What Is Psoriasis?

By January 14, 2016Skin

Do you have dandruff that never goes away java image? Or a chronic fungal nail infection? It may actually be Psoriasis. Psoriasis is a long-term skin disease, which can also affect certain joints, fingernails and toenails.

What causes psoriasis?

  • the cause is not fully known.
  • it seems to be related to three things:
    • an immune system disorder (T-cells that malfunction)
    • specific inherited genes (a family history is common in psoriasis)
    • environmental triggers (infections, certain drugs, stress, skin injury/sunburn, alcohol excess, smoking)
  • in psoriasis, the immune system overreacts, causing skin cells to form too quickly (in days, rather than a month).
  • these skin cells stay on the surface on the skin, and aren’t shed, like normal skin cells.
  • this results mostly in thick red plaques or patches forming, covered by silver scales.

What does psoriasis look like?

  • The appearance depends on the type of psoriasis a person has.
  • Symptoms can vary from person to person.
  • Psoriasis patients experience cycles of flare-ups and periods of better control.

Different types of psoriasis:

a) Plaque psoriasis (psoriasis vulgaris = meaning “common”)

  • The most common type -red, raised patches on the skin, covered by silver scales.
  • Knees, elbows, scalp, lower back commonly affected (can occur anywhere).
  • Can itch.

b) Guttate psoriasis

  • Small red spots, often triggered by an infection (upper airway, Strep throat).
  • Limbs, trunk, face, scalp (can occur anywhere, all over the body).
  • It can clear up spontaneously within a few months.

c) Pustular psoriasis

  • Pus-filled lumps with red, swollen skin.
  • Affects soles of feet and palms of hands.
  • If involving other parts of the body and the person is ill with a fever, urgent medical help must be sought.
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d) Inverse psoriasis (intertriginous/flexural psoriasis)

  • Red skin patches that appear raw and smooth.
  • In areas of skin to skin contact (armpit, groin, genital area, buttock, below breasts).

e) Erythrodermic psoriasis (exfoliative psoriasis)

  • Can be a serious medical emergency.
  • Nearly all the skin on the body looks bright red/burnt.
  • Often very itchy and painful, associated with fever/chills.

f) Psoriatic arthritis and nail changes

  • swollen, tender or painful joints (knees, hands, ankles)
  • nails often develop pits, discolour and separate from the nail-bed

How is psoriasis treated?

  • Treatment depends on: the type of psoriasis, severity and size of areas affected,
  • Although currently not curable, psoriasis is controllable with medication and many promising new treatments are on the horizon.
  • Following a healthy lifestyle is important as smoking, alcohol consumption and being overweight have all been shown to make psoriasis worse,

There are 3 main types of treatment:

a) Topical

  • topical corticosteroids
  • vitamin D analogues
  • coal tar
  • anthralin
  • salicylic acid
  • topical retinoids
  • calcineurin inhibitors
  • moisturisers, lubricants and bath solutions

b) Light therapy

  • Involves natural or artificial UV light.
  • Can be used on its own, or in conjunction with medication.

c) Systemic therapy (oral or injected)

  • retinoids
  • methotrexate
  • cyclosporin
  • immune-modulator drugs (biologicals)
  • other medications (hydroxyurea, thioguanine)
  • medications still under research