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]
Yuma
Yuma (Cocopah: Yuum) is a city in and the county seat[4] of Yuma County, Arizona, United States. It is located in the southwestern corner of the state, and the population of the city was 93,064 at the 2010 census, up from the 2000 census population of 77,515.[2]
Yuma is the principal city of the Yuma, Arizona Metropolitan Statistical Area, which consists of Yuma County. According to the United States Census Bureau, the 2014 estimated population of the Yuma MSA is 203,247.[5] More than 85,000 retirees make Yuma their winter residence.[6]
The area’s first settlers for thousands of years were Native American cultures and historic tribes. Their descendants now occupy the Cocopah and Quechan reservations.
In 1540, Spanish colonial expeditions under Hernando de Alarcon and Melchior Diaz visited the area and immediately recognized the natural crossing of the Colorado River as an ideal spot for a city. The Colorado River narrows to slightly under 1,000 feet wide in one area. Military expeditions that crossed the Colorado River at the Yuma Crossing include Juan Bautista de Anza (1774), the Mormon Battalion (1848) and the California Column (1862).
During and after the California Gold Rush to the late 1870s, the Yuma Crossing was known for its ferry crossings for the Southern Emigrant Trail. This was considered the gateway to California, as it was one of the few natural spots where travelers could cross the otherwise very wide Colorado River.