- by Bangalore Baptist Hospital
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- Feb 09 2017
What Is Psoriasis?
Psoriasis is a chronic scaly inflammatory skin disease, which appears as red, thickened areas with silvery white scales, most often on the scalp, elbows, knees and lower back.
What Causes Psoriasis?
The exact cause of psoriasis is not known, but it can be caused due to hereditary and genetic factors. In psoriasis the skin sheds itself too rapidly – every 3 to 4 days. Patients often notice new spots 10 to 14 days after the skin is cut, scratched, rubbed or severely sun burnt. It can be precipitated by infections such as streptococcal sore throat and also by some medications.
Facts About Psoriasis:
- Psoriasis is not contagious
- Psoriasis does not spread from one part of the body to another
- Psoriasis gets better and worse spontaneously and can have periodic remissions (clear skin)
- Psoriasis is controllable with medication but not curable. It has to be maintained under remissions
- Many people note a worsening of their symptoms in the winter with spontaneous remissions in summer
- Psoriasis is not caused by allergies, infections, dietary deficiencies
- It may be inherited in 10% cases
- Natural sunlight is used to treat psoriasis. Daily, short, controlled exposures to natural sunlight may help or clear psoriasis in some patients
How Does Psoriasis Appear?
Psoriasis typically looks like red or pink areas of thickened, raised, dry skin which gradually enlarge in size with accumulation of powdery silvery white scales over it. When the flakes are removed the tender exposed skin bleeds. Elbows, knees, legs, scalp, lower back and nails are the commonly affected areas. Lesions often appear symmetrically on both sides of the body. The severity can vary from person to person. Palms and soles may be involved separately. The face is often spared. On the scalp, it may look like severe dandruff with dry flakes and red areas of skin. Nails may have tiny pits on them; it may loosen, thicken or crumble and are difficult to treat. 10 to 35% of psoriatic patients also have arthritis (joint inflammation), which is not too severe. The small joints of the hands & feet, wrists, elbows and back can be affected.
How Serious Is Psoriasis?
Psoriasis does not affect the overall general health. If it is widespread it can certainly cause a great deal of skin discomfort and emotional embarrassment, and can affect job and leisure activities.
Is There A Cure For Psoriasis?
At present there is no cure for psoriasis, but there are a number of treatment options that can relieve and control psoriasis, often for long periods of time. However, in most cases it is persistent.
How Is Psoriasis Diagnosed?
Dermatologists diagnose psoriasis by examining the skin, nails and scalp. They may need to take a skin biopsy to examine the skin under the microscope.
What Is The Treatment For Psoriasis?
The goal of treatment is to reduce inflammation & to slow down rapid cell division. Treatment is based on patient’s health, age, lifestyle and severity of psoriasis. Special measures need to be taken while determining the treatment options in a pregnant lady, an elderly individual, an alcoholic person, etc. There is no one way of treatment, for each person with psoriasis may respond differently.
All patients with psoriasis are advised on the use of emollients and on skin protection. In psoriasis, emollients improve skin texture, reduce skin scaling, promote skin comfort and prepare the skin for active topical therapies.
For patients with minimal psoriasis, therapy is limited to topical medications, applied on the skin. For patients with moderate or severe to widespread psoriasis, topical treatments are combined with oral medications and photochemotherapy (ultraviolet light therapy). The oral medications are to be used under very careful supervision of the dermatologist. Phototherapy is quite safe and effective under careful supervision.
For psoriatic arthritis, systemic medications are required to stop the progression of permanent joint destruction. Newest drugs called biologics modulate (adjust) and sometime suppress the immune system that is overactive in psoriasis.
The above treatments alone or in combination can clear or greatly improve psoriasis in most cases, but no treatment permanently cures it. Researchers are constantly testing new drugs & treatments.
What Are Its Complications?
Rare complications include generalized spread (erythroderma), pustulation (pustular psoriasis) and disabling arthritis.
What Are The Precautions For Psoriasis?
- Sun exposure: For most psoriatic patients, moderate sun exposure is very helpful, but sunburn can cause psoriasis to flare
- Skin injury: Any form of mechanically irritation like rubbing, scratching and sunburn can make psoriasis worse
- Diet: A healthy balanced diet is important for personal good health. Psoriasis can worsen if patients are overweight – weight loss is helpful in controlling psoriasis. Food rich in omega 3 fatty acids (sea food) helps in controlling psoriasis
- Alcohol will flare up psoriasis
- Stress / anxiety make psoriasis worse
- Medications: Some drugs given for other reasons can worsen psoriasis. These drugs include antihypertensive (beta-blockers), pain killers and antipsychotics (lithium)
- Infections: Some throat and upper respiratory tract infections can worsen psoriasis. This is most commonly seen in children and adolescents.