Speaker 1: Welcome to Brainstuff, a production of iHeartRadio. Hey brain Stuff,
Speaker 1: Lauren Vogelbaum here. You may have heard that your body
Speaker 1: replaces and replenishes all of its cells every seven years.
Speaker 1: This isn't quite true. It's catchy, but our bodies are complicated,
Speaker 1: and your rate of cellular renewal depends person to person
Speaker 1: and organ to organ. Your skeletal cells might change out
Speaker 1: every ten to fifteen years or so. Some of the
Speaker 1: cells in your brain and heart will stay with you
Speaker 1: for your entire life. On the flip side, the cells
Speaker 1: in your liver get replaced every three years, and the
Speaker 1: ones in your gut turnover within a few months. But
Speaker 1: if it were a race, your skin would win. Under
Speaker 1: normal conditions, the cells in your epidermis, your skin's outermost layer,
Speaker 1: replace themselves in just four weeks. That's because the outer
Speaker 1: layer of the epidermis is actually made up of tough,
Speaker 1: dead cells that help protect us from germs and rough
Speaker 1: surfaces and everything else in the world around us. We're
Speaker 1: constantly sloughing off the old ones as they wear out.
Speaker 1: We shed some forty thousand dead skin cells every minute.
Speaker 1: That adds up to about one and a half pounds
Speaker 1: of skin around seven hundred grams shed every year, but
Speaker 1: that's assuming that everything is working properly. Sometimes, for reasons
Speaker 1: that we don't entirely understand, your skin can go into overdrive.
Speaker 1: In a condition called psoriasis, your skin tries to replace
Speaker 1: its outermost layer every four days or so. This leads
Speaker 1: to a build up of skin cells that can cause discolored,
Speaker 1: uncomfortable patches on your skin that are annoying at best.
Speaker 1: It's caused by your immune system being way overactive. So
Speaker 1: it's not contagious, but there's no cure, not yet anyway.
Speaker 1: But what's going on here? How could a process that's
Speaker 1: supposed to be good, the maintenance of our body's first
Speaker 1: line of defense turn against us today? Let's talk about
Speaker 1: what we know and don't know about psoriasis. First off,
Speaker 1: not allsrisis looks the same. The symptoms and their severity
Speaker 1: can really differ, and they come and go over time
Speaker 1: in flares. Very basically, soriasis usually manifests as patches of
Speaker 1: irritated skin that are tender, itchy, or even painful. The
Speaker 1: patches are often reddish or purplish in color, sometimes with
Speaker 1: scales or flakes coming off. They could occurb anywhere on
Speaker 1: the body, though they're most common around the elbows and knees,
Speaker 1: hands and feet, around the torso and scalp, and anywhere
Speaker 1: the skin folds, like under the arms. The finger and
Speaker 1: toenails can also be effected, showing pitting, discoloration, or other
Speaker 1: deformation of the nail, along with pain or tenderness. Psorisis
Speaker 1: can pop up in anyone at any age. People usually
Speaker 1: see their first flare between the ages of fifteen to
Speaker 1: twenty five, but it can happen earlier or later. We
Speaker 1: know that genetics has something to do with it. You're
Speaker 1: more likely to develop psoriasis if someone in your family
Speaker 1: has it. Researchers are investigating a number of associated genes
Speaker 1: but haven't really pinned any down yet. About a tenth
Speaker 1: of the population may be genetically predisposed to psoriasis, but
Speaker 1: only two to three percent of people will actually develop it.
Speaker 1: It seems that something has to trigger your immune system
Speaker 1: to start acting up. That something might be an injury
Speaker 1: to the skin or a seemingly unrelated illness like a
Speaker 1: strep infection. It can be a change in the weather
Speaker 1: or just stress, and once a flare happens, the condition
Speaker 1: is chronic, meaning it'll usually keep recurring and resolving and
Speaker 1: recurring throughout your life. And unfortunately, researchers aren't exactly sure
Speaker 1: why this happened. It seems like a combination of genetic
Speaker 1: predisposition and some environmental trigger causes your skin to stress out.
