Psoriasis is a common, chronic, non-dermatological disease that speeds up the life cycle of skin cells. This causes cells to build up rapidly on the surface of the skin.
It involves the skin and nails and is associated with many types of comradeship. Skin lesions are localized or generalized, especially symmetrical, sharply demarcated, red papules and plaques, and usually covered with white or silver scales.
In people with psoriasis, this production process can occur within a few days. Because of this, there is no time for skin cells to fall. This rapid overproduction leads to the formation of skin cells.
Scales usually develop on the joints, such as the elbow and knee. They can develop anywhere on the body, including:
Less common types of psoriasis affect the area around the nails, mouth, and genitals.
It occurs equally in men and women at any age. This is a lifelong disease that often comes and goes. The main goal of treatment is to prevent skin cells from growing so quickly.
There is no cure for psoriasis, but you can manage the symptoms. Lifestyle measures such as moisturizing, quitting smoking, and managing stress can help.
Types and manifestations
Most types of psoriasis go through a cycle, flare up for a few weeks or months, then go on for a time or in complete remission.
There are seven types:-
- Psoriasis Vulgaris (plaque psoriasis)
- Intertriginous/Inverse/Flexural psoriasis (in folds and genital areas)
- Guttate (droplet) psoriasis
- Pustular psoriasis
- Erythrodermic psoriasis
- Nail psoriasis
- Psoriatic arthritis
1. Psoriasis Vulgaris
The commonest form of psoriasis is may be thick, thin, large or small and plaque psoriasis are red or salmon pink in color. In this patients may have sharply circumscribed, round-oval, or nummular (coin-sized) plaques. These plaques are commonly found on the elbows, knees, and scalp.
Intertrigninous psoriasis causes deep-red or white, flat, intensely demarcated, wet patches or plaques, bright areas of shiny, inflamed skin. It is also known as inverse psoriasis as well as flexural.
The place and appearance of these lesions establish inverse psoriasis apart from other types of psoriasis.
Patches of inverse psoriasis almost exclusively affect the flexural body sites – axillae, antecubital fossa, inframammary crease, navel, gorge, genital area, gluteal cleft, popliteal fossa and other body folds.
3. Guttate (droplet)
This mostly affects adolescents/childhood and young adults. This type usually triggered by a bacterial infection such as strep throat and causes small pink spots as red, scaly, small, teardrop-shaped spots.
The most common sites for guttate psoriasis include the trunk (torso), arms, scalp, and legs. These spots are unusually thick or raised likewise plaque psoriasis.
Less than 1/3 of people with psoriasis have this kind. It’s not as broad as plaque/Vulgaris.
The start is associated with streptococcal infection of the upper respiratory tract and former skin symptoms.
You might get it only once, or you could have several flare-ups. In some cases, this type of psoriasis doesn’t go away. With the help of your doctor, you can find a treatment to keep your symptoms under control.
Pustular (PUHS-choo-lar) is classified by white pustules (blisters of noninfectious pus) circled by red skin. It is usually localized on small areas of the body, such as the hands or feet, but maybe wider. Pus may also cover most of the body.
Pus contains white blood cells and is not an infection, nor is it contagious. Multiple factors can trigger pulmonary psoriasis, including:
- Internal medicine
- Teasing topical agents
- UV light overexposure
- Systemic steroids
- Emotional stress
- Sudden withdrawal of systemic drugs or potent topical steroids.
Erythrodermic (eh-REETH-ro-der-mik) is a severe and very rare type of psoriasis that often affects most of the body’s surface.
This form often covers large parts of the body once or more in the lifetime of 3 percent of people who have psoriasis. It may occur with von Zambush pustular psoriasis.
The skin appears almost sunburn and usually appears on people who have unstable plaque psoriasis. Scales that often develop are closed into large sections or sheets.
It is not uncommon for a person with this type of psoriasis to have a fever or become very ill.
Severe redness and exfoliation of most of the surface of the body. The most severe type of psoriasis, potentially life-threatening, as it can cause hypothermia, hypoalbuminemia, and high output heart failure.
This type can be fatal, so individuals should see a doctor immediately.
Nail-psoriasis can alter the view of fingernails and toes. It can affect the nail growing pouch, abnormal nail growth, and discoloration.
Nails may become thicker loose and detach from the nail bed (onycholysis) and may develop pinprick holes and also change color or shape. In severe cases, tender and bruising may occur, and the nail crumbles.
This results in significantly worse psoriasis severity scores in patients compared to no nail involvement.
People can treat these problems with medicine. The cosmetic repair can make nails look better.
