Winter more woeful for skin condition sufferers

Psoriasis is a chronic skin disease that mostly occurs in young people. The rate of the disease’s outbreak is highest among those who are in their 20s, followed by those in their teens. Seventy five percent of sufferers are younger than 40 years of age.

Psoriasis is an inflammatory skin condition in which the growth of skin cells speeds up. Plaque psoriasis is the most common type of the disease. About 80 percent of sufferers have plaque psoriasis, which appears as patches of raised, reddish skin, known as lesions, covered by silvery-white scale. These patches, or plaques, frequently form on the elbows, knees, lower back and scalp.
“Psoriasis patients develop keratin in the outer layer of the skin eight times faster than a normal person and the multiplication of cells has more than doubled,” said Lee Joo-heung, a dermatologist at the Samsung Medical Center. Occasionally, pus can form in the lesions. Psoriasis can occur on fingernails and toenails but is different from athlete’s foot. Between 10 and 20 percent of people who develop psoriasis get a related form of arthritis called “psoriatic arthritis,” which causes inflammation of the joints. This mainly affects the joints of fingers and toes, but it can also involve the neck, lower back, knees and ankles.
The cause of psoriasis is believed to be an abnormality in the immune system, which is mistakenly triggered. Those with a genetic disposition react to external factors and develop the skin condition.
The most common triggers of psoriasis are stress, injury and some types of infection and reactions to certain drugs.
There are also seasonal factors. The condition improves in summer and worsens in winter. This is because the condition is aggravated by dry air, decreased sunlight and cold temperatures.
Thus, in winter, using a humidifier is advised to maintain moisture in the air and excessive heating should be avoided. Light showers are recommended rather than long baths, and after washing, skin lotions should be applied to keep the skin moist.
To treat the condition, sufferers can use creams, oral medications or light therapies. Most creams contain adrenal cortex hormones, immunomodulators or vitamin D derivatives. The hormone-based medications are the fastest acting, but they can cause side effects.
“Extended use of hormone-based medications can lead to atrophied skin and the body eventually becomes tolerant to the medication,” Dr. Lee said.
Recently, immunomodulator medications have been widely prescribed. One, however, retinoid-based acitretin, can cause birth abnormalities if used during pregnancy, and pregnancy should be avoided for at least two years after its use.
“Psoriasis is a chronic disease, and doctors should find ways to maximize the effects of medications and minimize the side effects,” Dr. Lee said. “A simultaneous use of two or more medicines, which can reduce the amount of each medicine needed, and a rotation of different medicines is used.”

by Hwang Se-hee