Psoriasis Is as Old as the Human Race - Research Paper Example

Psoriasis Introduction Psoriasis is perhaps as old as human race. In the present day, it is a well known skin infection, in which genetic, immunologic, and environmental factors contribute in etiopathogenesis. However, even with its frequency, visibility and chronicity it is difficult to find its description in the works of the early physicians. Dermatology grew slowly, first with emergence of the proto dermatologists in late 18th century, and progressed following the arrival of the early dermatologists. Since those olden days, psoriasis assumed a distinct position, although its descriptions remained vague until recent years. During this era psoriasis denomination was still to be standardized and its translation from one language to another faced a huge discrepancy. Such is the case that different authors termed the ailment differently, while diverse ailments had the same names. Confusion in description and terminology of psoriasis went on for centuries. Considered the ugliest disease of the olden days, psoriasis became synonymous with all kind of people, whether a king, member of the kingly family, politician, business person or ordinary person. According early scholars, psoriasis is much similar to the tzaraat disease cited in the Bible. Psoriasis was first mentioned by a Greek physician called Hippocrates (460-377 BC). However, this did not offer formal introduction until a roman author called Cornelius Celsus described it in the first century. According to his description Psoriasis is a condition caused by staphylococcus pyogenes characterized by red patches and watery blisters on the skin. Having been kept unattended for thousands of years, this condition is became a real concern following the exhumation of the Egyptian mummies. The Greeks termed it “psora”, meaning “to itch” a reason that makes it to be considered an understatement of the centuries! During this period, majority of the medical minds found it hard to isolate the symptoms and only remained baffled with the condition. Throughout this period, people remain superstitious over the causes and development of psoriasis until Hippocrates (Father of Medicine 460-377 B.C.) replaced the superstitious mind with knowledge in curing skin ailments. Using this knowledge, Hippocrates introduced the treatment of skin ailments using tar that was added to the superstitious mix and also prescribed topical arsenic (Langley, pg34). This condition presented great problem typified with confusion with other related skin conditions believed to be contagious. Psoriasis was commonly linked to leprosy, a factor that contributed to social stigma and isolation. People suffering from psoriasis, (thousands in medieval Europe) were required to ring a clapper whenever they walk in the public as a warning of their arrival. During this era, people associated psoriasis to cases of poor nutrition, microbes, poor hygiene, the blood stream, allergies and dysfunctional organs of the body. Various pre-19th-century, poorly-researched treatments were developed to help "treat" skin conditions related to psoriasis. Persons seeking treatment were offered recipes and remedies that included dog and cat dung, fresh oil, semen and goose oil, a mixture of onion, urine and sea salt, and other waste-product, ingredient-rich formulations. Trial and error treatment methods included skin lubrication that was followed by wrapping the patient body in sheets for many days thought to create a cover (occlusion) that loosen the scales. Common applications would sometimes include toxic elements such as sulfur, nitrates and mercury that mostly caused serious side effects damaging enough to overshadow any benefits. Majority of the solutions given were irritating, smelly, and time-consuming. Progressive firsts The following paragraphs present a number of the many historical contributors to the progressive knowledge on diagnosis and treatment of psoriasis. The present medical enlightenment started in the 19th century and developed in the subsequent centauries to give the well defined remedies offered today. In the 1800s, Dr. Robert Willan from England became the first person to recognize psoriasis leading to its identification as an independent clinical entity. Consequently, he gave it an accurate description and embraced the study of skin as his lifetime work (Mitchell, pg112). Later in 1836, Henry, Dagget Bulkley established the first dispensary in the United States of America that specialized in treatment of psoriasis and related dermatological ailments. In the 1840s, Doctor Ferdinand von Hebra, the founder of present dermatology, scraped off the term "lepra" when describing psoriasis, a factor that distinguished it from leprosy for all time. 1960s realized the beginning of studies that sought to uncover psoriasis as an autoimmune ailment. During this period, Psoriatic arthritis was acknowledged as a medical condition in its own right. In the 1970s, also considered the twentieth century, research on psoriasis took another turn following the discovery