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A variety of factors -- ranging from emotional stress and trauma to streptococcal infection -- can cause an episode of psoriasis. Recent research indicates that some abnormality in the immune system is the key cause of psoriasis. As many as 80% of people having flare-ups report a recent emotional trauma, such as a new job or the death of a loved one. Most doctors believe such external stressors serve as triggers for an inherited defect in immune function.
Injured skin and certain drugs can aggravate psoriasis, including certain types of blood pressure medications (like beta-blockers), the anti-malarial medication hydroxychloroquine, and ibuprofen (Advil, Motrin, etc.).
Psoriasis tends to run in families, but it may be skip generations; a grandfather and his grandson may be affected, but the child's mother never develops the disease. Although psoriasis may be stressful and embarrassing, most outbreaks are relatively harmless. With appropriate treatment, symptoms generally subside within a few months.
It is now clear that there is a genetic basis for psoriasis. This hereditary predisposition is necessary before the disease can be triggered by environmental factors. White blood cells called T-cells mediate the development of the psoriatic plaques that are present in the skin. When someone has psoriasis, their body is unable to offer protection from invaders. Instead, inflammation is promoted and skin cells are on overdrive. When cell growth is increased, old skin cells pile up instead of flaking off, causing psoriasis to occur. Currently, most experts conclude that environmental, genetic and immunologic factors interact to cause the disease.
Scientists are unclear as to what causes psoriasis. However, thanks to decades of research, they have a general idea of two key factors: genetics and the immune system.
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Psoriasis symptoms differ from person to person and depend on the type of psoriasis. Areas of psoriasis can be as small as a few flakes on the scalp or elbow, or cover the majority of the body.
Psoriasis signs and symptoms are different for everyone. Common signs and symptoms include:
Red patches of skin covered with thick, silvery scales
Small scaling spots (commonly seen in children)
Dry, cracked skin that may bleed
Itching, burning or soreness
Thickened, pitted or ridged nails
Swollen and stiff joints
Psoriasis patches can range from a few spots of dandruff-like scaling to major eruptions that cover large areas.
Most types of psoriasis go through cycles, flaring for a few weeks or months, then subsiding for a time or even going into complete remission.
There are several types of psoriasis. These include:
Plaque psoriasis. The most common form, plaque psoriasis causes dry, raised, red skin lesions (plaques) covered with silvery scales. The plaques might be itchy or painful and there may be few or many. They can occur anywhere on your body, including your genitals and the soft tissue inside your mouth.
Nail psoriasis. Psoriasis can affect fingernails and toenails, causing pitting, abnormal nail growth and discoloration. Psoriatic nails might loosen and separate from the nail bed (onycholysis). Severe cases may cause the nail to crumble.
Guttate psoriasis. This type primarily affects young adults and children. It's usually triggered by a bacterial infection such as strep throat. It's marked by small, water-drop-shaped, scaling lesions on your trunk, arms, legs and scalp.
The lesions are covered by a fine scale and aren't as thick as typical plaques are. You may have a single outbreak that goes away on its own, or you may have repeated episodes.
Inverse psoriasis. This mainly affects the skin in the armpits, in the groin, under the breasts and around the genitals.
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