Friday, January 20, 2012

The Many Faces of Psoriasis

This 26 year old female noticed that her nails had been changing over a 6 month period.  Note the small pits and separation of the nail plate from the nail bed.  This lifting is called onycholysis.  There is only one disease where both of these findings are seen together and that is psoriasis.

Most people think of psoriasis as a skin disorder with patchy silvery plaques that form on the elbows, arms, knees and back.   But it is a genetic condition that can also affect the nails and 1/3 of patients develop psoriatic arthritis.  It is actually a very common disorder with wide variation in skin, joint and nail involvement.   The condition can come and go and there are a number of treatments to control symptoms, but no cure.

severe psoriasis
Before and after treatment
Psoriasis is not contagious and you cannot "catch" it.  The National Psoriasis Foundation conducted a survey of patients with psoriasis in 2008 and 71% said psoriasis was a difficult problem for them with self consciousness and embarrassment about the condition.  More than a third said they limited social activities and limited intimate interactions.

Education is the key.  If everyone understood the skin and nail changes of this condition they would know there is nothing weird about it and nothing to fear.


15 comments:

KM said...

Is the woman in the photo in pain?

Toni Brayer, MD said...

KM: No it is not painful at all

maldives tours said...

Thanks for sharing an interesting information.

Emily Rose said...

What treatment did the man use?

kaney said...

With any disease, ensuring that the sufferer gets adequate rest, manages stress, exercises, and follows a healthy eating plan are very important when trying to overcome any sickness. The last item is of especially great importance to psoriasis sufferers to help control the condition by following a proper psoriasis diet.

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Anonymous said...

To Toni Brayer, MD...YES IT IS PAINFULL...EMBARASSING, ANNOYING, DISGUSTING AND VERY ITCHY WITCH IN TURN HURT...WHAT KINDOF FUCKING STUPID DOCTOR ARE YOU ??????

Anonymous said...

I have severe psoriasis and it can most definitely be painful. In addition to the itching, my skin feels very inflamed some days (I have good days and bad days).

Toni Brayer, MD said...

Anon: (both of you) Got it. What kind of stupid doctor am I? One that tries to educate people who have no idea what psoriasis is. One that tries to dispel prejudice about this skin condition. And one that would never use your language and hostility on a website.

Get a life!

Anonymous said...

I was diagnosed with psoriasis at a young age and over the years it has gotten worse. Educating people about the disease is extremely important but it is important to get the facts straight...it is extremely painful. Don't try to educate when you don't know the facts. It is completely understandable that someone would get upset that you could claim that is wasn't painful.

Julian said...

The naked chick could still get it... Im just sayin

Lia said...

I also disagree, having this kind of psoriasis IS PAINFUL! Every 3-4 days the excess skin sheds and a new skin emerges, like the kind you have after you've burnt yourself and its beginning to heal. Its very tight (sometimes feels like a "Chinese-burn" all over your body), and it definitely is painful, to the point of needing medication. Its also very radiant, and with that kind of surface area, its sometimes also difficult to maintain body heat, there's too much escaping through the plaques, and you can feel very cold, even though the patches are very hot to touch, and this can lead to uncontrollable shakes. But there is DEFINITELY pain involved with such a large surface area affected.

From a like-sufferer

Anonymous said...

It is extremely painful! I used to use a half of a tub of vasoline every night just to be able to sit upright the next day without my stomach cracking and bleeding through my shirt. Never mind the torment that we are constantly subjected to. If anyone out there has 10% or more body coverage, i 100000% recommend biologic treatment. I used Humaria and i am almost 100% clear in about 4 weeks! I was at 23% body coverage when i started! All that is left is the outlines of the psoriasis spots, from being tan and the spots not tanning over yet. And a little on my leg. Other than that, im clear and it is AMAZING!

Anonymous said...

Suffered from psoriasis for many years & my goodness, it is very painful. I can not bend my knees at the moment. Thank you for giving everyone out there FALSE information about psoriasis which feels like a stab in the heart for everyone who has suffered in agony with this condition!!!

Rosemary A said...

Thank you for the very informative post. I will be using the image of the woman in a poster presentation at AMSA. I will surely reference this website. Hopefully, you will get more hits!

Rose A said...

Thank you for the information. I will be using the severe psoriasis image in a poster presentation at AMSA so hopefully you will get more hits. I will reference this page!