October 19th is National Psoriatic Arthritis Day.
Psoriasis is a non-contagious skin disease that affects almost 10 million people across North America. About 500,000 people are living with psoriasis in Canada. Psoriasis usually appears between the ages of 15 and 35 and the average age at diagnosis is 28, but people of any age can be affected. Of these 1/3 can develop psoriatic arthritis.
So, What Is Psoriasis?
Psoriasis is an immune-mediated disease (a disease with an unclear cause and affects how your immune system works) that causes inflammation in the body. There may be clear signs of the inflammation such as raised plaques and scales on the skin.
This occurs because the overactive immune system speeds up skin cell growth. Normal skin cells completely grow and shed (fall off) in a month. With psoriasis, skin cells do this in only three or four days. Instead of shedding, the skin cells pile up on the surface of the skin. Some people report that psoriasis plaques itch, burn and sting. Plaques and scales may appear on any part of the body, although they are commonly found on the elbows, knees, and scalp.
Inflammation caused by psoriasis can also affect other organs and tissues in the body and sometimes people with psoriasis may also experience other health conditions.
One in three people with psoriasis may also develop psoriatic arthritis (PsA). In psoriatic arthritis it is the joints that are under attack, causing swelling, pain, warmth, redness and stiffness as well as fatigue. Psoriatic arthritis can appear in any joint or where ligaments and tendons connect to the bone. It can also cause neck and back pain and stiffness.
PsA often goes undiagnosed, particularly in its milder forms. However, it’s important to treat PsA early on to help avoid permanent joint damage.
Causes and Risk Factors
Although the exact cause of psoriasis is yet to be found, researchers believe a combination of genetic, environmental, and immune factors may be involved.
- The risk of getting psoriasis increases if a close biological relative has it.
- If one of your parents has psoriasis, you stand 10-25% chance of developing it.
- If both of your parents have it, your odds increase to 50%.
- Researchers have suggested that psoriasis patients are more likely to be obese than the general population.
- Studies have shown that losing weight can help with symptoms of psoriasis and make treatments more effective.
Treatments for Psoriasis and Psoriatic Arthritis
While there is no cure for psoriasis, a wide variety of treatment options exist for people living with the inflammatory disease. Treatments are usually categorized as topical, light- or photo- therapy, systemic or biologic therapy.
Take an active role in your treatment by asking questions and keeping your doctor informed of any concerns. If you are not seeing improvement after using a particular treatment or if you are having uncomfortable side effects, talk to your physician and one of our pharmacists.
Topical treatments such as creams and ointments are often the first therapies recommended to treat psoriasis. Topical treatments primarily work by reducing inflammation and slowing down and regulating skin cell turnover. Topicals exist in many different forms, such as lotions, creams, ointments, foams, or shampoo. Depending on the location of psoriasis plaques on the body, a specific formulation may be better suited for treatment. Many topical medications require a prescription, but some do not.
Here is where a compounding pharmacy can help. We work together with your doctor to create a cream/lotion that is tailor made to you and your psoriasis.
When psoriasis is more severe, topicals are likely to be combined with oral medications, phototherapy, or biologics.
These medications are available by prescription only. Taken by mouth or by injection, they affect the entire body. Systemic drugs for psoriasis are typically prescribed when topical treatment fails to adequately treat psoriasis. These medications work by suppressing the overactive immune system in psoriatic disease. While typically more effective than topical medications, traditional systemic drugs can have a greater risk of side effects.
As the name suggests, this psoriasis treatment uses natural or artificial ultraviolet light. Medically supervised phototherapy is the preferred method of phototherapy as it minimizes the risk of skin cancer by controlling the type and amount of ultraviolet light. Forms of light therapy include the medically supervised use of ultraviolet A (UVA) or ultraviolet B (UVB) light. In any form, light treatment is only effective if you get short-exposure – burns and skin damage can worsen psoriasis symptoms.
Phototherapy requires repeated exposure of the skin to ultraviolet light using one of several techniques. The procedure is done under medical supervision and may be advised when topicals alone are not effective.
BIOIDENTICALS AND BIOSIMILARS
These are the newest group of drugs approved for the treatment of moderate-to-severe psoriasis. These drugs are given by intravenous infusion or by injection under the skin (subcutaneous injection), and are usually prescribed to patients who have moderate-to-severe psoriasis who have failed or had adverse reactions to systemic therapy or an inadequate response to systemic therapy. Some of these treatments are also effective in patients who also have psoriatic arthritis. Biologics work by blocking interactions between certain immune system cells and inflammatory pathways that are responsible for the signs and symptoms of psoriasis and psoriatic arthritis. Though these medications target only parts of the immune system, they can increase your susceptibility to an infection.
To learn more about psoriasis and psoriatic arthritis you can always speak to one of our pharmacists or visit https://www.canadianpsoriasisnetwork.com