It is a skin condition where scaly patches and a reddish tinge are seen on the skin.
In some cases, psoriasis can cause severe pain and be quite disabling. This chronic skin disease, in some cases involves the joints.
The damage is mainly observed in the bony prominences such as elbows, knees, but it can occur anywhere on the body.
In some cases, it causes stiffness, pain, and swelling in the joints , known as psoriatic arthritis.
Psoriasis cannot be spread by touch from person to person. It can affect men or women of any race or age.
Psoriasis can also be a cause of social embarrassment, anger, sadness, and depression .
Causes of psoriasis
The exact cause of psoriasis is not known despite the large number of investigations that have been conducted.
It is said to be related to the body’s immune system, environmental and genetic factors.
Psoriasis occurs when the immune system overreacts and produces flaking of the skin that causes inflammation.
In some cases, psoriasis can be inherited. People with psoriasis often notice times when their skin worsens.
Things that can cause these flare-ups or worsening of the disease include cold and dry weather, stress , infections, and dry skin.
Also definitive drugs like non-steroidal anti-inflammatory drugs and drugs used to treat high blood pressure or certain mental illnesses can trigger an outbreak.
Smoking, especially in women, can cause psoriasis and worsen the disease when it is already suffered.
Symptoms of psoriasis
The symptoms of Psoriasis can be limited to some areas of the skin or they can be moderate or generalized and acute.
There are several types of psoriasis. Symptoms for each type can vary in acuity and appear in a wide range of combinations.
The main features are bright red areas of raised patches or plaques on the skin that are covered with loose silver micaceous scales.
Plaques can appear anywhere, but are most commonly seen on the elbows, knees, scalp, feet, hands, or lower back.
Points of bleeding can be seen when scratching the scales called Auspitz’s sign.
Joint swelling, tenderness, and joint pain can also be seen.
Koebner phenomenon can occur when a person with psoriasis has an injury, such as a burn, cut, or excessive sun exposure to a particular area of the skin that is not affected by the disease.
Psoriasis spots appear on wounded skin or anywhere else on the skin, from several days to about two weeks after injury.
Because this response is common, it is essential that people with psoriasis avoid irritating or injuring the skin.
Psoriasis vulgaris is the most common form. The first signs of an outbreak are:
- Red spots or patches.
- The patches get larger and become scaly.
- The upper scales fall in large quantities, while the lower layers of scales are firmly attached.
- When the scales are removed, several small bleeding spots can be seen underneath.
Nail psoriasis often manifests as small gums on the nails.
The outbreak can be so severe that the nail thickens and falls apart.
Flexural psoriasis occurs in the folds of the skin (flexes).
Red, itchy plaques appear in the armpits, under the breasts, on the stomach, in the groin, or on the buttocks.
The plaques are often infected by the yeast-like fungus Candida albicans.
Guttate psoriasis is a special variant that occurs mainly acutely in children and young people due to a streptococcal infection of the throat.
Gouty scaly patches appear all over the body. In many cases, the condition clears up on its own after a few weeks or months.
Scalp psoriasis can be difficult to distinguish from a severe case of cradle cap, and sometimes the two occur simultaneously.
An outbreak of psoriasis can lead to lesions on the face, ears, or hairline.
Diagnosis of psoriasis
A dermatologist can usually diagnose psoriasis by looking at patches on the skin, scalp, or nails.
Occasionally a skin biopsy is required in certain cases to confirm.
Treatment for psoriasis
There is no complete cure for psoriasis, but various treatments can help you manage psoriasis symptoms.
There are accessible treatments, but due to its chronic and repetitive nature, psoriasis is challenging to treat.
Treatment is based on the type of psoriasis you have, its location, severity, age, and general health.
It also depends on how much you are affected by the condition, either physically, due to factors such as joint pain, or emotionally, due to the embarrassment or frustration of a skin rash that can cover a large or visible area of the body.
The treatment will be conditioned to the age and general health of the patient and the nature of the psoriasis.
Moisturizing creams are important in the treatment of psoriasis, and in the case of mild psoriasis, it is likely to be a unique and effective treatment.
These reduce dryness, cracking and flaking of the skin, they also reduce the need for active treatment.
Specific local treatments include creams and ointments that contain coal tar, dithranol, tazarotene (Zorac), or vitamin D-related compounds, for example, calcipotriol (Dovonex), calcitriol (Silkis), or tacalcitol (Curatoderm).
Occasionally, corticosteroid-containing ointments are used for a short time.
Combine a corticosteroid with another topical treatment, either as separate products used at different times of the day, or as a combination product.
As is the case with dovobet (calcipotriol and betamethasone) or Alphosyl HC (coal tar and hydrocortisone), it can be beneficial for chronic psoriasis vulgaris.
There are currently specific lotions on the market that are indicated for the treatment of psoriasis of the scalp.
The content of these lotions is often salicylic acid, coal tar, sulfur, or corticosteroids.
Vitamin D-based scalp applications are also available.
Topical treatment can be combined with sunlight or ultraviolet light and this therapy is known as phototherapy.
Ultraviolet B, UVB or ultraviolet A psoralent phototherapy are used in specialized dermatology centers for generalized psoriasis. Many patients find that natural sunlight helps, too.
Oral medications are used to treat moderate and severe cases of psoriasis.
Oral treatment with immunosuppressants such as cyclosporine (Neoral) or methotrexate (such as Maxtrex) or the vitamin A derivative acitretin (Neotigason) can be used in patients with severe, disseminated psoriasis.
Injections of the immunosuppressants etanercept (Enbrel), adalimumab (Humira), ustekinumab (Stelara), or infliximab (Remicade) may be used for people with severe plaque psoriasis that has not responded to cyclosporine, methotrexate, or photochemotherapy, or for people who may take or tolerate these treatments.
Patients taking oral medications require frequent follow-ups and laboratory investigations to detect possible side effects.
Some of the oral medications are not safe during pregnancy.
Systemic corticosteroids should not be used as they can worsen the disease process.
New treatment modalities for psoriasis include biologics.
Biological products are similar or the same as proteins produced by the body, which have a specific mode of action.
They block the harmful response of the body’s immune system that causes psoriasis symptoms.
They have shown promising results in keeping the patient symptom-free for a longer period of time, but long-term biological safety is unknown.
The limiting factor for the use of biologics is the cost of the drug.
Ways to cope with psoriasis
There is no way to prevent psoriasis. The following measures can improve symptoms or help reduce the number of psoriasis flare-ups.
- Keep your skin moist and your weight under control, as obesity can make psoriasis worse.
- Avoid cold and dry climates. Cold weather can make symptoms inappropriate.
- Exposure to sunlight, hot, and humid weather can improve symptoms, but hot, humid weather can make certain types of psoriasis worse.
- Avoid scratching or pinching the skin and avoid skin injuries (cuts or scrapes).
- Avoid infections, alcohol consumption, and smoking.
- Try to avoid certain medications. When your doctor prescribes any medication, it should be reported that the patient is suffering from psoriasis.