Psoriasis : symptoms, causes and treatment
- Psoriasis: understanding everything in 2 minutes
- Who is injured?
- Medical Causes
- Types of Psoriasis
- The hygiene of life
- Evolution and possible complications
- Medical treatments
- Natural treatments and psoriasis
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Psoriasis is an inflammatory skin disease. It is usually characterized by the appearance of thick patches of skin that peel off (peel in the form of white "scales").
The spots appear in different areas of the body, most often on the elbows, knees and scalp. They leave areas of red skin.
Photo by bongkarn thanyakij from Pexels
This chronic disease progresses in cycles, with periods of remission. It is not contagious and can be well controlled by treatment.
Psoriasis: understanding everything in 2 minutes
Psoriasis can be very unpleasant or even painful when it appears on the palms of the hands, the soles of the feet or in the folds of the skin. The extent of the disease varies greatly from one person to another.
Depending on where the plaques are located and their extent, psoriasis can be embarrassing and interfere with social life. In fact, the vision of other people about skin diseases is often painful.
Who is injured?
It is estimated that approximately 2-4% of the Western population is affected. Psoriasis mainly affects Caucasians.
The disease usually appears in adulthood in the late 20's or early 30's.
However, it can affect children, sometimes even before the age of 2. Psoriasis affects both men and women.
The precise cause of psoriasis is unknown. It is believed that there are several factors involved in the development of the disease, particularly genetic and environmental factors.
For example, a family history of psoriasis is found in about 40% of cases.
Physical stress (infections, injuries, surgery, medications, etc.) or psychological stress (nervous fatigue, anxiety, etc.) can contribute to the appearance of the disease.
Psoriasis can also be caused by autoimmune reactions in the skin. These reactions would stimulate the multiplication of cells in the epidermis.
In people with psoriasis, these cells are renewed at too fast a rate: every 3 to 6 days instead of every 28 or 30 days. As the life of the skin cells remains the same, they accumulate and form thick scabs.
The causes of psoriasis are not yet well known, although it is known that there is a genetic component, with familiar forms in almost 30% of cases. Several genes are responsible for psoriasis.
In addition, it is now known that this disease is accompanied by an increase in a line of immune cells: Th173 lymphocytes, as well as a significant production of inflammatory cytokines, including TNFα, IL23 and IL174.
They seem to play an important role in chronic inflammatory reactions. They are also found in certain pathologies, such as rheumatoid arthritis and Crohn's disease.
Finally, there are other factors such as stress related to emotional shocks, trauma, certain medications (beta-blockers) or certain infectious conditions (strep throat). And while the sun generally improves injuries, alcohol and tobacco use aggravates them.
The digestive system
Psoriasis is a complex disease in which skin dysfunction is only a symptom.
People with psoriasis have clinical signs of inflammation, which indicate an overactive immune system.
However, one of the major entry points for the agents that activate this system is, of course, the intestine.
If it has the task of first providing the nutrients necessary for the survival of the organism, it must also be able to protect it from the intrusion of microbes (viruses, bacteria), or other exogenous agents (contaminants or chemicals).
To do this job properly, the intestine must be a perfectly waterproof barrier between the intestinal contents and the body. Studies show that many people suffer from permeable bowel syndrome.
This may be due to an excessive secretion of zonulin, a protein involved in the regulation of intestinal permeability, and whose increased production increases it.
It can also be related to dysbiosis , that is, an imbalance in the intestinal flora or microbiota.
The liver, which is particularly damaged by the current diet, which is highly contaminated with pesticides, heavy metals, food additives, dyes, preservatives, sugars, trans fats, etc..
All these substances will have to be treated by the liver, which is therefore subject to an overload of work.
In addition, the chronic inflammation that occurs in people with psoriasis also increases the work of the liver. And it is not surprising that people with skin problems have an overloaded liver.
In fact, one study has shown that people with fatty liver are very often affected by psoriasis, in 45% of cases.
Types of Psoriasis
There are several types of psoriasis. The most common form is plaque psoriasis, also known as psoriasis vulgaris (because it represents over 80% of cases). The other forms are
- guttate psoriasis,
Observed especially in children and young adults, corresponds to an efflorescence of small psoriasis lesions less than 1 cm in diameter that predominate on the trunk and roots of the arms and thighs, which in most cases do not affect the face and occur most often within 15 days following an episode of streptococcus ENT (but also anogenital) β-hemolytic group A (2 / 3 of cases), C, viral infection by Gou.
Most of the time, the guttate psoriasis rash develops for about 1 month, then persists for 1 month and in half of the cases it resolves spontaneously at 3 or 4 months.
However, sometimes guttate psoriasis can become chronic, with some residual plaques or even outbreaks of the disease lasting several years.
In addition, guttate psoriasis can be a way into psoriasis, as one third of patients end up developing chronic plaque psoriasis.
