What is psoriasis?
Psoriasis is an immune-mediated genetic disease found on the skin, joints, or both. Although it can affect any part of your body, psoriasis plaques most often develop on the elbows, knees, scalp, back, face, palms of the hands, and feet. The lesions are small and solitary or are accompanied by large plaques that usually form geometric patterns with the central area of normal skin.
In many cases, the nails become thick, laminate unevenly, and become brittle. In addition to plaque psoriasis, there are four other types of this disease, including guttural, pustular, transverse (or flexural), and erythrodermic.
Who gets psoriasis?
It affects 2-4% of men and women. It can begin at any age, including childhood, with early peaks between 15 and 25 years and between 50 and 60 years. Lasts a lifetime, wide fluctuations, and intensity. It is very common in Caucasians but affects people of any race. One-third of psoriasis patients have relatives with psoriasis.
Types of psoriasis
The different types of psoriasis are:
- Psoriasis Vulgaris: The most common form of psoriasis affecting 80% of sufferers is psoriasis Vulgaris (“Vulgaris” means common). It is also known as plaque psoriasis because of the well-defined areas of increased redness that characterize this form. These enlarged red plaques are silvery-white in colour with a layer called scale made up of dead skin cells. The scale often becomes loose and falls off.
- Guttate psoriasis: This is a subtype of psoriasis, an autoimmune skin disease. Gutta is the Latin word for a drop of liquid. This can cause tiny droplet-shaped papules or scars.
- Inverse psoriasis: This is also known as flexural psoriasis. This is a skin condition that affects the folds of the skin.
- Pustular psoriasis: This is a skin disease characterized by the appearance of white, purulent blisters surrounded by pale, red skin.
- Erythrodermic psoriasis: This is a rare, but very serious form of psoriasis. It causes a bright red rash that is itchy and painful. The skin peels off in large sheets.
Causes of psoriasis
It makes skin cells overactive – they grow five times faster than normal skin cells. And your body can’t keep up. Instead of slowing down old cells, they form thick, scaly, itchy patches.
Doctors are not clear about what causes psoriasis. However, thanks to decades of research, they have a general idea of two main factors: genetics and the immune system.
Psoriasis is an autoimmune disease. The body attacks itself, causing autoimmune diseases. In the case of psoriasis, white blood cells called T cells accidentally attack skin cells.
In a normal body, white blood cells implant to attack and destroy invading bacteria and to fight infection. This erroneous attack causes the skin cell production process to accelerate. Speed up skin cell production New skin cells grow very quickly. They push themselves to the surface of the skin, where they pile up.
Some people inherit genes that make them more likely to improve psoriasis. If you have an immediate family member with a skin condition, your risk of developing this skin disease is high. However, the percentage of people with this skin disease and genetic predisposition is low.
Risk factors that include:
- Stress/emotional disorders
- Skin injuries
Signs and symptoms of psoriasis
Dry, thick, and raised patches on the skin are the most basic sign of this disease. These patches are often covered in a silvery-white coating called the scale and itch.
Although patches of thick, dry skin are common, it can cause many signs and symptoms. What you see and feel varies:
- Bright red raised patches of skin (called plaques). They are usually loose, covered in silver scales. They are usually located on the knees, elbows, or lower back.
- Small areas of bleeding when the skin scales are picked or scraped (Auspitz’s sign).
- Smooth scaling to thick, crusted plaques on the scalp.
- Itching, especially during a flash fire or when psoriasis plaques are found in the folds of the body, such as under the breasts or buttocks.
- Discoloured or pitted nails.
Diagnosis of psoriasis
There is no laboratory test for this disease. Most likely, your doctor will easily identify this common disease by the type and location of the inflammation. However, many diseases can be confused with this skin disease: seborrheic dermatitis, eczema, lupus, syphilis, and some types of skin cancer, Your doctor will need to perform a physical exam to rule out these possibilities. In rare cases, it requires a skin biopsy to rule out other conditions that can cause similar symptoms.
Treatment for psoriasis
There are many effective treatment options for this skin disease. The best treatment is determined by the treating physician on an individual basis and, to some extent, by the type, severity, and amount of skin disease.
The treatment options include:
- Biologics that target the immune system
- Medications that you take by mouth
- Light therapy
- Topicals such as creams and ointments
- Alternative treatments, such as mind-body practices, pain management, and lifestyle changes
- For scalp psoriasis, medicated shampoos
For moderate and severe skin disease, which covers very large areas of the body (> 10% or more of the total skin surface), topical products may not be effective or practical to apply. This may require ultraviolet light treatments or topical medications (whole-body treatments such as pills or injections). Internal medications often have higher risks. Since the topical treatment does not affect topical arthritis, systemic medications are generally needed to stop the progression of permanent joint destruction.
Remember that, as with any medical condition, all medications can have side effects. Not all drugs are 100% effective, and drugs are not 100% safe. The decision to use any single-use medication requires thorough consideration and discussion with your healthcare provider. The potential risks and benefits of standard medications must be considered for each type of this disease and each individual. The two patients with the same disease, one can tolerate it with very little treatment, the other may be incapacitated and may require internal treatment.
The proposal to reduce the toxicity of some of these drugs is commonly called “rotational” therapy. The idea is to change the medications every six to 24 months is to reduce the toxicity of a medication. Depending on the choice options, this proposal is an option. The exception to this proposal is the use of new biological drugs as described below. A person who has been using strong topical steroids over large areas of their body for a long time can benefit from stopping steroids for a time and switching to a different treatment.
Having this skin disease puts you at risk for several health conditions:
- High blood pressure
- High cholesterol
- Cardiovascular disease
- Liver disease
- Kidney disease
- Uveitis (an eye disease)
- Crohn’s disease
- Diet: Eat plenty of fruits, vegetables, and whole grains, and avoid saturated and trans fats, refined carbohydrates, and processed foods. Diets with oily fish such as mackerel, salmon, sardines, or herring can be a useful complement in the treatment.
- Baths: Sunbathing, sea bathing, and daily UV exposure can improve this disease. Mild soaps or soap substitutes should be used. Antiseptics should not be used in a way that irritates the skin.
- Say no to tobacco: Using tobacco in any form can make this skin disease worse. Stop smoking or chewing tobacco for better prevention.
Departments to consult for this condition
- Department of dermatology