Psoriasis

Description

Psoriasis is a chronic, non-contagious, autoimmune skin disease that causes rapid development of skin cells. The production of these cells is so rapid that it doesn’t allow the cells to shed off leading to plaques of thickened, scaly skin surrounded by inflammation and redness. Bleeding and cracking of these patches is fairly common. It typically affects the joints such as elbow and knees but may develop anywhere on the body.

There are different types of Psoriasis:

Plaque psoriasis: It is the most common type with red, inflamed patches covered with whitish-silver plaques.
Guttate psoriasis: It is common in childhood with small pink spots.
Pustular psoriasis: It is common in adults with small pus-filled blisters with large areas of red, inflamed skin.
Inverse psoriasis: Areas of red, shiny, inflamed skin in the folds of armpits, navel, breasts, and groin.
Erythrodermic Psoriasis: It is a severe type of psoriasis. Large areas of skin are affected which look like sunburn.

Causes

Causes of Psoriasis are still unclear but majorly two factors are linked:

Defect in immune system: Psoriasis is an autoimmune disease, T cells mistakenly attack the skin cells leading to excessive production of skin cells.
Genetics: Psoriasis may run in the family. However, the chances are low.

Triggers for a psoriasis outbreak include:

Injuries to the skin like cuts and scrapes
Stress
Anxiety
Medicines like Hydroxychloroquine, Indomethacin, and quinidine.
Infections

Risk factors

Factors that can increase your chance of getting this disease include:

Cardiovascular disease
Metabolic syndrome
Skin injury
Family history of psoriasis.

Symptoms

The presentation of this disease may vary, but the most common symptoms include the following:

Red, patchy skin with silvery scales (patches may range from a few small spots, or larger patches over larger areas)
Itchy, dry and cracked skin
Burning and soreness of the affected area
Nails that are thickened, pitted or ridged
Joints can be swollen and stiff.

There are several different types of psoriasis, including:

Plaque psoriasis (the most common type, involving the classic red raised lesions with silvery scales)
Erythrodermic psoriasis
Pustular psoriasis
Nail psoriasis
Guttate psoriasis
Scalp psoriasis
Inverse psoriasis
Psoriatic arthritis

There are also a lot of complications that may occur in patients who are diagnosed with psoriasis. For example:

Psoriatic Arthritis: This type of arthritis causes damage to the joints, and may even cause a loss of function.
Complications in the eye: these include blepharitis, uveitis and conjunctivitis.
Heart diseases, hypertension and stroke

Diagnosis

To reach a diagnosis, your doctor will ask for your complete medical history and perform a simple physical exam. Psoriasis is usually diagnosed by the sign and symptoms.

If the diagnosis is unclear, your doctor may take a sample from the skin (biopsy) to confirm the diagnosis.

Management

If the diagnosis is confirmed, your doctor will choose the treatment according to the type and severity of psoriasis. The treatment options include:

Topical treatment:

Topical medicine can be used to relieve the local symptoms, it includes: Salicylic acid, steroid based creams, coal tar ointment and shampoos, vitamin D3 alongside corticosteroids, and Retinoid.

Phototherapy:

This method involves exposure to UV light regularly to reduce cell growth, suppress autoimmune condition, and reduce irritation. This method is done under medical supervision or at home using a light box if the initial treatment is successful.

Medicines for Psoriasis:

Medicines for the treatment of Psoriasis are:

Methotrexate: It is used to treat psoriatic lesions.
Oral retinoids.
Biologics: Adalimumab, brodalumab, and several others have helped relieve joint pain and skin symptoms.

When to consult a doctor?

Consult your doctor immediately if there is unrelieved itching, swelling or tenderness of joints, anxiety or depression, and symptoms of a heart disease or diabetes.