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]
Kansas City
Kansas City is the largest city in Missouri and the sixth largest city in the Midwest. According to the U.S. Census Bureau, the city had an estimated population of 475,378 in 2015,[6] making it the 36th largest city by population in the United States. It is the anchor city of the Kansas City metropolitan area, which straddles the Kansas–Missouri border. Kansas City was founded in the 1830s as a Missouri River port at its confluence with the Kansas River coming in from the west. On June 1, 1850 the town of Kansas was incorporated; shortly after came the establishment of the Kansas Territory. Confusion between the two ensued and the name Kansas City was assigned to distinguish them soon thereafter.
Sitting on Missouri’s western border, with Downtown near the confluence of the Kansas and Missouri rivers, the modern city encompasses some 319.03 square miles (826.3 km2), making it the 23rd largest city by total area in the United States. Most of the city lies within Jackson County, but portions spill into Clay, Cass, and Platte counties. Along with Independence, it serves as one of the two county seats for Jackson County. Major suburbs include the Missouri cities of Independence and Lee’s Summit and the Kansas cities of Overland Park, Olathe, and Kansas City.
The city is composed of several neighborhoods, including the River Market District in the north, the 18th and Vine District in the east, and the Country Club Plaza in the south. Kansas City is also known for its cuisine (including its distinctive style of barbecue), its craft breweries and its major league sports teams.