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Psoriasis
Psoriasis [pronounced sore-EYE-ah-sis] is a noncontagious, lifelong skin disease that has been diagnosed in 4.5 million adults in the United States.

The most common form, plaque [plak] psoriasis, appears as raised, red patches or lesions covered with a silvery white buildup of dead skin cells, called scale.


Plaque psoriasis


Psoriasis is a very diverse skin disease that appears in a variety of forms. Each form has distinct characteristics. Typically, people have only one type of psoriasis at a time, but occasionally two or more different types of psoriasis can occur at the same time. Psoriasis can also occasionally change from one form to another. Trigger factors may "convert" some forms of psoriasis, such as plaque, to another form, such as pustular. Generally, one type of psoriasis will clear and then another form of psoriasis will appear later.

Plaque psoriasis is the most prevalent form of the disease. About 80 percent of all those who have psoriasis have this form. Its scientific name is psoriasis vulgaris (vulgaris means common). It is characterized by raised, inflamed, red lesions covered by a silvery white scale. It is typically found on the elbows, knees, scalp and lower back.

Guttate psoriasis

Guttate [GUH-tate] psoriasis is a form of psoriasis that often starts in childhood or young adulthood. The word guttate is from the Latin word meaning "drop." This form of psoriasis resembles small, red, individual spots on the skin. Guttate lesions usually appear on the trunk and limbs. These spots are not usually as thick as plaque lesions.
Guttate psoriasis often comes on quite suddenly. A variety of conditions have been known to bring on an attack of guttate psoriasis, including upper respiratory infections, streptoccocal infections, tonsillitis, stress, injury to the skin and the administration of certain drugs (including antimalarials and beta-blockers). A streptococcal infection of the throat (strep throat) is a common guttate psoriasis trigger. Strep throat can be present without symptoms and can still cause a flare of guttate psoriasis. Talk with your doctor about getting a strep test to determine if you have an underlying strep infection. Guttate psoriasis may persist despite clearance of the strep infection. Some doctors prescribe antibiotics to help prevent an occurrence of an infection that can cause the outbreak of guttate psoriasis.


Inverse psoriasis

Inverse psoriasis is found in the armpits, groin, under the breasts, and in other skin folds around the genitals and the buttocks. This type of psoriasis first shows up as lesions that are very red and usually lack the scale associated with plaque psoriasis. It may appear smooth and shiny. Inverse psoriasis is particularly subject to irritation from rubbing and sweating because of its location in skin folds and tender areas. It is more common and troublesome in overweight people and people with deep skin folds.

Pustular psoriasis

Primarily seen in adults, pustular [PUHS-choo-ler] psoriasis is characterized by white pustules (blisters of noninfectious pus) surrounded by red skin. The pus consists of white blood cells. It is not an infection, nor is it contagious. It may be localized to certain areas of the body–for example, the hands and feet. Pustular psoriasis also can be generalized, covering most of the body. It tends to go in a cycle–reddening of the skin followed by formation of pustules and scaling.
Pustular psoriasis reportedly may be triggered by internal medications, irritating topical agents, overexposure to UV light, pregnancy, systemic steroids, infections, emotional stress and sudden withdrawal of systemic medications or potent topical steroids.

It is not unusual for doctors to combine or rotate treatments for pustular psoriasis due to the potential side effects of systemic medications and phototherapy.

Erythrodermic psoriasis

Erythrodermic [eh-REETH-ro-der-mik] psoriasis is a particularly inflammatory form of psoriasis that often affects most of the body surface. It may occur in association with von Zumbusch pustular psoriasis. It is characterized by periodic, widespread, fiery redness of the skin. The erythema (reddening) and exfoliation (shedding) of the skin are often accompanied by severe itching and pain.
Patients having an erythrodermic psoriasis flare should make an appointment to see a doctor immediately. Erythrodermic psoriasis causes protein and fluid loss that can lead to severe illness. Edema (swelling from fluid retention), especially around the ankles, may also develop along with infection. The body's temperature regulation is often disrupted, producing shivering episodes. Infection, pneumonia and congestive heart failure brought on by erythrodermic psoriasis can be life threatening. People with severe cases of this condition often require hospitalization.

Known triggers of erythodermic psoriasis include abrupt withdrawal of systemic treatment; the use of systemic steroids (cortisone); an allergic, drug-induced rash that brings on the Koebner response (a tendency for psoriasis to appear on the site of skin injuries); and severe sunburns.

Initial treatment usually includes medium-potency topical steroids and moisturizers, combined with wet dressings, oatmeal baths and bed rest. Antibiotics may also be used. Careful attention is paid to restoring and maintaining fluids in the body.



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