Psoriasis

Overview

Psoriasis is a chronic skin condition that causes itchy patches, rashes and scaly regions. The usual places of occurrence include the knees, scalp, elbows, etc. It can be quite painful for some people, even obstructing their usual sleeping pattern and ability to focus - thus affecting their overall productivity in the process.

The symptoms of psoriasis may, at times, flare up causing extra irritation to the suffering individual's skin, and at other times, subside. These cycles may span over a couple of weeks or months. Even though psoriasis does not have any cure, there are treatment options to manage its symptoms.

What is Psoriasis?

Psoriasis is, essentially, an autoimmune skin disease which causes skin cells to multiply faster. It causes the emergence of thick, discoloured patches of scaly and itchy regions on the skin. It greatly intervenes with the daily lives of individuals, causing high degrees of discomfort to the affected individual.

The symptoms of psoriasis can flare up at any point and then proceed to subside. They can manifest into painful plaques, causing the sufferer to become increasingly aware of the itch. This, as a result, impacts their sleep, daily life and social presence. Psoriasis is a condition where the skin gets inflamed and is characterised by a scaly, flaky appearance.

Healthcare professionals may prescribe certain ointments and creams to deal with the itching and to manage symptoms in the long run. However, there is no ultimate cure for psoriasis.

Types of Psoriasis

Different types of psoriasis affect people. Here are the types categorised based on the symptoms they trigger:

Plaque Psoriasis

This is the most common type of psoriasis causing raised, dry-looking, itchy patches of skin known as plaques. They are covered with scales and mostly appear on the knees, elbows, scalp and lower back.

Nail Psoriasis

This type of psoriasis causes unusual nail growth patterns and discolouration of nails. The nails may even get separated from the nail bed, a phenomenon known as onycholysis. Severe stages of the disease can cause nails to break off or crumble.

Guttate Psoriasis

This type appears in the form of small-sized, drop-like scaly areas in children and young adults. Psoriasis of this type can be triggered by a bacterial infection and is usually seen on the arms, legs or trunk.

Inverse Psoriasis

This type typically occurs on the folds of the skin covering the buttocks, groin region or breasts. It can be triggered by a fungal infection and shows up in the form of patches of inflamed skin.

Pustular Psoriasis

This is a rare type of psoriasis identified distinguishably from the appearance of blisters filled with pus. These blisters mainly occur on the palms of the hands or soles of one’s feet.

Erythrodermic Psoriasis

This is the most uncommon type of psoriasis which can either be acute or chronic. It triggers a peeling rash on the entire body, that causes an itching or a burning sensation.

Symptoms of Psoriasis

Symptoms of psoriasis may differ based on the type of psoriasis one is diagnosed with. However, some common symptoms include patchy and itchy rashes, discoloured rashes that may be purplish, reddish, pinkish or even brownish across different scales, smaller scaling regions mostly seen on children, cracked and dried skin that is prone to bleeding and feelings of burning/soreness.

The patchy rashes may vary from person to person, appearing as tiny scaling areas on some and resulting in large areas of affected skin on others. Individuals diagnosed with psoriasis also experience cyclic rashes i.e. when the rashes flare up and subside within a specific period.

Causes of Psoriasis

Different causes and sources have been associated with psoriasis. First and foremost, it is thought to be an autoimmune disease where otherwise the infection-combatting immune system attacks healthy skin cells, mistakenly deeming them as a threat.

Other than this, there are certain environmental and genetic factors at play. For example, certain people may have a genetic predisposition to psoriasis and the disease may be triggered by an environmental condition. Certain environmental factors which may lead to skin inflammation include cold temperatures and dry weather conditions.

Other causes include bacteria infections (strep throat), skin infections, skin injury (bug bites, sunburn, a scarp), smoking and passive smoking, alcohol consumption, rapid and sudden withdrawal of corticosteroids, high blood pressure medicines, lithium and antimalarial drugs.

Psoriasis Diagnosis and Tests

Healthcare professionals will analyse the affected person's medical records and their family's medical history. This analysis shall be followed up by questions from the doctors for further clarification.

Questions may include prompts like whether or not one is experiencing itching or burning sensations, whether or not they experience joint pain, take any specific medicines or have a relative with psoriasis. It shall also be taken into account if the individual has experienced high levels of stress or had an illness. Doctors shall then examine the scalp, skin and nails for signs of psoriasis before making the final diagnosis.

Sometimes, a small sample of the skin may be examined under the microscope to rule out the existence of any other skin condition.

Psoriasis Management and Treatment

Usually, a dermatologist specialising in psoriasis treatment can treat the concerned individual. Treatment options include topical therapies like ointments, creams, foams or solutions containing corticosteroids; methotrexate given orally or injected (suppresses the immune system and slows cell growth); oral retinoids and biological response modifiers that prevent skin inflammation.

Other treatment methods include immunosuppressants, oral phosphodiesterase 4 inhibitors (reduce skin inflammation) and oral tyrosine kinase 2 inhibitors (blocks activity of specific immune cells). If large areas of the skin are affected by the condition, healthcare professionals may recommend phototherapy.

Preventive Measures for Psoriasis

A few lifestyle tweaks can serve as the ultimate preventive measures against psoriasis. For example, taking daily showers and gently washing the skin instead of scrubbing, shall be a good place to start. The skin should be kept moist and hydrated.

It's recommended that affected areas be kept covered as one sleeps. Avoid scratching and other psoriasis triggers as much as possible. Preferably, expose the skin to small amounts of sunlight for short periods. Overall, aim to maintain a healthy lifestyle and remain in neutral to cool temperature zones most of the time.

Myths and Facts Related to Psoriasis

Here are some myths when it comes to psoriasis and the facts to clear up the confusion:

Myth 1: Psoriasis Can Be Contagious
Fact: Psoriasis is not contagious. Instead, it is an autoimmune disease which cannot be passed down from one person to another via direct touch, sharing of bodily fluids, or even from eating off the same plate.

Myth 2: Psoriasis is Just Dry Skin, it’s not that Serious
Fact: Psoriasis can cause great levels of discomfort and irritation to the affected individual. It is not just dry skin. The condition can cause painfully itchy patches to form and even be prone to bleeding at times. People often require professional attention to be able to manage the symptoms effectively.

Myth 3: Psoriasis Results From Poor Hygiene
Fact: Psoriasis does not result from poor conditions of hygiene. It is an autoimmune disease where the body's immune system mistakenly attacks the host's healthy skin cells, leading to the inflammation of certain areas. While it is recommended that one showers daily and maintains proper hygiene standards, the opposite does not directly result in the condition.