7. Psoriatic arthritis
In addition to inflamed, papular skin, psoriatic arthritis causes inflamed, painful joints that are typical of arthritis.
Infrequently joint symptoms are the first or only manifestation of psoriasis or at a time only nail changes are seen. Marks range from mild to severe, and psoriatic arthritis can affect any joint.
Although the disease is not usually as severe as other forms of arthritis, it can cause stiffness and progressive joint damage that can lead to a permanent deformity in the most severe cases.
What are the signs and symptoms?
Its symptoms vary from person to person and depend on the type of psoriasis. Its Areas can be as small as a few flakes on the skull or elbow or cover most of the body.
The most common symptoms of plaque psoriasis include:
- Red, bulging, bulging patches of skin
- Red patches of skin covered with thick or white-silver scales on red patches
- Small scaling spots (usually seen in children)
- Dry, chapped skin that can flush
- Soreness around patch
- Itching and burning around the patch
- Thick, hard or bruised nails
- Painful, swollen joints and stiff joints
- Psoriasis patches can range from scaling such as dandruff to large eruptions that cover large areas.
Not everyone will experience all these symptoms. Some people will experience completely different symptoms if they have less common types of psoriasis.
Most people with psoriasis undergo a “cycle” of symptoms. The condition can cause severe symptoms for a few days or weeks, and then the symptoms may become apparent and almost go unnoticed. Then, in a few weeks or if worsened by a common psoriasis trigger, the condition may flare up again. Sometimes, the symptoms of psoriasis disappear completely.
When you have no active signs of the disease, you may be in “remission”. This does not mean that psoriasis has not returned, but for now, you are symptom-free.
What are the causes?
Doctors are unclear as to what causes psoriasis, but it is believed to be related to two major factors: genetics and the immune system. Researchers believe that both genetics and the immune system play a role.
(1.) Immune system
Psoriasis is an autoimmune condition. Autoimmune conditions are the outcome of the body attacking ourselves.
In the matter of psoriasis, white blood cells, which are identified as T cells, mistakenly attack skin cells. T cells usually travel through the body to protect against foreign substances, such as viruses or bacteria.
But if you have psoriasis, T cells mistakenly attack healthy skin cells, such as to heal wounds or fight infection.
Overactive T cells also trigger expanded production of healthy skin cells, more T cells and other white blood cells, mainly neutrophils. These cause redness in the skin and sometimes pus in the purulent lesions. Thin blood vessels in the areas affected by psoriasis cause heat and redness in skin lesions.
This process becomes a continuous cycle, in which new cells of the skin move to the outermost layer of the skin very quickly – in days rather than weeks. Skin cells form thick, crusted patches on the surface of the skin until the treatment stops the cycle.
What causes T cells dysfunction in people with psoriasis is not entirely clear.
Unusual people inherit genes that make them more likely to generate psoriasis. If you have immediate family members with a skin condition, then your risk for developing psoriasis is high.
However, the percentage of people with psoriasis and a genetic tendency is small. According to the National Psoriasis Foundation (NPF), the condition develops in about 2 to 3 percent of people with the gene.
What are the triggers (stress, alcohol, smoking, etc)?
Psoriasis usually starts or worsens due to a trigger that you may be able to detect and avoid. External “triggers” can initiate a new bout of psoriasis. These triggers are not the same for everyone. They can also change over time for you.
Factors that trigger may include:
- Infections, such as strep throat or skin infections
- Skin injury, such as being cut or scratched, bug bite or strong sunlight
- Heavy alcohol consumption
- Vitamin D deficiency
- Certain medications – including lithium, prescribed for bipolar disorder, hypertensive drugs (high blood pressure medications) such as beta-blockers, antimalarial drugs, and iodides.
Diseases & Treatment
In most situations, the diagnosis of psoriasis is fairly straightforward. Two tests or examinations may be necessary to make the diagnosis:
Physical examination and medical history
Your doctor can diagnose psoriasis by examining your medical history and your skin, scalp, and nails in general.
During this exam, be sure to show all areas of concern to your doctor. Also, tell your doctor if any family members have the condition.
Rarely, your doctor may take a small sample of the skin (biopsy). They will probably apply a local anesthetic first. The specimen is examined under a microscope to determine the exact type of psoriasis and to detect other disorders.
Most biopsies are done in your doctor’s office on the day of your appointment. Your doctor may have injected a local numbing medication to make the biopsy less painful. They will then send a biopsy to a laboratory for analysis.
When the results return, your doctor may request an appointment to discuss findings and treatment options with you.
