MG217 Psoriasis Treatment from Triton Consumer Products

Psoriasis Triggers

Last month you lost your temper with your boss. On the same day you were stuck in a traffic jam after work. That evening you discovered your son broke a neighbor's window with a baseball. It's 30 days later and for some reason your psoriasis is acting up. Is this outbreak stress-related?

Eleven-year-old Steven recovered from an upper respiratory infection about two weeks ago. Now his psoriasis is starting to flare again. Did his flu induce the onset of his psoriasis?

Jeannette's psoriasis seemed to be in remission. She hadn't had an outbreak in several months. One afternoon she slipped on the driveway and badly scraped her knee. A few days later she noticed a new patch of psoriasis around the injury site. Did her abrasion cause the psoriasis to appear?

These are examples of what researchers have been studying as factors that can trigger the onset of psoriasis. In a March 1993 scientific workshop on "Epidemiology of Skin Disease" at the National Institutes of Health, these issues were addressed by Dr. Gerald Krueger. Dr. Krueger is Professor of Medicine, Division of Dermatology, at the University of Utah School of Medicine. Dr. Krueger suggested that three factors are recognized as triggering the onset of psoriasis, causing new lesions, or inducing a flare-up. They are stress, skin injury and infection.

Stress

According to Dr. Krueger, it is common for many patients (30-50%) to report a flare-up following stress. Studies have shown that a stressful event that occurred 30 days prior to the onset of a flare-up can be the cause. Patients who had stress as a precipitating factor who then learned to effectively cope with stress, had healed better with psoriasis therapy than those who didn't recognize stress as a precipitating factor at all.

Krueger went on to say that because much can be offered for stress management today (e.g., drugs, behavioral approaches), it seems probable that many patients who flare secondary to stress could be offered an additional therapeutic approach in conjunction with more traditional therapies.

The Koebner reaction or the development of localized psoriasis in skin following injury, was also discussed.

Some studies show this phenomenon to occur in 30-50% of patients. Up to 90% of patients who have a flare-up or have had the Koebner reaction in the past, also report psoriasis developing in the injured skin site as it heals.

Infection

Infections, especially strep infections, have also been linked to psoriasis. A study of 245 children revealed that 25% had the onset of their disease after an infection. In children already having psoriasis, 50% had a flare-up within two-three weeks of an upper respiratory infection.

Recent evidence has also demonstrated that AIDS exacerbates existing psoriasis and will induce it in AIDS patients with no previous history at all.

Other Factors

We know that psoriasis is an inflammatory skin disease triggered by various circumstances. After onset, it tends to wax and wane but seldom goes into spontaneous remission. Much has been learned of the epidemiology of psoriasis, but there are still many unanswered questions.

In addition to the examples Dr. Krueger pointed out, diet, climate, alcohol, smoking, weight, and drug use can be added to the list of factors to research.

Are they related? Do they cause an outbreak? The NPF recently funded a $50,000 grant toward the study of infections and their relationship to psoriasis and if (or how) they trigger the onset of a flare-up. Additional long-term study of the epidemiology (those factors in the environment and inherent to the patient that affect the disease) of psoriasis is costly and desperately needed to better understand this disease that involves so many people.