Speaker 1: Your skin and your immune system try to work together
Speaker 1: to protect you, which is good, but in this case,
Speaker 1: researchers think that some kind of feedback loop happens, a
Speaker 1: sort of perfect storm where your skin produces more and
Speaker 1: more replacement cells and your immune system is really gearing
Speaker 1: up for a fight, getting extra blood flow and defensive
Speaker 1: cells to the area, and nothing comes of it, so
Speaker 1: you're left with patches of flaky, inflamed skin. It doesn't
Speaker 1: help that this perfect storm that is psoriasis can present
Speaker 1: in a number of ways. Let's talk more about those
Speaker 1: different symptoms. Researchers divide them into five basic types of psoriasis.
Speaker 1: The most common by far is called plaque soriasis because
Speaker 1: it causes raised scaly patches on the skin known as plaques.
Speaker 1: On light colored skin, they often look red with white scales.
Speaker 1: On darker colored skin, they often look purple with gray scales.
Speaker 1: They usually appear on the elbows, knees, torso, and scalp,
Speaker 1: but can show up anywhere and can be puffy and
Speaker 1: itchy or painful. Plaques show up on about eighty percent
Speaker 1: of people with psoriasis. What's called inverse psoriasis is a
Speaker 1: little less common. It causes dark red to purple, sort
Speaker 1: of shiny patches in places where our skin folds, like
Speaker 1: under the arms, around the groin, and under the breasts.
Speaker 1: The patches aren't usually scally, but they can be really
Speaker 1: itchy and tender. Around twenty five percent of people with
Speaker 1: riasis experience these more rarely, like less than ten percent
Speaker 1: of the time. The condition can cause what's called gut
Speaker 1: tape csoriasis, which is sort of like plasoriasis, but the
Speaker 1: scally spots are smaller and more numerous, often spread over
Speaker 1: the entire arms, legs, or torso. It's a lot of small,
Speaker 1: thin patches of irritation rather than a few big ones.
Speaker 1: This one often shows up in adolescence rarely, in about
Speaker 1: three percent of cases. Psoriasis can cause pustules to develop
Speaker 1: a rash of painful, pus filled bumps across the palms
Speaker 1: or souls, or sometimes other areas. Of the body. That's
Speaker 1: called pustular psoriasis. Also, rarely, in about two percent of cases,
Speaker 1: you find really widespread discoloration and irritation over large areas
Speaker 1: of the body. This is called erythrodermic psoriasis, and it's
Speaker 1: a more severe version that can be accompanied by flu
Speaker 1: like symptoms like fever, chills, and fatigue. If this happens
Speaker 1: to you or a loved one, definitely call a doctor
Speaker 1: right away because it counts as a medical emergency. Generally speaking,
Speaker 1: if you have any of these symptoms, getting in touch
Speaker 1: with a healthcare professional is the best thing to do
Speaker 1: because well, a, you're probably uncomfortable, and b they'll be
Speaker 1: able to help with the diagnosis and figure out from
Speaker 1: there how best to manage and reduce those symptoms and
Speaker 1: any others that may come up. All forms of psoriasis
Speaker 1: are tricky to treat because, again, it's not caused by
Speaker 1: some germ that medicine can help you fight. It's an
Speaker 1: instance of your own body turning against you. A healthcare
Speaker 1: provider will evaluate your symptoms and do a skin biopsy,
Speaker 1: that is, take a small sample of skin to look
Speaker 1: at under a microscope to tell whether you're experiencing psoriasis
Speaker 1: or a different condition. Well, once you have a diagnosis,
Speaker 1: there are lots of treatment options for relieving discomfort and
Speaker 1: reducing the severity and occurrence of skin patches. There are
Speaker 1: topical treatments, creams, and other products that you apply directly
Speaker 1: to your skin. Some can be bought over the counter
Speaker 1: from drug stores or grocery stores, but others, like topical
Speaker 1: steroids and some strong alternatives, need a prescription. Topicals are
Speaker 1: great because, depending on the product, they're non invasive ways
Speaker 1: to reduce inflammation, or control skin growth or smooth rough patches.
