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]
Altoona
Altoona is a city in south central Pennsylvania Blair County, Pennsylvania, United States. It is the principal city of the Altoona Metropolitan Statistical Area (MSA). The population was 46,320 at the time of the 2010 Census, making it the eleventh most populous city in Pennsylvania. The Altoona MSA includes all of Blair County and was recorded as having a population of 127,089 at the 2010 Census,[6] around 100,000 of whom live within a 5-mile (8.0 km) radius of the Altoona city center according to U.S. Census ZIP Code population data. This includes the adjacent boroughs of Hollidaysburg and Duncansville, adjacent townships of Logan, Allegheny, Blair, Frankstown, Antis, and Tyrone, as well as nearby boroughs of Bellwood and Newry.
Having grown around the railroad industry,[7] the city is currently working to recover from industrial decline and urban decentralization experienced in recent decades. The city is home to the Altoona Curve baseball team of the Double A Eastern League, which is the affiliate of the Major League Baseball team Pittsburgh Pirates. It also houses the 75-plus-year-old Altoona Symphony Orchestra,[8] under the direction of Teresa Cheung. Prominent landmarks include the Horseshoe Curve, the Railroaders Memorial Museum, the Juniata Shops of the Altoona Works, the Mishler Theatre, the Cathedral of the Blessed Sacrament, and the Jaffa Shrine Center.