There is no cure for psoriasis. The aim of treatment is to reduce inflammation and scales, slow the growth of skin cells and remove plaque. Psoriasis treatment falls into three categories:
1. Topical treatments
Used alone, creams and ointments that are applied to your skin can effectively treat mild to moderate psoriasis. When the disease is more severe, the cream may be combined with oral medications or light therapy. Topical psoriasis treatments include:
- Topical corticosteroids
- Vitamin D analogues
- Salicyclic acid
- Calcineurin inhibitor
- Topical retinoids
- Coal tar.
2. Phototherapy (Light Therapy)
Natural or artificial ultraviolet light is used in this treatment. The most simplistic and most natural form of phototherapy involves exposing your skin to a controlled amount of natural sunlight.
Other forms of light therapy include:
- UVB Phototherapy
- Narrow Band UVB Phototherapy
- Goekerman therapy
- Psoralen Plus Ultraviolet A (PUVA)
- Excimer laser.
3. Systemic (oral or injection) medications
People with moderate to severe psoriasis, and who do not respond well to other treatment types, may need to use oral or injected medications. Due to severe side effects, some of these drugs are used only for brief periods and may be optional with other forms of treatment.
Oral or injected medications include:
- Drugs that alter the immune system (biologics) include etanercept (Enbrel), infliximab (Remicade), adalimumab (Humira), ustekinumab (Stelara), golimumab (Simponi), apremilast (Otezla), secukinumab (Cosentyx) and ixekizumab (Taltz).
- Thioguanine (tabloid) and hydroxyurea (Droxia, Hydrea) are drugs that can be used when other drugs cannot be given.
4. Alternative medicine
Many alternative treatments are claimed to reduce the symptoms of psoriasis, including specialized diets, creams, dietary supplements, and herbs. None have been proven to be effective of course.
These treatments would be best suited for people suffering from appendicitis, plaque disease, and not for those suffering from pyorrhea, erythroderma or arthritis.
- Aloe vera
- Fish oil
- Oregon Grape
If you are considering dietary supplements or other alternative medicine to reduce the symptoms of psoriasis, consult your doctor. He or she can help you weigh the pros and cons of specific alternative treatments.
5. Home remedies
Although self-help measures will not cure psoriasis, they can help improve the appearance and feel of damaged skin. You can benefit from these measures:
- Take and soak in bathwater daily with bath oil, colloidal oatmeal, Epsom salts or the Dead Sea salt.
- Use moisturizers after bathing, apply deep, ointment-based moisturizers while your skin is still humid/moist.
- Expose your skin in controlled amounts in sunlight. First, ask your doctor about the best way to use natural incense to treat your skin. Too much sun exposure or spread can worsen and increase the risk of skin cancer.
- Find out what triggers, if any, go wrong for you and take steps to prevent or avoid them. Infection, injury to your skin, stress, smoking, and exposure to strong sunlight can all worsen.
- Avoid drinking alcohol, alcohol consumption may reduce effectiveness.
The key point
To help indicate your personal trigger:
Keep a diary or use a smartphone app. Log details about what is going on in your life, when these diseases flare-up. For example, include:
- Medicines you are taking
- How much alcohol or tobacco are you using
- what the weather is like
- Even if you are experiencing seasonal allergies
- Any diet changes
Log in how you are feeling. Note details such as:
- Severe stress
- Symptoms of a disease
Review your diary for patterns. Over time, see patterns in your lifestyle and when these symptoms flare-up. for example:
- Do you have a flare during the cold season?
- Do you experience more symptoms when stressed?
With a little detective work, you can uncover what can you do to affect your psoriasis symptoms. Then, take action to avoid those triggers. It can help to discuss your plan with your doctor, especially if you need the best advice to avoid your triggers.
Psoriasis can begin at any age, but most diagnoses occur in adulthood. The average age of the start is between 15 and 35 years. According to the World Health Organization (WHO), some studies estimate that approximately 75 percent of psoriasis cases are diagnosed before the age of 46. The second peak period of diagnosis can be in the late 50s and early 60s.
According to the WHO, males, as well as females, are affected equally. Whites are dissatisfied. People of color diagnose a very small proportion of psoriasis.
Being a family member with the condition increases your risk of developing psoriasis. However, many people with the condition have no family history. Some people with a family history do not develop psoriasis.
About one-third of people with psoriasis will be diagnosed with psoriatic arthritis. In addition, people with psoriasis are more likely to develop a condition such as:
Although this data is not exhaustive, research suggests that psoriasis cases are becoming more common. Whether people are improving skin diseases or doctors are only getting better at diagnosing is not clear.
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