Treating Psoriasis To Prevent Heart Attacks And Strokes
In the past, psoriasis was viewed primarily as a cosmetic problem that would not extend beyond the obvious lesions on the skin. With a better understanding of the immune responses involved in this disease, and clinical evidence revealing the frequent associations between psoriasis and other serious diseases, we now know that psoriasis is a much more serious disease affecting the whole body and quality of life.
Psoriasis
Psoriasis is a common skin disorder that affects at least 6 million people in America. Psoriasis usually occurs as red, scaly, crusty patches that reveal fine silvery scales when scraped or scratched. These patches may itch, irritate, and cause discomfort.
Psoriasis is most frequent on the knees, elbows and scalp, but can appear anyplace on the body. In some types the nails or joints are also affected. The condition is chronic, lasting for many years, sometimes painful, disabling, especially when associated with arthritis.
Causes Of Psoriasis
The reason psoriasis occurs is unidentified. However, it is accepted that the immune system plays an important role in the disease development. When psoriasis strikes, the over-reactive immune cells release inflammatory cytokines and set off the rapid turnover of skin cells. Normally, it takes up to 28 days for newly formed skin cells to rise to the surface of the skin and separate from healthy tissue, but in psoriasis it takes just two to six days. When the skin cells replenish themselves too quickly, they are immature and flawed as part of skin barrier.
Based on medical research, it is now recognized that psoriasis is a chronic immune-mediated hyper-proliferative inflammatory skin disease. Psoriasis is characterized by an over-production of immune-inflammatory mediators and complex interactions among epidermal cells and inflammatory/immune network.
Psoriasis Is Linked With Serious Medical Conditions
There is a growing awareness that psoriasis is more than 'skin deep'. Over the years, multiple studies have uncovered that psoriasis is associated with a number of potentially serious medical conditions including cardiovascular disease, cancer, obesity, psoriatic arthritis, metabolic syndrome, diabetes, autoimmune diseases (Crohn's disease), psychiatric diseases (such as depression and sexual dysfunction), sleep apnea, and chronic obstructive pulmonary disease (COPD).
Recently, a convincing association between psoriasis and vascular diseases becomes apparent. Psoriasis patients have an increased occurrence of heart attack, stroke, and peripheral vascular disease. Studies also revealed that patients with severe psoriasis have shorter life expectancies by an average of three to five years than those who do not have psoriasis.
Inflammation Is The Underlying Link Between Psoriasis And Cardiovascular Diseases
The exact connection between psoriasis and vascular diseases remains unclear, but existing evidence supports that inflammation may serve the causal link between psoriasis and cardiovascular disease.
Psoriasis and atherosclerosis (hardening of the arteries, the leading cause of heart attacks, stroke, and peripheral vascular disease) share similar immune-inflammatory responses. In psoriasis, local release of inflammatory cytokines initiates a cascade of immune-inflammatory cell activation, continuous skin cell proliferation, and development of psoriatic plaques. In atherosclerosis, activated inflammatory cells gather at the sites of vascular injury, contribute to formation of atherosclerotic plaque, and destabilize the plaque which eventually leads to heart attack and stroke.
Psoriasis Treatments
Psoriasis treatments are intended to control the over-reative immune-inflammatory responses, slow cellular growth, and alleviate associated itching and scaling.
Treating psoriasis often involves combination of different medications and interventions such as:
--Topical drug therapy (including corticosteroids, vitamin D derivatives, tar preparations, dithranol preparations and vitamin A derivatives)
--Phototherapy (also known as light therapy)
--Systemic medications (prescribed to suppress specific immune-inflammatory molecules or pathways in the body)
Along with drug treatments, moisturizers are often used to avoid water loss and ease the dryness associated with the disease or caused by treatments.
Apparently, there are undesirable effects and risks linked with long-term drug therapy. Common side effects of corticosteroids include skin thinning, loss of pigment, allergic to steroids, and increased risk of infection.
Common side effects of systemic immunomodulatory therapy (impact the entire immune system) and newer biologic drugs (target individual factor or specific pathway of the immune system) include increased risk of infection, flu-like symptoms, injection site reactions, and weakened immune system.
Can Treating Inflammation Benefit Both Psoriasis And Cardiovascular Disease
Due to important role of inflammation in psoriasis and atherosclerosis, it is believed that suppressing immune-inflammatory responses may be effective treatments for both psoriasis and atherosclerosis. Various studies are carried out to determine whether a treatment to reduce inflammation in psoriasis patients could be associated with a decrease in cardiovascular diseases.