The treatment of guttate psoriasis is usually based on the administration of ultraviolets in a cabin under medical supervision.
- Erythrodermic Psoriasis (widespread form)
- and pustular psoriasis. See the symptoms section for a detailed description.
The location of the plates varies from person to person and includes, among other things:
- Psoriasis of the scalp, very common;
- Palmoplantar psoriasis, which affects the palms of the hands and soles of the feet;
- The reverse psoriasis, which is characterized by plaques in the folds of the skin (groin, armpits ...);
- The psoriasis of the nails (or nails).
In about 7% of psoriasis patients, joint pain with swelling and stiffness is accompanied by pain in the joints, known as psoriatic arthritis or psoriatic rheumatism.
This form of arthritis requires specific treatment by a rheumatologist and may require extensive treatment.
The hygiene of life
The modification of the diet is essential in psoriasis. With a proper diet, the symptoms of the disease can be greatly reduced.
You can find more information in this article: Living better with psoriasis through diet.
Therefore, in practice, patients with psoriasis should adopt an anti-inflammatory diet, such as the Mediterranean diet that has been shown to be effective for psoriasis with a strict exclusion of gluten.
Although the cessation of gluten is particularly onerous for some people, it is necessary. Especially if zonulin levels are too high.
In fact, it is a diet that must be followed permanently to ensure the regression of the injuries.
Psoriasis is a chronic disease that requires continuous treatment. However, the Mediterranean diet is quite easy to follow.
It gives a privileged place to vegetables, legumes, fruits and olive oil, which is present in large quantities.
Omega 9 fatty acids (oleic acid), but also polyphenols (hydroxytyrosol) have important anti-inflammatory activity.
This diet excludes all foods rich in saturated fatty acids, trans-fatty acids, sugars, food additives, etc.
It is also important to drink a lot of water but also tea, rich in catechins, polyphenols that are very anti-inflammatory.
Evolution and possible complications
The disease evolves in quite unpredictable and highly variable relapses according to the individual.
Symptoms usually last 3 to 4 months, then may disappear for several months or even years (this is the period of remission) and then reappear in most cases.
People with a moderate or severe form of psoriasis can be very affected by their appearance and therefore suffer from stress, anxiety, loneliness, loss of self-esteem and even depression.
It seems that people with psoriasis suffer more cardiovascular disorders, metabolic syndrome and obesity, for reasons that are not yet known.
Allopathic treatments are mainly local, in particular anti-inflammatory creams based on corticoids, vitamin D or vitamin A derivatives (topical retinoids).
They are also natural phototherapy or heliotherapy (action of the sun's rays), whose effects are known since ancient times.
Finally, when the plaques are too large, immunosuppressive treatments such as methotrexate are used.
Methotrexate has been used successfully for over 40 years as a treatment for psoriasis.
There are also cyclosporine or anti-TNFα. The latter is used only to treat the joint form of psoriasis.
Unfortunately, all of these treatments have side effects, such as immune disorders and/or liver or kidney toxicity. For this reason, it is necessary to look for more natural treatments to treat psoriasis.
Natural treatments and psoriasis
In fact, there are many natural treatments that can improve the symptoms of psoriasis.
It is important to ensure the correct intake of various micronutrients.
Vitamin D is used in local treatments14 and has been shown to be effective.
People with psoriasis should avoid vitamin D deficiency.
They are very important for the general population, and also for people with psoriasis15. Vitamin D plays a very important immunomodulatory and anti-inflammatory role.
Omega 3's are just as important, firstly because of their anti-inflammatory role16. In fact, DHA or docosahexaenoic acid is necessary for the secretion of anti-inflammatory prostaglandins.
One study shows that the administration of omega 3 in the form of EPA and DHA is an effective treatment for psoriasis plaques.
Some studies show that 1 to 2 grams per day should be consumed for six weeks and up to six months.
They can be eaten as fatty fish such as sardines, herring or mackerel or as omega 3 capsules.
It is also advisable to consume oils rich in omega 3, such as flaxseed oil or camelina oil, but your intake of alpha-linolenic acid may not be enough.
On the other hand, the enzyme systems that convert alpha-linolenic acid into EPA and DHA must be fully functional.
This is not always the case, especially under stress or after age 50. The enzyme that allows this conversion, delta-6-desaturase, is then altered17.
Marine lecithin has shown interesting and promising results in people with psoriasis.
In fact, lecithin contains phospholipids extracted from wild fish, which accelerate the healing of lesions after only six months of treatment.
This is shown in this study of psoriasis patients who ingested 400 mg of marine lecithin per day.
They are extremely important for the proper functioning of repair systems (a bio-evaluation will detect their deficiency).
These include selenium and zinc.
Vitamins B and A
Vitamin B is necessary for healthy skin. Especially vitamin B6 which helps regulate cell growth.
Psoriasis patients are often deficient in vitamin A and beta-carotene19. 19 In such cases, supplements may be considered.
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