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]
Edmonds
Edmonds is a city in Snohomish County, Washington, United States, and is a Northern Suburb of Seattle located 11 miles (18 km) north of the city. Edmonds has a view of Puget Sound and both the Olympic Mountains and Cascade Range. The third most populous city in Snohomish County after Everett and Marysville, the population was 39,709 according to the 2010 census and the estimated population in 2015 was 40,490.[3] Based on per capita income, one of the more reliable measures of affluence, Edmonds ranks 20th of 281 areas in the state of Washington.[5]
Edmonds is a port in the Washington State Ferries system. Currently, the only ferry from Edmonds is a run to Kingston, Washington; in the past, there have been much longer routes from Edmonds to Port Townsend, Washington.[6]
Edmonds is the oldest incorporated city in Snohomish County. Logger George Brackett founded Edmonds in 1890, naming the city either for Vermont Sen. George Franklin Edmunds[7] or in association with the nearby Point Edmund, named by Charles Wilkes in 1841 and later changed to Point Edwards.[8] Brackett came to the future site of Edmonds while paddling a canoe north of Seattle, searching for timber. When a gust of wind hit his canoe, Brackett beached in a location later called “Brackett’s Landing”.[9]
The town was named Edmonds in 1884, but was not incorporated until 1890 as an official “village fourth class” of Snohomish County. In that same year, Brackett sold 455 acres (1.84 km2) to the Minneapolis Realty and Investment Company. The town was plotted and a wharf was added along the waterfront. Modest houses and commercial structures sprouted up with a row of shingle mills dominating the cityscape.