Psoriasis is a chronic autoimmune skin disorder in which body cells proliferate exponentially than normal cells. This leads to the formation of red bumps with white scales.
The onset of psoriasis (1)
Psoriasis normally starts in adulthood and can affect any part of the body. But mostly it attacks the knees, elbows, scalp, and lower back. In severe cases, patches heal up for a short duration and can reappear throughout a patient’s life.
Types of psoriasis (2)
- Plaque psoriasis
According to the American Academy of Dermatology (AAD), 80% of people suffer from this type of psoriasis. In this type, red and inflamed patches are formed on the skin of the knee, scalp, and elbow. These patches are mostly surrounded by whitish-silver plaque or scales.
- Guttate psoriasis
This type of psoriasis appears in childhood. In guttate psoriasis pink spots are formed on the skin of legs, arms, and torso. These spots are less thick and resemble plaque psoriasis.
- Pustular psoriasis
It appears in adulthood. A person suffers from white and pus-filled blisters with red and inflamed skin areas in the surroundings. This type of psoriasis is normally localized to the areas of hands and feet but can widespread to other parts of the body as well.
- Inverse psoriasis
Patient with inverse psoriasis shows signs of red, shiny, and inflamed areas of skin. It may occur under the breast or armpits, around the genital skin folds, or in the groin.
- Erythrodermic psoriasis
It is a very rare and severe type of psoriasis. Its abrupt onset affects almost the whole body. High fever and sickness are very common in a person suffering from erythrodermic psoriasis. Scales formed in this type may slough off in huge sections or sheets. It is triggered by certain chemicals, sunburn, and infections.
Causes of psoriasis
The exact cause of psoriasis is still unknown. Generally, it is believed that there is a combination of things that trigger the immune system, which in response causes skin cells to multiply rapidly. Normally it takes 10 to 30 days for old cells to shed off and new cells to grow at that place. But in the case of psoriasis new cells form every fourth day. Two main factors are considered for the outbreak of psoriasis.
- Immune system- the function of the immune system is to defend the body against foreign particles. In the case of psoriasis, the immune system mistakenly attacks the body’s cells. White blood cells from the immune system hit the body’s healthy cells and cause them to proliferate rapidly. An increased number of cells piles up and appear as red inflamed bumps on the skin.
- Genetics- psoriasis is an inheritable disorder. So a person with an affected gene is more likely to get psoriasis. However, there is a small percentage of people with a genetic predisposition. According to National Psoriasis Foundation (NPF), about 2-3% of people with genetic disposition may develop the disorder.
Some other triggers of psoriasis are:
- Surgery, scrapes, or cuts
- Emotional stress
- Strep infections
- Antimalarial medication such as hydroxychloroquine
- Medications of blood pressure
The signs and symptoms of psoriasis vary in patients. Patient experiences symptoms in cycles. For instance, he may show very noticeable symptoms for the first few weeks and then these symptoms may vanish completely for a short duration with the possibility of flaring up again after some time. The most common symptoms that can be seen in Psoriasis are:
- Extremely dry skin with the possibility of getting cracked and bleed.
- Red inflamed patches appear on the skin
- Swollen and painful joints
- Red patches with whitish-silver scales on surroundings
- Burning and itching sensations
- Thick and pitted nails
A patient does not need to show all of the above symptoms. Some patients with a less common type of psoriasis exhibit different signs and symptoms.
- Physical examination
Many general physicians can diagnose psoriasis simply by examining the physical condition of the patient. Red patches develop in psoriasis are evident and distinguishable from other conditions that exhibit similar signs. A doctor thoroughly checks all the affected areas and asks for family history.
- Lab test
A biopsy can be done to diagnose psoriasis when the physical examination is considered not enough to diagnose the conditions. In this procedure, a small piece of skin is removed and tested for any skin disorder. However, no test specifically rules out psoriasis.
Treatment of psoriasis
Fortunately, there are many ways to treat psoriasis. Some of those treatments slow down the proliferation of new cells and some provide relief from itching and burning sensation. The doctor designs an appropriate treatment plan according to the age of the patient, location of the infection, size, and severity of the rash, and overall health. Some commonly followed treatments are:
- Moisturizers that heal up the dry skin
- Creams having steroids
- Coal tar- it is available in foams, creams, lotions, and shampoo and treats psoriasis on the scalp
- Ointments and creams
- Retinoid creams
Means of treating severe to moderate psoriasis are:
- Light therapy
A beam of ultraviolet light is imparted on the affected area, which slows down the rapid growth of new cells. There is another treatment known as PUVA in which a medicine “psoralen” is combined with UV light and then both helps in curing psoriasis.
It is used for treating a severe type of Psoriasis. A patient will have to get a chest X-ray, lab tests, and probably a liver biopsy. This treatment can cause liver disease, bone marrow, and lung disease.
These gels, creams, lotions, foams, and pills possess vitamin A. Retinoidswork by suppressing the immune system. It is a treatment of choice when a patient does not respond to other treatments. It can cause various side effects such as kidney damage, high blood pressure, birth defects in the fetus of pregnant women.