Overview of psoriasis
Psoriasis is a long-term (chronic) disorder, which is generally characterized by the formation of scaly rashes anywhere on the body. This disorder affects about 1–3% of the individuals worldwide with the highest incidence noted during the late teens and the 50s. However, it may affect individuals at all ages. In case of adults, both men and women are equally affected, while in case of children, girls appear to be more commonly affected when compared to boys.1,2
Signs and Symptoms of psoriasis
Psoriasis is typically characterized by the formation of circular, red eruptions (papules) or plaques with a gray or silvery-white, dry scale on the skin. These eruptions or scales are noticed in a symmetrical pattern on the scalp, elbows, knees, lower back region and in the body folds such as the armpits. The joints (referred to as psoriatic arthritis), nails and genital areas may also be affected. Occasionally these plaques may be observed on the inner cheek or tongue.
Itching at the affected sites is a commonly noted symptom, which may or may not be associated with burning sensation or pain. A small point of bleeding may be noticed if the scales on the skin are pulled out. In case of psoriatic arthritis, joint pain is noted along with the signs and symptoms of the skin. The affected nails may display pits on the nail surface with accumulation of yellowish material under the nail plate or detachment of the nails.
Based on the appearance, psoriasis has been categorized as follows:
Plaque-type psoriasis—This is the commonest type of psoriasis, characterized by scales on the skin.
Guttate psoriasis—Small oval/tear drop-shaped papules.
Pustular psoriasis—Pus-filled eruptions; these may be observed only in certain specific areas (localized) or spread over a wide area (generalized)
Erythrodermic psoriasis—scales associated with reddening of the skin (erythema).2–4
Causes of psoriasis
Although the exact cause of psoriasis is not known, a wide number of factors interplay to cause this debilitating disorder. The defense system of the body known as the immune system is affected by these factors, which results in the formation of additional blood vessels and increased number of skin cells.
Psoriasis is said to be a hereditary (genetic) disorder, as it tends to affect members of the same family. Increased stress (both physical and emotional) has been proposed to precipitate the occurrence of psoriasis in individuals who are genetically prone to develop psoriasis. Streptococcal throat infections (tonsillitis), Candida infections (thrush) and certain yeast infections can result in flaring up of the psoriasis. Some of the medications such as lithium, beta-blockers and antimalarials have been known to aggravate the existing psoriasis. Other factors such as obesity, increased alcohol intake or smoking also have also been associated either with the occurrence or with the severity of the disorder.2,3
Diagnosis of psoriasis
The diagnosis is easily made based on the characteristic appearance of the scales or the reddish papules on the skin and other features specific to the area affected. A skin biopsy may be advised at times to rule out the presence of any other associated conditions.4
Treatment of psoriasis
Although there is no permanent cure for psoriasis various types of treatment modalities are available that control the severity of the condition in most of the affected individuals.
The main categories of drugs that are used to treat the symptoms of psoriasis include corticosteroids, vitamin D3 analogs (calcipotriene), coal tar products, retinoids (tazarotene) and anthralin. These are available as ointments, creams, lotions, shampoos, bath oils and soaps. On basis of severity and extent of the disorder, the doctor will decide the type of medication to be applied and the duration of the treatment. These medications are helpful in reducing the inflammation of the skin, decrease the formation of scales and enhance normal skin formation. The medications can be advised either as an individual agent or in combination with other medications or treatment modalities.
Other treatment modalities that have been associated with varying degree of success include sunlight exposure, UV light therapy (phototherapy), injection of corticosteroids into the affected skin and oral tablets. Self-decided sun exposure and phototherapy should be avoided, as it may lead to flare up of the symptoms in certain cases. Biological treatments, which block some of the important steps in the occurrence of psoriasis are being studied and advised in certain cases that are unresponsive to other types of treatment.1–4
Complications of psoriasis
Common complications associated with psoriasis are the burning sensation or pain in the affected areas. Intense scratching can result in infection of the affected areas. Psoriasis may be disabling in certain individuals who suffer from the severe variant. The symptoms may relapse after a symptom free period.
Prevention of psoriasis
There are no known methods to prevent the occurrence of psoriasis. Leading a stress free life and a healthy lifestyle are helpful in preventing the flare up of psoriasis. Daily baths, avoiding hard scrubbing of the skin and keeping the skin clean and moist may be helpful in reducing the flare up of psoriasis.
1.Afifi T, de Gannes G, Huang C, Zhou Y. Topical therapies for psoriasis. Can Fam Physician. 2005; 51(4): 519–525.
2.Langley RGB, Krueger GG, Griffiths CEM. Psoriasis: Epidemiology, clinical features, and quality of life. ARD. 2005; 64: ii18–ii23.
3.Smith CH. Psoriasis and its management. BMJ. 2006; 333: 380–384.
4.Pardasani AG, Feldman SR, Clark AR. Treatment of psoriasis: An algorithm-based approach for primary care physicians. Am Fam Physician. 2000; 61(3): 725–733, 736.
Written by: healthplus24.com
Date last update:Januaary 05, 2016