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]
Murfreesboro
Murfreesboro is a city in and the county seat of Rutherford County, Tennessee.[7] The population was 108,755 according to the 2010 census, up from 68,816 residents certified in 2000. In 2015, census estimates showed a population of 126,118.[5]The city is the center of population of Tennessee[8] and is part of the Nashville metropolitan area, which includes thirteen counties and a population of 1,757,912 (2013). It is Tennessee’s fastest growing major city and one of the fastest growing cities in the country.[9] Murfreesboro is also home to Middle Tennessee State University, the largest undergraduate university in the state of Tennessee, with 22,729 total students as of fall 2014.[10]
In 2006, Murfreesboro was ranked by Money as the 84th best place to live in the United States, out of 745 cities with a population over 50,000.[11][12]
In 1811, the Tennessee State Legislature established a county seat for Rutherford County. The town was first named “Cannonsburgh” in honor of Newton Cannon, then Rutherford County’s member of the state legislature, but it was soon renamed “Murfreesboro” for Revolutionary War hero Colonel Hardy Murfree.[13] Author Mary Noailles Murfree was his great-granddaughter.
As Tennessee settlement expanded to the west, the location of the state capital in Knoxville became inconvenient for most newcomers. In 1818, Murfreesboro was designated as the capital of Tennessee. Eight years later, however, it was itself replaced by Nashville.[14]