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]
Lebanon
Lebanon /ˈlɛbnən/ is the county seat of Wilson County, Tennessee, United States.[4]
The population was 26,190 at the 2010 census, 28,608 in 2013 and 32.372 following a special census conducted in 2016[5].
Lebanon is located in Middle Tennessee, approximately 25 miles (40 km) east of downtown Nashville. Lebanon is part of the Nashville Metropolitan Statistical Area.
The city was incorporated in 1801,[6] and was named after the biblical cedars of Lebanon.[7] Local residents have called Lebanon “Cedar City”, mostly a reference to the abundance of cedar trees in the area. The city is home to Cumberland University, a small, private four-year liberal arts institution.
As of the census[2] of 2000, there were 20,235 people, 7,987 households, and 5,319 families residing in the city. The population density was 692.0 people per square mile (267.2/km²). There were 8,693 housing units at an average density of 297.3 per square mile (114.8/km²). The racial makeup of the city was 82.89% White, 13.78% African American, 0.33% Native American, 0.82% Asian, 0.03% Pacific Islander, 1.00% from other races, and 1.15% from two or more races. Hispanic or Latino of any race were 2.26% of the population.
There were 7,987 households out of which 30.9% had children under the age of 18 living with them, 47.7% were married couples living together, 15.0% had a female householder with no husband present, and 33.4% were non-families. 28.5% of all households were made up of individuals and 11.1% had someone living alone who was 65 years of age or older. The average household size was 2.41 and the average family size was 2.94.