Speaker 1: Then there's phototherapy. This is a category of also non
Speaker 1: invasive treatments that use ultraviolet light to slow down skin
Speaker 1: growth on an ongoing basis. Basically, a dermatologist will prescribe
Speaker 1: a consistent schedule for you to either go into a
Speaker 1: medical office or use a machine at home that exposes
Speaker 1: affected areas of your skin to a specific amount of
Speaker 1: ultraviolet light for a specific amount of time. Consistency is key,
Speaker 1: but home photo therapy especially can be a convenient and
Speaker 1: affordable treatment. Those are the first two categories of treatment
Speaker 1: that healthcare providers will usually try, but if they're not
Speaker 1: working or for whatever reason you need something different. There's
Speaker 1: what's called systemic treatments. They're called systemic because they're not
Speaker 1: applied to a particular topical area. Instead, these are prescripts
Speaker 1: medications that help control immune or skin activity throughout your body.
Speaker 1: Some can be taken orally and work to moderate your
Speaker 1: immune response or your skin growth in specific ways. Others,
Speaker 1: called biologic drugs, have to be given by either injection
Speaker 1: or IV. Biologics are super targeted drugs that block particular
Speaker 1: activity in your immune system. Systemics are powerful tools against soriasis.
Speaker 1: All of these treatments can come with risks and side effects.
Speaker 1: A health care provider can help you figure out which
Speaker 1: ones are right for you and manage any side effects
Speaker 1: that do occur. And it is important to treat psoriasis
Speaker 1: because first of all, it is uncomfortable and having skin
Speaker 1: problems can be embarrassing and you don't need to live
Speaker 1: with that. But also, untreated csoriasis is associated with greater
Speaker 1: risk of what's called comorbidities, which are other conditions that
Speaker 1: often occur alongside a health issue. In the case of psoriasis,
Speaker 1: they're often inflamma related and can include things like diabetes,
Speaker 1: inflammatory bowel disease and cardiovascular disease. It also includes a
Speaker 1: real specific one called syriatic arthritis. Around a third of
Speaker 1: people with psoriasis will experience this. It's a condition that
Speaker 1: causes swelling and stiffness or pain in the joints and
Speaker 1: places where connective tissues attached to the bones, but especially
Speaker 1: in the outer joints of the fingers and toes. As
Speaker 1: with psoriasis, the symptoms really vary. They can be mild
Speaker 1: or severe, and can flare up, then resolve, then flare
Speaker 1: up again over time. It's distinct from other kinds of
Speaker 1: arthritis for a few reasons, including where it occurs, and
Speaker 1: because it's often accompanied by the nail symptoms of psoriasis.
Speaker 1: Researchers aren't exactly sure what's going on here either, but
Speaker 1: it seems that the inflammation from that overactive immune system
Speaker 1: you see in psoriasis isn't just skin deep. If that
Speaker 1: inflammation reaches the joints, you get discoloration and discomfort there too.
Speaker 1: This can also damage the joints over time, so it's
Speaker 1: especially important to talk to a healthcare professional if you
Speaker 1: experience these symptoms. They might use different tests like X rays, MRIs,
Speaker 1: ultrasounds and blood tests to help rule out other conditions
Speaker 1: and make sure that you get the right diagnosis and treatment.
Speaker 1: Those treatments include the systemics we talked about a minute ago,
Speaker 1: oral medications or biologics that help control your immune system
Speaker 1: unlessen inflammation throughout your body. I don't have personal experience
Speaker 1: with psoriasis, but just as a human whose job it
Speaker 1: is to explain how things work, it's frustrating that this
Speaker 1: is such a complex condition that we don't entirely understand
Speaker 1: it and can't cure it. But research is ongoing and
Speaker 1: the treatments available are improving all the time. Our bodies
Speaker 1: are weird and wonderful. They can do amazing things and
Speaker 1: can also behave in very strange ways. Please take care
Speaker 1: of yours. Today's episode is an original written by me.
Speaker 1: Brain Stuff is production of iHeart Radio and is produced
Speaker 1: by Tyler Klang. For more podcasts from my heart Radio,
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