Psoriasis the disease

What is psoriasis?Normally, the cells of the uppermost skin layer (epidermis) renew themselves about every 28 days. In psoriasis, this process lasts only three to four days.

Psoriasis is a chronic inflammatory systemic disease that primarily affects the skin, but can also affect the fingernails and toenails. Chronic means, in contrast to an acute disease, that it is a slowly developing and long-lasting disease. It is often not curable, but the inflammation can be reduced or even inactivated by treatment. The name psoriasis is derived from the Greek word "psora" and means "itch". In common parlance, psoriasis is also known as "psoriasis".

Psoriasis is one of the so-called autoimmune diseases. In this case, the defense cells of our immune system attack the body's own structures, in this case the skin cells. Inflammation occurs as a reaction to this supposed injury. Among other things, this leads to a constant overproduction of new skin cells. The skin cells of the epidermis multiply and grow faster than would be necessary for normal skin renewal. This leads to an accumulation of immature skin cells on the skin surface, which form the scales (plaques) typical of psoriasis. They are visible on the surface as shiny silvery scales.

Plaque psoriasis (also called psoriasis vulgaris) is the most common form of psoriasis. More than 80 percent of all psoriasis sufferers have this form of the disease.

How psoriasis manifests itself?

In psoriasis, more new skin cells are formed than are detached from the top layer of skin. Therefore, a thickening occurs there, in which neighboring skin cells stick together and the typical plaques form. These are raised, reddened, dry areas of skin covered with silvery white scales, sharply bordered by a narrow, red fringe. This redness is caused by dilated blood vessels through which specific inflammatory cells and messenger substances of the immune system enter the skin.

The scales of psoriasis can often be easily removed with the fingernail. Underneath, there is a red spot covered by a thin membrane. If this is removed, there is a punctate bleeding, the so-called bloody dew. In many sufferers, psoriasis causes itching or a feeling of tightness. However, this can be pronounced very differently from individual to individual.

In the most common form of psoriasis, psoriasis vulgaris (plaque psoriasis), the skin changes appear primarily on the elbows, knees, above the buttocks and on the scalp – initially as small patches. As the disease progresses, these patches can enlarge and also merge, eventually appearing in large areas all over the body and face. In a relatively rare form of psoriasis, the main trigger factors are hand. Soles of the feet affected (psoriasis palmaris et plantaris). In about half of those affected with psoriasis, changes form on the fingernails and toenails. Typical here are, among other things, pinhead-sized indentations in the nail surface (spotted nail) or yellow-red-brown shimmering spots under the nail plate (oil spot).

What is the course of psoriasis?

The course of psoriasis can vary greatly from one sufferer to another. In some cases, it progresses in episodes, between which the symptoms subside or even disappear altogether. Psoriasis symptoms are often more pronounced in spring and autumn, as there is less UV radiation at this time of year, which has a positive effect on the skin in summer. In others, the symptoms occur continuously without interruptions.

In psoriasis, joint involvement can occur in addition to the symptoms on the skin. Doctors then speak of psoriatic arthritis. In addition, other diseases can occur in connection with psoriasis. These are, for example, diseases of the cardiovascular system such as high blood prere, atherosclerosis, heart attack and stroke, as well as metabolic diseases such as obesity or type II diabetes. It can also lead to lipometabolic disorders or chronic inflammatory bowel diseases such as Crohn's disease or ulcerative colitis.B. Crohn's disease or ulcerative colitis. In patients with psoriasis, there is also an increase in depression and stress reactions. These are partly related to stigma, partly to psoriasis itself.

What are the causes of psoriasis?

Although the cause of psoriasis is still unknown, researchers have already identified several cells and messenger substances of the immune system that are involved in the development and inflammatory process of the disease – these include tumor necrosis factor-alpha (TNF-α), interleukin 12 (IL-12), IL-17 or IL-23. Based on these findings, many therapies have been developed in recent years for the effective treatment of psoriasis.

The cause of psoriasis is still not fully understood. It is amed that there is an existing, very variable genetic predisposition for psoriasis and that it is a matter of a malfunction in the immune system of the affected person. Misdirection of the immune system triggers an inflammatory response that accelerates the skin's renewal process.

There are certain trigger factors that are relevant when psoriasis first appears. However, they can also trigger a new relapse in the further course of the disease. However, in many cases it is not possible to find out exactly which factor led to the development of psoriasis or the triggering of an attack.

In order for the disease to break out, other factors, the so-called trigger factors, usually have to be present. These include:

– Irritations of the skin (e.g. B. Injuries, friction, sunburn, tattooing) – Emotional stress – Alcohol and smoking – Medications such as z. B. certain antihypertensive drugs, certain antibiotics, certain antidepressants – infections (e.g., infections that cause psoriasis). B. by streptococci, staphylococci) – metabolic disorders (z. B. Diabetes) – Hormonal changes (e.g. B. Pregnancy, puberty) – Environmental influences (z. B. cold, dry air) – overweight

Living well with psoriasis

Psoriasis is a chronic disease. A cure is not yet possible according to current medical knowledge. Nevertheless, an early, individual therapy concept can in many cases lead to a significant improvement up to freedom from symptoms and a significant improvement in your quality of life.

Because of the visible skin changes, people affected with psoriasis suffer more often from social exclusion than people with healthy skin (stigma). As a result, those affected report anxiety-. Feelings of shame up to social withdrawal. Affected persons may also suffer from depression or other mental illnesses.

It is important to start therapy for psoriasis as early as possible. Depending on the course of the disease and its severity, your doctor may combine different treatment methods. At the same time, you yourself can support the success of the therapy and maintain your quality of life by doing simple things in your everyday life. Strengthen z. B. Your contacts with your partner, friends or work colleagues, or with people who are also affected and whom you u. a. can find information about self-help groups.

Living well with a chronic inflammatory disease

Even with a chronic inflammatory disease, one can lead a satisfied and fulfilling life. In our patient guide FeelinX ®, you can find out what this can look like – through information and advice from us or from experience reports and tips from patients who would like to share their story with other affected persons.

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