Psoriasis is believed to stem from an aberration in the immune system, where T-cells, typically tasked with combatting infections, instead target healthy skin cells. This misguided assault prompts an overproduction of new skin cells in the deeper layers, perpetuating the cycle and manifesting as psoriatic symptoms. The interplay of genetic predisposition and environmental factors fuels this process.
Regarding genetic susceptibility, familial ties are significant, with about one-third of psoriasis patients having relatives affected by the condition. Notably, if one identical twin is afflicted, the likelihood of the other twin developing psoriasis stands at 70%. This underscores a genetic underpinning to psoriasis, with identified genetic loci associated with the condition.
Numerous genes are implicated in psoriasis susceptibility, particularly those involved in immune function, such as the major histocompatibility complex (MHC) and T cells. Chief among these genetic determinants is PSORS1, accounting for nearly half of all hereditary psoriasis cases.
Research is actively exploring gene mutations that significantly impact the immune system, including IL12B and IL23R, to better understand their involvement in psoriasis development.
Environmental Triggers for Psoriasis
Environmental factors play a crucial role in triggering and exacerbating psoriasis symptoms. These triggers can vary widely among individuals but may include:
- Stress: Emotional stress has long been recognized as a common trigger for psoriasis flare-ups. Stress management techniques such as mindfulness, meditation, and exercise may help reduce symptom severity.
- Infections: Certain infections, particularly streptococcal throat infections, have been linked to the onset or worsening of psoriasis symptoms. Practicing good hygiene and promptly treating infections may help minimize their impact on psoriasis.
- Climate: Climate-related factors, such as cold weather, dry air, and low humidity, can aggravate psoriasis symptoms. Conversely, some individuals may experience improvement in symptoms with exposure to sunlight and warmer temperatures.
- Trauma to the Skin: Injuries to the skin, such as cuts, scrapes, bug bites, or sunburns, can trigger the development of psoriasis lesions, a phenomenon known as the Koebner phenomenon. Taking precautions to protect the skin from trauma can help prevent flare-ups.
- Medications: Certain medications, including lithium, antimalarial drugs, beta-blockers, and nonsteroidal anti-inflammatory drugs (NSAIDs), have been reported to exacerbate psoriasis symptoms in some individuals. It’s essential to discuss potential side effects with a healthcare provider before starting any new medication.
- Smoking and Alcohol: Smoking tobacco and excessive alcohol consumption have been associated with an increased risk of developing psoriasis and worsening existing symptoms. Quitting smoking and moderating alcohol intake may help improve psoriasis outcomes.
- Dietary Factors: While the role of diet in psoriasis is not fully understood, some individuals report that certain foods, such as gluten, dairy, and nightshade vegetables, may trigger flare-ups. Maintaining a balanced diet and paying attention to potential food triggers may help manage symptoms for some individuals.
- Chemical Exposures: Exposure to certain chemicals, such as solvents, detergents, and household cleaning products, may aggravate psoriasis symptoms in susceptible individuals. Using gentle skincare products and avoiding harsh chemicals can help minimize irritation.
- Obesity: Obesity is associated with an increased risk of developing psoriasis and may exacerbate existing symptoms. Maintaining a healthy weight through regular exercise and a balanced diet may help improve psoriasis outcomes.
- Alcohol: Excessive alcohol consumption has been linked to an increased risk of psoriasis and may worsen symptoms in individuals with existing psoriasis. Limiting alcohol intake or abstaining altogether may help improve psoriasis management.
Encouraging individuals with psoriasis to minimize their exposure to these triggers can be beneficial in managing their symptoms and preventing flare-ups of the condition.
HIV and Psoriasis
Individuals living with HIV have an equal likelihood of experiencing psoriasis compared to the general population. However, those with HIV often endure more severe symptoms. Consequently, there is a notably higher incidence of psoriatic arthritis among HIV-positive patients with psoriasis compared to their counterparts. The severity of symptoms necessitates treatments beyond standard psoriasis therapy for many patients.
Medications for Psoriasis
Several medications have been associated with triggering or exacerbating symptoms of psoriasis in certain patients. These medications include:
- ACE inhibitors
- Antimalarial drugs
- Beta-blockers
- Calcium channel blockers
- Interleukins
- Interferons
- Lithium
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Terbinafine
- TNF inhibitors (e.g., infliximab or adalimumab)
Additionally, discontinuing the use of topical corticosteroid creams may worsen symptoms due to a rebound effect. For more information consult with Dr Hera Tabassum, she is the best dermatologist in Roorkee or you can visit our clinic. Find the map location mentioned below.