the psoriasisis an inflammatory skin disease that manifests as inflammatory red patches with dander (or scabs) white. All parts of the body can be affected, such as elbows, extremities, nailsthe scalp or the folds of skin… But where do these patches come from? Are scales dead skin?
Psoriasis, a disease that evolves in flare-ups
In fact, in people with psoriasis, “the blood vessels are hyperactive, and very dilated: the skin is constantly reforming itself without having time to remove itself”explains Dr. Marc Perrussel, liberal dermatologist in Auray in Morbihan and responsible for a psoriasis consultation at the Pontchaillou Hospital of the University Hospital Center of Rennes.
The disease progresses in flare-ups, during which skin condition worsens : for example the surface affected by the crusts increases. These outbreaks, or crises, are interspersed with periods of remission: the symptoms regress or even disappear, sometimes for years. There is also another form of psoriasis, called rheumaticwhich causes pain in the joints similar to that of patients suffering from rheumatism (hence its name). But in this case, these pains are not necessarily associated with dermatological symptoms.
A genetic and environmental disease
Although psoriasis is a genetic disease, it does not appear at birth. It “triggers” only on the occasion of a stressful event. It may be an accident involving the life of the person, the death of a close person, or a emotional shock. “During this stressthe brain releases P-substances that activate lymphocytes (cells of the immune system) modified, this is what generates the thrust”details the dermatologist.
Because in people with psoriasis, “the lymphocytes have undergone a modification which makes them hyperactive: they produce a substance that stimulates the blood vessels and the skin”, explains Dr. Perrussel.
Several other triggers have been identified. For example, a viral infection or bacterial, or taking certain medications may also be involved. Beta blockers, lithium, antimalarialssummaries, antihypertensives and corticosteroidsorally should therefore be monitored. On favorable ground (presence of psoriasis in the family) or in an affected patient, the risks and benefits of the drug must be assessed. “If no other solution is possible, it is better to keep a drug that aggravates the psoriasis, but which could save the patient’s life, for example beta-blockers for the heart”, tempers the specialist.
Certain pathological conditions can also favor the appearance of psoriasis: this is the case with obesityof the cholesterol disordersor metabolic disease. The latter, commonly called fatty liver disease, is thus associated with psoriasis in 45% of cases. “Fat cells produce adipokines that stimulate inflammation and genetically modified immune cells,” explains the doctor.
Stress, alcohol and tobacco: aggravating factors to avoid
In general, patients are advised to avoid the stress which has a deleterious effect on the dermatological manifestations of psoriasis. Other factors can also make seizures worse. L‘alcohol, for example, is a metabolic and hepatic disruptor. “It is often because patients are depressed that they turn to alcohol for its effect. antidepressant. So it’s because of the disease that they drink, which further aggravates their symptoms, it’s a vicious circle”deplores Marc Perrussel.
the tobacco, he is 100% involved in palmoplantar pustular psoriasis (which manifests as pustules on the hands and feet). It is mainly found in women and exclusively in smokers. Harmful inhalants trigger immune dysfunction. In women, hormones can also cause symptoms to vary, depending on estrogen and progesterone levels. “Some women see their psoriasis disappear after menopausebut the link with hormones is not formal, it may be concomitant events”, warns the dermatologist. He also specifies that this disease affects as many women as men.
Sun and weight loss to avoid psoriasis flare-ups
Conversely, certain behaviors improve the condition of patients’ skin. The sun has a beneficial effect thanks to UVA and UVB. However, excessive sun poses a risk of skin cancer long-term. Also watch out for sunburn. “In psoriasis, the skin is in perpetual healing. Any sunburn will therefore cause a plaque because it over-activates this process”warns the specialist.
Losing weight is also a good way to improve symptoms, as shown in a recent study published in the American Journal of Nutrition. With fat loss, there are fewer adipokines and therefore less inflammation: the patient’s condition improves.
What treatments for psoriasis?
A few tips can also be used to take care of your skin: wear loose clothing in soft, non-irritating materials, use suitable shampoos and cleaning productswithout soap or perfume, and above all, moisturize your skin well every day with products designed for very dry skin. “Psoriasis improves with creams and other treatments, but as soon as the patient stops, there is a high risk of relapses. It is a chronic disease that has no cure and therefore requires chronic treatments”warns Dr. Perrussel.
In addition to moisturizers, oral or injection treatments improve more severe symptoms. For the most important cases, biotherapy (a powerful treatment based on antibodies) or phototherapy(UV contribution) can be indicated. Some dermatologists are interested in natural treatment avenues like the one explored by Dr. Paul Dupont with marine lecithin.
Finally, if the psoriasis is neither psychic nor psychosomatic, it is necessary to take into account the psychological state of the patient and the impact of his symptoms on his life. Many people with psoriasis suffer from discrimination, for example in their workplace, due to their illness. The treatments will indeed be adapted according to these parameters.
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