of the underlying mechanisms by which psoriasis manifested itself. Following this discovery, treatment methods were developed based on effectiveness for individual conditions, according to the needs expressed by each person and replaced the previous trial and error methods. These included topical (rubbed on the skin), systemic (injected, oral or IV medication known to suppress the immune system). In the 1970s, Israeli Dead Sea became a common reference for people suffering from psoriasis, having been said to posses healing properties since biblical time. 1990s realized the development of the Human Genome Project sparking a systematic search to discover the genes that cause psoriasis. Later in 1998, Biologic medications were introduced and became the basis for psoriasis investigations and treatment. These agents come from substances situated in living cells and perform well using the bodys immune system (Smith, pg134). Here, they treat this condition by destroying overzealous immune cells that cause the psoriasis. During Hippocrates era, psoriasis acquired different names like Psora, Lepra, Leichen and alphos. In 1776, plenck of Vienna described this disease as scale like or scaly disease and went further to introduce it in the medicinal literature. Plenck work failed to make comparison between Psoriasis and other skin conditions, a factor that necessitated the work of Thomas Bateman and Robert William (1757-1812). In their work, the Batemen and William divided this condition into two categories (1) Psora Leprosa, as the condition when it became eruptive; and (1) Leprosa Graecorum, as the condition when the skin had scales. In 1841, a Viennese dermatologist named Ferdinand von Hebra while working on Willian’s notes named this condition “Psoriasis,” a name he derived from from the Greek term “Psora” or “to itch” in English. He went further to describe the Psoriasis clinical picture that is used today by dermatologists (Smith, 45). Later work realized its differentiation into more specific types that include pustular psoriasis, plaque psoriasis, guttate psoriasis, inverse psoriasis, psoriatic arthritis, erythrodermic psoriasis, nail psoriasis, seborrheic psoriasis, and scalp psoriasis. Diagnosis of psoriasis has been a big challenge for the many dermatologists .this follows the idea that this condition depicts similar characteristics to many other skin conditions including; acne, fungus and other s, particularly when psoriasis is presented in its mild form. Identification of the psoriasis symptoms involves examining the characteristic skin changes which often depict a preference for particular body parts. The common symptoms of the disease include thickness of the skin, redness and scaling. The disease does not only affect the skin but also the scalp, nail and joints as well. Different kinds of psoriasis show their own unique symptoms. Psoriasis types and their known symptoms Plaque-type or Psoriasis vulgaris is the most prevalent form of the disease. The three well known indication of this condition include redness, thickening of the skin, and scaly skin. Skin thickening characteristically ranges from mere perceptibility to being several millimeters thick. The skin color ranges from faint pink to deep beefy red. For persons with darker skin, the condition causes a reduced redness and instead increases the darkening (Langley, 34). The scaly condition may differ from being non-existent to showing oyster-like plates referred as ostraceous scales. Removal of these scales through scrapping results in a condition called Auspitz’s sign. The areas targeted may include the topside of tiny capillaries, a factor that carries the probability of causing vertical undulation all over the thickened skin. Another widely known symptom linked to the condition is termed the Koebner Phenomenon. This takes place whenever there is a new area of the disease developing in the affected skin. This condition occurs commonly following a surgery. Here, it develops around the scar caused by the surgery. Koebner phenomenon further gives an explanation as to why the condition occurs on places characterized with low intensity trauma, for instance the knee, and the elbows. Away from that, Koebner Phenomenon may occur following non-traumatic skin injuries like sunburn or allergies ensuing from medication. For cases where the patient suffers from face or scalp seborrheic dermatitis or dandruff, the condition often superimposes itself following an irritation and scratching. This condition has also been linked to the development of a combined dermatitis termed “sebopsoriasis.” However, the Koebner occurrence is not explicit to psoriasis. The pustular type (also known as Von Zumbusch Pustular Psoriasis), occurs in smaller parts of the skin or in main body parts, typified by innumerable tiny white pustules. This condition can be triggered by medication, contamination, constant worry, or close contact to particular chemicals. The eythrodermic type causes reddening of the skin and scales presence in the entire body. If this occurs, skin biopsy may be necessary to help distinguish the condition from other conditions characterized by scaling and reddening of the skin. Eythrodermic psoriasis may depict a reaction to taking corticosteroids (cortisone) or any related medication. Additionally it may be caused by severe sunburn or prolonged activity of poorly controlled psoriasis. Guttate psoriasis is derived from the Latin word “Gutta” meaning “drop.” This follows its characteristic miniature, teardrop-shaped lesion appearing on the trunk, limbs, and scalp, commonly triggered by infections on the upper respiratory organs (example a sore throat resulting from streptococcal microorganisms). Guttate psoriasis is commonly thought to be an early stage of psoriasis and it mostly affects children and young adults. Inverse psoriasis is the other kind that is characterized by smooth, inflamed red patches occurring in the wrinkles of the skin in the armpits, close to the genitals, and under the breasts. This condition is aggravated by sweating and friction. Inverse psoriasis patients present great difficulty when undergoing treatment, a factor that closely links the condition to breast cancer. The other type is the Nail psoriasis, which appears as tiny white pits spread in clusters across the nails (commonly in the toenails) yellowish in color. In this case, the nail bed peels off from the finger skin giving room for the dead skin to build under the nail. Scalp psoriasis, is another type identified by scale-capped plaques on the skull surface and it is common to many people diagnosed with other types of psoriasis. Psoriatic arthritis that is associated with arthritis symptom in patient with inflammatory condition of stiff, tender joints points to the possibility of developing psoriasis. AIDS patients carry the highest risk of developing psoriatic arthritis. Close to 75% of patients diagnosed with psoriatic arthritis also suffer from psoriasis in the nails. Psoriatic arthritis is generally associated with SAPHO (Synovitis, Acne, Pustule eruptions, Hyperostosis, Osteolysis). Psoriasis generally affects the quality of lives of the affected persons. The effects are more or less the same as those presented by other chronic ailments such as hypertension, depression, type 2 diabetes, myocardial infarction and congestive heart failure. Affected persons may complain of physical uneasiness and some degree of disability, depending on the conditions’ flare up location and severity. The most known complaint regarding psoriasis is pain that is accompanied by itching. Following the uncontrollable scratching, majority of the patients’ commonly suffer from minor and sometimes deep scratches. Pain experienced by the patients is usually caused by inflammation at the joints, especially with regard to psoriatic arthritis. Itching and Pain posses the capability of hindering usual activities like sleeping, walking and other self-care (Smith, 67). Majority of the patient’s experience sleeplessness when psoriasis flares up, a factor that may in turn highest the severity. Psoriasis plaque that appears on the scalp cause great embarrassment since its forms flaky plaques that easily confused as dandruff. In conclusion, Psoriasis is a persistent, chronic (long-lasting) disease. Patients may experience alternates periods with regard to symptoms, sometimes improving and other times worsening. For some patients, this ailment is a nuisance. For other people, its disabling, particularly when connected with arthritis. Currently, no cure has been found; however, psoriasis management may offer considerable relief. Lifestyle dealings, that include applying a nonprescription cortisone balm and exposing the affected area to small amounts of natural sunlight, carry the ability to improve a patient’s psoriasis symptom. Psoriasis history, with its vague theories regarding the disease origin and the consequent outrageous remedies, failed to satisfy patient’s initial quest for detailed information. Later advancement in technological research, better understanding of its causes, treatment founded on facts instead of trial and error, prevention moves that target genes causing psoriasis and development of medications that destroy haywire immune cells changed psoriasis management for the better. Today, research efforts focus on treatments that are customized to suit individual requirements of persons with psoriasis. The future holds greater prospect for treatment of this condition. A good example is the development of personalized vaccines devised from patient’s own immune cells. This cell serves to inhibit cell growth and thus hinder the development of psoriasis. The study continues on the scientific, educational and social platform to help device ways to switch psoriasis off forever. It is important to acknowledge that todays research works creates tomorrows history. Works Cited Langley, Richard G. B.. Psoriasis. 2nd ed. Toronto: Key Porter Books, 2010. Print. Mitchell, Tim, and Rebecca Penzer. Psoriasis. 2nd ed. London: Class, 2005. Print. Smith, Catherine, and Jonathan Barker. Psoriasis. Oxford: Health Press, 2002. Print. Read More