Psoriasis – Embarrassing Illnesses
What is psoriasis?
Psoriasis is a chronic, noncontagious skin condition that causes raised red patches topped with silvery, scaling skin, usually on the knees, elbows, scalp, and back (Plate 8). The fingernails, palms, and soles of the feet may also be affected. The patches, called plaques, are made up of dead skin cells that accumulate in thick layers. Normal skin cells are replaced every 30 days. In psoriasis, skin cells are replaced every 3 to 4 days.
Small patches of psoriasis can often be treated with regular use of hydrocortisone cream. Limited exposure to the sun may also help (protect unaffected skin with sunscreen). If psoriasis affects the scalp, mild tar shampoos may help. Stress may flare your psoriasis, and stress reduction generally helps. If your psoriasis covers much of your body or is very red and itchy, seek a dermatologist’s care. We now have biologic therapies for moderate to severe psoriasis; these include injections and infusions with proteins that modify the immune response.
Term:
Psoriasis–A condition in which the skin of an individual appears to be scaly and inflamed, particularly near the joints.
I have several small, scaly red patches on my face and arms. What are these, and what can I do?
Seborrheic dermatitis can show raised plaques and/or yellow greasy-looking scales found in the hairline, on the face, behind the ears, in the beard, and on the trunk and genitalia (Plate 9).
Symptoms can include itch, redness, and scaling and may mimic psoriasis, impetigo, fungus, and other irritating problems. When people have neurological problems such as stroke, there is an increased incidence of seborrheic dermatitis. Treatment includes topical steroids, topical and shampoo antifungal agents, and other prescriptions.
Terms:
Seborrheic dermatitis – A disorder of the skin located on the scalp resulting in itchy skin and dandruff.
Impetigo – An infection of the skin caused by bacteria like Staphylococcus aureus.
I have several small, scaly red patches on my face and arms. What are these, and what can I do?
Seborrheic dermatitis can show raised plaques and/or yellow greasy-looking scales found in the hairline, on the face, behind the ears, in the beard, and on the trunk and genitalia (Plate 9).
Symptoms can include itch, redness, and scaling and may mimic psoriasis, impetigo, fungus, and other irritating problems. When people have neurological problems such as stroke, there is an increased incidence of seborrheic dermatitis. Treatment includes topical steroids, topical and shampoo antifungal agents, and other prescriptions.
What is rosacea?
Rosacea (pronounced roh-ZAY-sha) is a common but little-known disorder of the facial skin that affects an estimated 14 million Americans. The disease can present with redness on the cheeks, nose, chin, or forehead; small, visible blood vessels on the face; bumps or pimples on the face; and watery or irritated eyes. Rosacea is becoming increasingly widespread as the baby boom generation enters the most susceptible ages. A Gallup survey found that 78% of Americans have no knowledge of this condition, including how to recognize it and what to do about it.
Because of its redness and acne-like effects on personal appearance, rosacea can cause significant psychological, social, and occupational problems if left untreated. In recent surveys by the National Rosacea Society, more than 76% of rosacea patients said their condition had lowered their self-confidence and self-esteem, and 52% reported that it had caused them to avoid public contact or cancel social engagements. Among rosacea patients with severe symptoms, nearly 70% said that the disorder had adversely affected their professional interactions, and nearly 30% said they had even missed work because of their condition. Some people mistakenly consider those with rosacea as alcohol abusers because of their skin ruddiness.
Although the cause of rosacea is unknown and there is no cure, help is available that can control the signs and symptoms of this disorder. Treatment includes oral antibiotics; the newest is an anti-inflammatory dosage of doxycycline such as Oracea®. Topical metronidazole gel such as MetroGel® 1% can also be used.
Term:
Rosacea – An inflammatory condition that manifests itself in the face as redness and small lesions. Rosacea (pronounced roh-ZAY-sha) is a common but littleknown disorder of the facial skin that affects an estimated 14 million Americans.
I have diabetes. What can I do to protect my skin?
Diabetes is a disease that has a huge impact on our culture. It is estimated to account for 15% of all healthcare costs in the United States. It has been implicated as the chief cause of nontraumatic lower-extremity amputations, 35% of new cases of end-stage renal disease, and a significant amount of cardiovascular disease. It has been said that 100% of all diabetic patients have their skin affected in one way or another. When you consider the older population, this effect is even greater. As many as 11 to 16 million people are affected with diabetes; the tremendous impact of the cutaneous manifestations of diabetes is obvious. The pathogenesis of these skin diseases is becoming clearer as more research is conducted. Even without that knowledge, some disorders are characteristically associated with diabetes. For example, diabetic bullae, the syndrome of waxy skin and limited joint mobility, and diabetic dermopathy are virtually pathognomonic for diabetes. Other diseases include fungal infections and acanthosis nigricans.
The feet are often affected, and oftentimes, because of the reduction in arterial supply and reduced sensation and pain awareness with diabetes, a person may get puncture wounds or imbedded foreign objects without noticing it. This can lead to ulceration and infection. Disorders of the diabetic skin that contribute to its pathology include microangiopathy, infection, and metabolic disturbances of the tissue. These problems cause disease in other parts of the body as well. Consequently, it is important to understand the dermal manifestations of diabetes so that one can effectively manage these common comorbidities. Treatment includes proper maintenance of blood sugar, diet, and exercise and carefully watching for signs of skin problems and infections.
Terms:
Diabetic bullae – A condition in which large blisters are found on the extremities of individuals who are diabetics.
Diabetic dermopathy – A condition that occurs on the legs of an individual who has diabetes. The skin has spots of hyper pigmentation caused by blood vessel leakage.
Acanthosis nigricans – A condition in which the skin becomes dark and thick, usually present in the areas of the body where skin folds.
Microangiopathy – A disease of the small blood vessels, more specifically the capillaries that leak protein and other chemicals.
