Psoriasis is an inflammatory skin condition characterized by red, dry, and thick plaques on the skin. Psoriatic lesions develop on the skin because of faster proliferation of skin cells which is caused by abnormal functioning of the lymphocytes present in the blood. Psoriasis is a non-communicable disease and is considered as mild or severe depending upon the spread of disease and the time for its recovery.
Psoriasis is a chronic, non-curable skin condition. However, patients may have a relapse period where the symptoms may recur & worsen after a period of improvement. Often the symptoms get worsened in winter. Other factors that trigger the condition include emotional stress, injury to skin, skin infections and use of certain medications.
Psoriasis is a global condition affecting people of all age groups with higher incidence in younger adults. The causes for development of psoriasis include family history and abnormal activity of the body's immune system resulting in rapid turnover of the skin cells forming thick patches on the surface. Other factors responsible for psoriasis include previous bacterial or viral infections, skin injuries, long dryness of the skin and low or high exposure to sunlight. Along with these factors, excessive alcohol intake, stress, and consumption of certain drugs also trigger psoriasis.
It is to be noted that immune, compromised individuals including those with AIDS, rheumatoid arthritis, and those who have had chemotherapy, are more likely to develop psoriasis.
The symptoms of psoriasis depend on the type of psoriasis. The most common symptoms include dry, red patches which can be itchy and irritating, often develop on the elbows and knees but can spread to other parts of the body. Other symptoms include genital lesions in males, pain in the joints, deformities & discoloration of the nails and severe dandruff on the scalp.
Based on the characteristics of plaques and the body part affected, psoriasis is categorized into five types, namely:
- Erythrodermic psoriasis: Spreads all over the body with characteristic red skin and sheds the scales in sheets
- Guttate psoriasis: Small pink spots develop on the trunk and limbs
- Inverse psoriasis: Smooth, shiny, bright-red lesions develop in the regions of skin folds such as arm pits, groin, under the breasts and around the groin
- Plaque psoriasis: Most common form of psoriasis and is characterized by red, raised plaques with silvery white scales that develop on elbows, knees, scalp and lower back
- Pustular psoriasis: Psoriasis sub-type with blisters of non-infectious pus surrounded by inflamed skin
The diagnosis of psoriasis involves the physical examination of the patient's skin and sometimes a skin biopsy can also be done for detailed analysis of the condition.
In case the patient is having any joint pain, then X-rays are also ordered to confirm the type of psoriasis.
Several options are available for treatment of psoriasis and the choice depends on the type of psoriasis, area affected, disease severity and other factors. The treatment approaches include topical treatment, systemic treatment and phototherapy.
In topical treatment, different medicated creams or lotions are applied directly on the skin or scalp for relieving the symptoms. In addition, some vitamin supplements are also prescribed for better symptomatic relief.
In systemic treatment, medications that suppress the auto-immune activity are recommended. The medicines include immuno-suppressants and a newer class of agents called biological drugs. Biological agents are proved to be very effective.
Phototherapy is exposure of affected skin to ultraviolet radiation. Several varieties of phototherapy treatments are available such as psoralen + ultraviolet A (PUVA), ultraviolet B (UVB), & narrowband UVB. In PUVA treatment, affected skin is exposed to light after giving the photosensitizing drug, psoralen. Psoralen makes the skin more sensitive to radiation and thereby treatment will be more effective.
In addition to the treatments mentioned above, your dermatologist may prescribe antibiotics to subside the associated infections, recommend other techniques such as stress-relieving techniques, oatmeal bath and exposure to the sun to improve the condition.