Psoriasis
Psoriasis is a long-lasting autoimmune disease characterized by patches of abnormal skin.[6] These skin patches are typically red, dry, itchy, and scaly.[3] On people with darker skin the patches may be purple in colour.[9] Psoriasis varies in severity from small, localized patches to complete body coverage.[3] Injury to the skin can trigger psoriatic skin changes at that spot, which is known as the Koebner phenomenon.[10]
There are five main types of psoriasis: plaque, guttate, inverse, pustular, and erythrodermic.[6] Plaque psoriasis, also known as psoriasis vulgaris, makes up about 90 percent of cases.[4] It typically presents as red patches with white scales on top.[4] Areas of the body most commonly affected are the back of the forearms, shins, navel area, and scalp.[4] Guttate psoriasis has drop-shaped lesions.[6] Pustular psoriasis presents as small non-infectious pus-filled blisters.[11] Inverse psoriasis forms red patches in skin folds.[6] Erythrodermic psoriasis occurs when the rash becomes very widespread, and can develop from any of the other types.[4]Fingernails and toenails are affected in most people with psoriasis at some point in time.[4] This may include pits in the nails or changes in nail color.[4]
Psoriasis is generally thought to be a genetic disease that is triggered by environmental factors.[3] In twin studies, identical twins are three times more likely to be affected compared to non-identical twins. This suggests that genetic factors predispose to psoriasis.[4] Symptoms often worsen during winter and with certain medications, such as beta blockers or NSAIDs.[4] Infections and psychological stress can also play a role.[3][6]Psoriasis is not contagious.[4] The underlying mechanism involves the immune system reacting to skin cells.[4] Diagnosis is typically based on the signs and symptoms.[4]
There is no cure for psoriasis; however, various treatments can help control the symptoms.[4] These treatments include steroid creams, vitamin D3 cream, ultraviolet light and immune system suppressing medications, such as methotrexate.[6] About 75 percent of cases can be managed with creams alone.[4] The disease affects two to four percent of the population.[8] Men and women are affected with equal frequency.[6] The disease may begin at any age, but typically starts in adulthood.[5] Psoriasis is associated with an increased risk of psoriatic arthritis, lymphomas, cardiovascular disease, Crohn’s disease and depression.[4] Psoriatic arthritis affects up to 30 percent of individuals with psoriasis.[11]
Niagara Falls
Niagara Falls (/naɪˈæɡrə/ ny-ag-ra) is a city in Niagara County, New York, United States. As of the 2010 census, the city had a total population of 50,193, down from the 55,593 recorded in the 2000 census. It is adjacent to the Niagara River, across from the city of Niagara Falls, Ontario, and named after the famed Niagara Falls which they share. The city is within the Buffalo–Niagara Falls Metropolitan Statistical Area as well as the Western New York region.
While the city was formerly occupied by Native Americans, Europeans who migrated to the Niagara Falls in the mid-17th century began to open businesses and develop infrastructure. Later in the 18th and 19th centuries, scientists and businessmen began harnessing the power of the Niagara River for electricity and the city began to attract manufacturers and other businesses that were drawn by the promise of inexpensive hydroelectric power. After the 1960s, however, the city and region witnessed an economic decline following an attempt at urban renewal under then Mayor Lackey, consistent with the rest of the Rust Belt as industries left the city old line affluent families relocated to nearby suburbs and out of town.
Despite the decline in heavy industry, Niagara Falls State Park and the downtown area closest to the falls continue to thrive as a result of tourism. The population, however, has continued to decline from a peak of 102,394 in the 1960s due to the loss of manufacturing jobs in the area.