What is Psoriasis?
Psoriasis is a chronic skin disease that causes the skin cells to multiply faster than normal. This leads to an overgrowth of skin cells that leads to scaling on the skin’s surface. The red, itchy, scaly patches are usually found on the elbows, scalp, knees, and lower back. It is considered to be an autoimmune disease.
There are different types of psoriasis - plaque psoriasis, nail psoriasis, guttate psoriasis, inverse psoriasis, pustular psoriasis, erythrodermic psoriasis, and psoriatic arthritis.
The symptoms of psoriasis include
- inflamed, red, raised patches of skin covered with whitish-silver scales
- plaque may also be present on the patches
- cracked and dry skin that is itchy and may bleed
- pitted and thick nails
- swollen and stiff joints
The symptoms are known to occur in cycles. They flare up for a few weeks and then subside. When they subside, you will be in remission and symptom-free till the symptoms appear again. Psoriasis can range from a few spots on your body to patches all over the body in severe cases.
Psoriasis is not a contagious disease. It does not spread between people but can spread to other parts of your body. People who have cardiovascular and metabolic syndrome, some trauma to the skin, or a family history of the condition are more prone to developing psoriasis.
Psoriasis results from a problem in the immune system where the body attacks itself. A type of white blood cells called T cells is usually produced in the immune system to fight off an infection. In the case of psoriasis, the T cells attack the skin cells by mistake. This causes excess production of skin cells and the formation of patches on the skin.
People with psoriasis are more prone to cardiovascular diseases, mental health conditions, obesity, type 2 diabetes, certain eye conditions, and psoriatic arthritis.
Genetics and Psoriasis
A person who has a family history of psoriasis is more likely to develop the disease. The percentage of people who have the disease and are predisposed to it genetically are small, only about 2 to 3 percent, according to the National Psoriasis Foundation (NPF).
PTEN Gene
The PTEN gene contains instruction for producing a protein called phosphate tensin homolog. This is found in all the tissues of the body and acts as a tumor suppressor. The function of a tumor suppressor is to prevent cells from multiplying and growing in an uncontrolled manner.
The PTEN enzyme is part of the cell death pathway called apoptosis in the body. It signals the cells to stop dividing and to self-destruct. PTEN is involved in cell signaling that regulates the growth and multiplication of cells like keratinocytes. Keratinocytes are found on the outermost layer of the skin. PTEN is found to interfere with this pathway and stop the multiplication of cells. In psoriasis, the PTEN gene is found to be altered and loses its function.
rs76959677 and Psoriasis
rs76959677 is an SNP found in the PTEN gene. The G allele is found to increase the risk of developing psoriasis.
IL13 Gene
The IL13 gene contains instruction for producing a protein called interleukin 13. Interleukins are a type of cytokines that are produced by certain immune cells in the body. They are responsible for mediating and regulating immunity and inflammation.
Interleukin 13 is produced by a group of cells called Th2. This suppresses the activity of another group of cells. This pathway is implicated in psoriasis - the production by Th-2 cells is decreased. This leads to [an excess of another type of cell called Th17 that produces certain molecules found in psoriatic conditions]. (https://pubmed.ncbi.nlm.nih.gov/20430301/#:~:text=Recent%20advances%20in%20genetic%20analyses,%2D17%20and%20IL%2D22.)
rs20541 and Psoriasis
rs20541 is an SNP found in the IL13 gene. The G allele is found to increase the risk of developing psoriasis. The A allele is termed as the non-risk allele, and there is less risk of developing the disease.
FASLG Gene
The FASLG gene contains instruction for producing a protein called the Fas ligand. The Fas ligand is a protein that binds to another protein called Fas and induces the process of apoptosis (cell death). This process is mainly involved in immune system regulation.
