections, this type of psoriasis affects children and young adults more often than older adults.
Guttate psoriasis presents as sores and scales that are finer and less-evident than red, patchy plaque psoriasis. While some sufferers only report a single outbreak of guttate psoriasis, others are chronically affected over the course of their lifetimes.

Flare-ups can appear on the head (scalp), upper body, and legs.

Read more on guttate psoriasis here.

DID YOU KNOW?
Many people suffer from more than one type of psoriasis, often appearing on their bodies at the same time

3. Inverse psoriasis

Considered a type of plaque psoriasis, inverse psoriasis tends to present itself in the folds and creases of skin that would probably be considered the most-sweaty parts of our bodies!

Recognized by moist, red patches of skin (rather than dry, flaky patches), inverse psoriasis is mostly found in the groin area, under the arms, or under a woman’s breasts.

Read more on inverse psoriasis here.

4. Pustular psoriasis

Not a very pleasant-sounding name for a rather unpleasant form of psoriatic disease, you can mostly recognize pustular psoriasis by white, pus-filled sacs and blisters (pustules) on various parts of the body – depending on which type of pustular psoriasis you may have.

Although the blisters contain only white blood cells (and are thus generated by the immune system itself), it is unsightly and tends to make others feel uncomfortable. Pustules can form on dry, flaky skin and merge to burst open, weep until the pustules glaze over, and then begin forming new pustules.

Rest assured that pustular psoriasis is not contagious but may become life-threatening if left untreated.

Read more on pustular psoriasis here.

5. Erythrodermic psoriasis

Developing as a complication from severe cases of either the plaque or pustular type, erythrodermic psoriasis is rare, but debilitating.

Most easily diagnosed by simply glancing at the red, inflamed blisters and patches covering a larger-than-average area of skin, the intense itch and burning sensations can be extremely uncomfortable to deal with.

Add to this that sudden onset (or a flare-up) of erythrodermic psoriasis can leave sufferers in intense pain.

In an effort to save the body from shutting down, the body retains fluids, skin dehydrates, and severe infections begin to fester in a body at war with itself.

As erythrodermic psoriasis results in whole, extended patches of skin peeling off (not just small flakes), the skin becomes vulnerable to bacteria, dirt, and sepsis.

There are no quick fixes, and nor do we recommend self-diagnosis or self-medicating. Therefore, if you or a loved one are currently experiencing any pain or discomfort please consult with your emergency healthcare practitioner immediately.

Read more on the erythrodermic type here.

What is psoriatic arthritis?

As the name implies, psoriatic arthritis is a disease that affects the joints of approximately 30% of all psoriasis sufferers.

Onset may be as early as childhood, although psoriatic arthritis generally occurs between the age of 30 and 50.

Affecting both men and women equally, psoriatic arthritis is a chronic, inflammatory condition that can attack any joint in the body, but is mostly found in the lower extremities and pelvic area.

Psoriatic arthritis can also affect individuals who display no symptoms of psoriasis but may have relatives with psoriatic disease.

In addition, psoriatic arthritis may develop prior to the onset of psoriasis, without warning.

Conclusion

There are many reasons why so many people worldwide have psoriasis.

Pre-existing and co-morbid conditions often go unnoticed or undiagnosed – until our body’s begin to shut down.

Genetics play a huge role in autoimmune diseases, as does the environment, trauma, an individual’s overall health and habits, and more.

While your most obvious symptoms may be itchy and flaky, it’s important to know that psoriasis is not just skin deep.

As an auto-immune condition, you have to see it holistically, and treat it as such.

Resources used in this document: