Psoriasis: Is it Just Dry Skin or Something Else

Psoriasis is generally an inherited skin condition by genetic testing there is a HLA-B27 or B28 gene that people with psoriasis posses. Psoriasis is often noted in children as white scaly patches on the knees, elbows, or scalp, but virtually can be on any part of the body. It appears pure white with silver glistening lesions that the upper layer can easily be scratched off with a finger nail coming off in sheets causing very minor bleeding. 1/3rd of the time it itches, it often goes unnoticed until the doctor observes it, notes it, or questions the patient. It generally is less noticeable in spring, summer and fall. It is more noticeable in the late fall and mostly in the winter as it generally improves with moderate sunlight and salt water and occasionally chlorinated water.

It usually, minimally presents and can flare and cover the body, and can even grow over parts of the eye and for no other reason it can vanish just as quickly as it appears. Psoriasis has certain triggers than can precipitate flares. Alcohol, lack of sunlight, spicy or hot foods, or abrading the erupted area can all lead to a much more intense response by the immune system. This is true of scratching or playing with the lesions, and you should try to avoid bothering the lesions. This is called Kubners phenomenon. It is non-contagious genetically inherited medical condition.

Interestingly psoriasis can often cause nail deformities mistaken as fungus and unsuccessfully self treated by a patient until they see a doctor. A different type of nail deformity called stippling is much like if you took a pencil and tapped on the external surface of the nail putting little dents in the nail. This is diagnostic of psoriasis. There is also ridging of the nails which looks like a Venitian blind closed and the edges of the blind ran the length of the nail from the cuticle to the tip of the finger.

The pathogenesis or background explanation, as to why psoriasis occurs is that cells in the skin that form by mitosis in the basement membrane of the skin and grow upward. Below the basement membrane are the blood vessels supplying nutrients and oxygen, as the cells grow upward in layers the oxygen gets less and less to the cells and eventually die off and slough off as part of the epidermis this is normal skin growth.

In a normal course of an injury, you may scrape your elbow and the usual repair mechanism takes place leaving a close resemblance of the original skin matrix. Patients with psoriasis may have the exact same scrape to the elbow that might have 30 cells layers above the basement membrane. This is supplied by the vascular system, however, the genetic program in these patients instead of re-growing 30 layers of cells, re-grows 200 layers of cells and the vascular supply was not designed for this magnitude and simply cannot support this increased thickness. The layers of dead skin now manifest as the traditional dried, scaly, white psoriasis lesions.

John Drew Laurusonis M.D.
Doctors Medical Center

Author's Bio: 

Dr. Laurusonis was conferred his Doctor of Medicine degree in 1983 and has been actively taking care of patients since completing his Internal Medicine residency in 1987 in the Garden State of New Jersey. Dr. Laurusonis has been licensed in four states but ultimately chose to permanently relocate to Georgia with his family and begin a private practice. Through his extensive experience in Internal Medicine, as well as in Emergency Rooms throughout the United States, Dr. Laurusonis saw how traditional Emergency Rooms were often overwhelmed by patients suffering medical conditions that were urgent but may not need the traditional “Level I Trauma Center”. Patients often waited six to twelve hours to be seen by a physician, were riddled with thousands of dollars in medical bills, and were generally unhappy with the system.
Dr. Laurusonis decided to open an Urgent Care Center instead of a 9-5 doctor's office. Through the last fifteen years he has received accolades from the community and his patients. He has expanded his practice to include many cosmetic therapies that have previously been treated with painful and extensive plastic surgery. He has been invited to the White House numerous times, has been named Physician of the Year from GA, as seen in the Wall Street Journal, and has served as Honorary Co-Chairman on the Congressional Physicians Advisory Board
Dr. Laurusonis and his practice, Doctors Medical Center, is open 7 days a week from 7:30 am to 9:30 pm offering such services as lab, x-ray, EKGs, aesthetics (Botox, dermabrasion, sclerotheraby and veins etc.), cold/flu, sore throats, fractures, sprains, lacerations, GYN, Pediatrics, Phlebology Anxiety/Insomnia/Depression Treatment, skin tag/mole removal, veins, allergies, asthma, physicals--just to name a few. Dr. Laurusonis welcomes you to either make an appointment or just walk-in to see him. Dr. Laurusonis will take the time to speak with you about your concerns--no problem is too big or too small. If you need additional services we have specialist referrals available or we can refer you to the neighborhood hospital emergency room. Give Doctors Medical Center a call--Dr. Laurusonis will be happy to speak with you.

John Drew Laurusonis, MD
Doctors Medical Center
3455 Peachtree Industrial Blvd
Suite 110
Duluth, GA 30096