Fas ligand is also involved in a pathway that induces the production of molecules that cause inflammation. These molecules are TNF-alpha and IL15. There is evidence that this pathway induces psoriasis.
rs12118303 and Psoriasis
rs12118303 is an SNP found in the FASLG gene. The C allele is found to increase the risk of developing psoriasis.
FUBP1, IKBKE, UBAC2, IL31, FUT2, and BRAP are a few of the other genes involved in psoriasis.
Non-genetic Factors That Influence Psoriasis
Apart from genes that can predispose you to this disease, few non-genetic factors increase your risk of psoriasis. These factors also act as triggers for the onset of psoriasis symptoms. A combination of genetic and environmental factors is needed in most cases to trigger psoriasis.
- Cold temperatures
- Smoking and alcohol consumption
- Skin injury
- Stress and tension
- Infections that weaken your immune system (e.g., strep infection)
- Autoimmune disorders like arthritis or HIV
- Certain medications used for treating high blood pressure and malaria
Tips for Managing Psoriasis
Psoriasis cannot be cured entirely but can be treated to a certain extent. The symptoms can be managed and reduced.
Topical Treatment
- Topical treatment is directly applied to the skin and is helpful in treating mild to moderate psoriasis.
- Topical medications include corticosteroids, retinoids, salicylic acid, anthralin, and synthetic vitamin D.
- Pimecrolimus cream and tacrolimus ointment are also used.
Systemic medication
- People who do not respond well to topical treatment need to take oral or injected medication to help with moderate to severe psoriasis.
- These medicines are taken under the advice of a doctor as they have severe side effects.
- These include methotrexate, cyclosporine, retinoids, and biologics.
Light therapy
- This is done to treat moderate to severe cases of psoriasis.
- Ultraviolet or natural sunlight exposure decreases the rapid outgrowth of cells by slowing cell growth.
Over the counter (OTC) remedies
- These can help relieve very mild psoriasis.
- Coal tar, hydrocortisone creams, salicylic acid, and anti-itch medications can be used to relieve symptoms.
Home remedies
- Doing yoga, exercise, or meditating helps reduce stress, which is a major trigger for psoriasis.
- Adopt cold showers as showering with hot water can cause dry, itchy skin.
Diet
- A heart-healthy diet should be followed. Intake of saturated fats found in meat and dairy products should be reduced and substituted with omega-3 fatty acids. Omega-3 fatty acids are found in salmon, sardines, shrimp, walnuts, flax seeds, and soybean.
- A vitamin-rich diet that includes citrus fruits, green leafy vegetables, and berries is also recommended.
- Identify foods that trigger your symptoms and avoid them.
Summary
- Psoriasis is an autoimmune chronic skin disorder characterized by the presence of red, itchy, and scaly patches due to the rapid overgrowth of skin cells.
- Psoriasis is not a contagious disease. There are few triggers for this condition, including smoking, alcohol consumption, and skin injury.
- Certain genetic variants are known to increase your risk for psoriasis. These variants include rs76959677 SNP found in the PTEN gene, rs20541 SNP found in the IL13 gene, and rs12118303 SNP found in the FASLG gene.
- Cold temperature, infections like strep that weaken your immune system, and certain medications are some of the non-genetic triggers of psoriasis.
- Psoriasis cannot be cured. The symptoms can be treated and managed to a certain extent.
- Certain home remedies like taking a cold shower, doing yoga, meditation, and following a heart-healthy and vitamin-rich diet can help relieve your symptoms.
- Treatment for psoriasis includes topical treatments, light therapy, and systemic medication.
References
https://www.mayoclinic.org/diseases-conditions/psoriasis/symptoms-causes/syc-20355840
https://www.healthline.com/health/psoriasis
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5458077/
https://www.healthline.com/health/psoriasis/causes#prevention
https://link.springer.com/article/10.1007/s00403-018-1879-8
https://medlineplus.gov/genetics/gene/pten/#synonyms
https://www.sciencedirect.com/science/article/pii/S0002944010620809