Although there has no conclusive evidence, early results suggest that treating psoriasis patients with drugs targeting inflammatory mediators can reduce vascular inflammation in psoriasis patients. However, multi-year follow-up studies are required to confirm if reduced inflammation in psoriasis patients is correlated with smaller and stable atherosclerotic plaques and reduced incidence of heart attack and stroke.
Topical Anti-inflammatory Remedies For Psoriasis Relief
To avoid systemic side effects related to long-term drug therapies, natural anti-inflammatory remedies, especially topical anti-inflammatory herbal remedies, are often used as alternative treatments for psoriasis relief. Anti-inflammatory herbal extracts have been consumed for centuries to ease inflammatory skin conditions including psoriasis. Some results from clinical trials using herbal remedies to treat psoriasis have been promising.
Accepted anti-inflammatory herbal extracts for psoriasis relief include White willow, Aloe vera, Licorice, Coptis, Scute, Rhubarb, Honey suckle, and Indigo naturalis. Pharmacological studies have shown that these herbs have anti-oxidant, anti-inflammatory, anti-allergic, and immuno-regulatory properties.
Topical Anti-inflammatory herbal remedies may provide following benefits for psoriasis relief:
--Ease of inflammation-related scaling and itching
--Balanced immune response against allergens, irritants, oxidative stress, and infections
--Augmented endogenous (i.e., derived internally) antioxidants, the most effective disease-fighting molecules in the body
--Nourishing environment for recovery of damaged skin cells and improved tissue repair
To learn and benefit from natural anti-inflammatory remedies, follow blog series "Nature's Best Anti-inflammatory Herbs" and "Natural Cures For Chronic Inflammatory Conditions".
References:
1. A tale of two plaques: convergent mechanisms of T-cell-mediated inflammation in psoriasis and atherosclerosis. Armstrong AW. et al. Experimental Dermatology. 20(7):544-9, 2011
2. Attributable risk estimate of severe psoriasis on major cardiovascular events. Mehta NN. et al. American Journal of Medicine. 124(8):775.e1-6, 2011
3. Can treatment of chronic inflammatory diseases reduce the risk of diabetes mellitus?. Bongartz T. Kudva Y. JAMA. 305(24):2573-4, 2011
4. Association between disease-modifying antirheumatic drugs and diabetes risk in patients with rheumatoid arthritis and psoriasis. Solomon DH. et al. JAMA. 305(24):2525-31, 2011
5. The 'psoriatic march': a concept of how severe psoriasis may drive cardiovascular comorbidity. Boehncke WH. et al. Experimental Dermatology. 20(4):303-7, 2011
6. Psoriasis and obesity: literature review and recommendations for management. Duarte GV. et al. Anais Brasileiros de Dermatologia. 85(3):355-60, 2010
7. Psoriasis--a systemic inflammatory disorder: clinic, pathogenesis and therapeutic perspectives. Boehncke WH. Sterry W. Journal der Deutschen Dermatologischen Gesellschaft. 7(11):946-52, 2009
8. Where the immune response meets the vessel wall. Bisoendial RJ. et al. Netherlands Journal of Medicine. 67(8):328-33, 2009
9. Yin-yang strategy: proposing a new, effective, repeatable, sequential therapy for psoriasis. Bhutani T. Zitelli KB. Koo J. Journal of Drugs in Dermatology: JDD. 10(8):831-4, 2011
10. Literature research of Chinese medicine recipes for the treatment of psoriasis vulgaris with blood-heat syndrome type. Tan YQ. et al. Chinese Journal of Integrative Medicine. 17(2):150-3, 2011
11. Which plant for which skin disease? Part 1: Atopic dermatitis, psoriasis, acne, condyloma and herpes simplex. Reuter J. et al. Journal der Deutschen Dermatologischen Gesellschaft. 8(10):788-96, 2010
About the Author
Dr Yi Shi, founder of Innovative Drug Discovery http://www.3Rskincare.com is well established in inflammatory disease research. Dr Shi has conducted numerous research projects and published over 40 research articles in medical journals. For nearly a decade, Dr Shi has led collaborative efforts to develop natural anti-inflammatory remedies and 3R Skincare System for inflammatory skin disorders.
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