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Skin Health

Understanding Psoriasis

Summary & Participants

Psoriasis is a chronic disease characterized by flaking, redness and inflammation of the skin. Though it affects over 7 million people in the U.S. alone, its exact causes are unknown. Research suggests, however, that the immune system has something to do with it. Tune in as our skin specialists examine the biology of psoriasis and the latest findings.

Medically Reviewed On: July 02, 2008

Webcast Transcript

The two most dangerous types are called erythrodermic psoriasis and pustular psoriasis. Erythrodermic psoriasis patients' entire skin surface turns bright red and scaly, and they lose all of the protective functions of their skin. They literally can't control body temperature. They lose nutrients through their skin, they lose fluid through their skin. They're susceptible to infection. The skin barrier against infection is lost, and that is a life-threatening form of psoriasis. Patients have actually died from that form of psoriasis.

The other form that I mentioned, pustular psoriasis, occurs in two variants. One of them is generalized pustular psoriasis, in which, again, patients lose all of those protective functions of the skin, and this becomes a life-threatening instance where patients can die from their psoriasis.

MABEL JONG: In very, very severe cases?

MARK LEBWOHL, MD: Very severe. And there is a localized form which, while it is not life-threatening, is just as debilitating, and that's localized pustular psoriasis of the palms and soles. Patients simply can't use their hands or feet. They can't walk, they can't handle anything with their hands, because it is a painful form of psoriasis. So that's pustular psoriasis.

Fortunately, the latter two forms are rare. They're most commonly triggered by systemic steroids, or withdrawal of systemic steroids.

MABEL JONG: If someone has a very chronic case of psoriasis, are other parts of the body affected by it, Dr. Lebwohl?

MARK LEBWOHL, MD: The one particular part of the body that can routinely be affected in patients with psoriasis are the joints. It turns out that roughly 7 percent, or a little less than one out of ten patients who have psoriasis, will have significant psoriatic arthritis, meaning inflammation of the joints. And there are several different forms of that, and it can range in severity from fairly mild to quite severe and debilitating.

MABEL JONG: Who gets psoriasis? How common is it, Dr. Lebwohl?

MARK LEBWOHL, MD: It affects a little over 2.5 percent of the population, and it can affect anyone. While I said it was inherited, ordinarily, about a third of patients will have a family history of the disease. So two-thirds of patients actually don't know of someone else in the family that has the disease. Nevertheless, it can affect anyone, and it can actually start at any age. There have been patients who were born with psoriasis. There are patients who develop psoriasis for the first time after the age of 100. An average age would be somewhere around 30 years old. But, again, it can affect any age. MABEL JONG: Is it safe to say that it isn't contagious?

KENNETH GORDON, MD: It is not contagious at all.

MABEL JONG: What is going wrong when psoriasis happens or develops in someone? Is it something to do with the immune system and how it operates?

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