Mar-Apr '08 | briefing | mail | interviews | articlespsorchat |  don't say this | flaker creativity | flakers' jargon | other places | archives | send mail | ed dewkesearch | acknowledgments | legal stuff | Flake: Confessions of a Psoriatic  | 2008 Ed Dewke

Did Severe Burns Trigger His Psoriasis?
from Don A.

Hi  Ed.  I ran across your site when out surfing and have a question.  Is it common for people who have been burned to acquire Psoriasis? I was burned over 50% of my TBSA and after about a year I developed P on some of my burn sites. My dermatologist and plastic surgeons believe the burns may have activated some antigen in my skin which allowed it to start. In my group of burn survivors I am the only one this has occurred to.  Just curious... -Don A.


Ed’s Response:  Hi Don.  I've never heard of burns being related to the onset of psoriasis.  But it makes perfect sense that burns could be a TRIGGER for psoriasis.  Psoriasis is really an immune system disorder.  The immune system responds to all sorts of things including burns and if you have a genetic predisposition to develop psoriasis, that may be the stimulus that starts it.  P-lesions are known to develop where the skin has been traumatized.  This is called the Koebner Phenomenon (named after the fellow who identified the cause/effect relationship).  Skin burns qualify as trauma in anybody’s book, so it can no doubt initiate the Koebner Phenomenon.

Among your group of burn survivors you may be the sole recipient of the genetic proclivity for psoriasis.  (Lucky you!)  Current thinking is that psoriasis is caused by several genes "doing their thing" in a fashion that grows lesions.  "Triggering" that genetic teamwork may or may not be a requirement to manifest the disease.  But the likelihood of a trigger being part of the equation would explain why some folks, who have no family history of psoriasis, suddenly "get it."  In other words, having the necessary genes may not, for some of us, be enough to mean you will become visibly psoriatic; a trigger is necessary.  But who the hell knows what his/her trigger(s) is(are)?  Well ... If it were simple, we'd have a cure by now.  Right?  -Ed

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