Urticaria and psoriasis: the big questions

They don’t know exactly what causes CSU which is why it’s so difficult to treat.^2,3 I tell my patients that instead of focusing in on what exactly caused this, they should focus on how to live best day to day with the disease, and how to best manage the symptoms they have.

Urticaria is related to the release of histamine and other inflammatory mediators which lead to the typical presentation of a hive with central swelling, surrounding erythema, and associated pruritus.⁴

In studies, approximately, 50% of patients resolved within 6 months⁵ and more than 90% of patients had resolved within 25 years.⁵

Another factor that makes this disease so tricky is that there isn’t a set of common triggers.⁶ It really is different for every person. While many patients say that things like stress and sleeplessness are often triggers, it’s still different for each individual.

Living with CSU is a lot about weighing up your options. Should I stop working out entirely because it triggers my hives? Should I change the way I eat? You have to find a balance with your life.⁷

If a patient’s CSU is not being controlled, a dermatologist referral is a good idea.⁸

Angioedema is a deep swelling of the skin and tissue.⁹ It often occurs around the face and lips and is more commonly painful than itchy.¹⁰ It resolves in less than 72 hours typically.¹⁰

CSU is a multifactorial disease, which means that developing the disease is related to different factors.^6,11 However, it is not a strongly linked genetic disease.¹¹

It’s a good idea to take some photos when you have hives on your body, that way when you come into the office, even if you’re not in a phase, your doctor can see what you’re going through. Keeping a diary of what treatments you have tried, what doses, for how long, and how well the urticaria was controlled with that treatment can also be helpful.¹²

Psoriasis is an inflammatory disorder, which can affect more than just the skin.¹⁴ Associations such as cardiovascular disease and joint disease may be seen.¹⁴ We need to do our best to educate people about this and show that psoriasis is much more than just skin deep.

In general when choosing a makeup to use on the skin, it is best to choose one that is hypoallergenic, fragrance free, and non-comedogenic (i.e. it doesn’t clog pores).¹⁵

Up to 30% of psoriasis patients develop psoriatic arthritis but having psoriasis doesn’t mean that you will for sure end up with PsA.^16,17

Typically no. It’s just a different manifestation of the disease.¹⁷ Some patients only get psoriatic arthritis, whereas others have just the skin disease.¹⁸ It can be hard to predict what patients may get arthritis.¹⁹

It is important to live a healthy well-balanced lifestyle.²⁰ We know that obesity and smoking, for example, can be related to psoriasis.^21,22 So, I always encourage patients to focus on lifestyle measures as well.²⁰

There’s actually very little data that suggests that psoriasis is caused by food allergies.²³

There is a genetic link with psoriasis; however, we know the condition is multifactorial which means that there are different factors that contribute to the risk of developing psoriasis.^13,22

PASI and DLQI scores are two tests that help doctors to better understand the severity of your psoriasis.²⁴ The PASI is an objective measurement of the severity of psoriasis. With the DLQI, patients are asked a series of questions to determine the impact of psoriasis on their quality of life.²⁴ These tests help doctors to better understand and treat the condition.²⁴

There are many patient advocacy groups for psoriasis that are a good point of contact. For example, the National Psoriasis Foundation is a great resource for those living in North America. Google to find one near you. And of course, I always tell people to go see their dermatologist.²⁵ They are best placed to give you advice and might have some great suggestions to find the support you need.