Psoriasis is a skin condition which can be quite irritating for people. In psoriasis, there are scaly patches and reddish tinge on the skin. In some instances, it can cause severe pain and be quite disabling. This article discusses about the causes, symptoms, treatment and ways to cope with Psoriasis
What Is Psoriasis?
Psoriasis is common chronic skin condition. It is immune-mediated and involves joints in few cases. It is characterized by scaly patches and reddish tinge on the skin. The damage is mainly seen on the bony prominences (elbows, knees) but can occur anywhere on the body. In some cases it leads to stiffness, pain and swelling of joints which is known as Psoriatic Arthritis. About 30 to 50% of psoriasis patients develop Psoriatic Arthritis. Psoriasis is not contagious. It cannot spread by touch from person to person. It can affect males or females of any race or age. Psoriasis can also be a cause of social embarrassment, anger, sadness, and depression.
What Causes Psoriasis?
The exact cause of psoriasis is not known in spite of tremendous research. It is said to be related to the body’s immune system, environmental and genetic factors. Psoriasis happens when the immune system overreacts resulting in flaking of skin causing inflammation. In few cases, psoriasis might run in families. People with psoriasis often notice times when their skin gets worse. Things that can cause these flare-ups or worsening of disease include dry and cold climate, stress, infections, and dry skin. Also definite medicines such as NSAIDs and medicines used to treat high blood pressure or certain mental illness may trigger an outbreak. Smoking, mostly in women, might lead to psoriasis and can make it worse, if someone already has it.
What Are The Symptoms Of Psoriasis?
Symptoms of Psoriasis can be limited to few areas of skin or it can be moderate or widespread and acute.
There are several types of psoriasis. Symptoms for each type may vary in acuteness and appear in a wide array of combinations. Main features being bright red areas of raised patches (plaques) on the skin which are covered with loose, silvery micaceous scales. Plaques can occur anywhere but most commonly are seen on the elbows, knees, scalp, feet, hands, or lower back. Bleeding points can be seen on scraping of scales (Auspitz’s sign). Joint swelling, tenderness, and pain over the joint can also be observed.
Koebner’s phenomenon can occur when a person with psoriasis has an injury (such as a burn, cut or excess sun exposure) to a particular area of the skin that is not affected by disease. Psoriasis blotches then appear on the wounded skin or any other part of the skin from several days to about two weeks after the injury. Because this response is usual, it is essential for people who have psoriasis to avoid irritating or injuring their skin.
Diagnosis Of Psoriasis
A dermatologist can usually diagnose psoriasis by looking at the patches on your skin, scalp, or nails. Occasionally a skin biopsy is required in certain cases to confirm.
What Are The Treatment Modalities For Psoriasis?
There is no complete cure for psoriasis but various treatments can help you to control the symptoms of psoriasis. There are treatments accessible but because of its chronic repetitive nature, psoriasis is a challenge to treat. Treatment is based on type of psoriasis you have, its location, severity, age, and overall health. It also depends on how much you are affected by the condition either physically (because of factors such as joint pain) or emotionally (because of embarrassment or frustration from a skin rash that may cover a large or visible area of the body). Treatment used for localized psoriasis consists of a topical corticosteroid or medicine related to vitamin D called calcipotriene, anthralin, and tars in a cream or ointment form.
Topical treatment can be combined with sunlight or ultraviolet light and such a therapy is known as phototherapy. Oral medications are used to treat moderate and severe cases of psoriasis. Most commonly used oral medicines include methotrexate, cyclosporine, and vitamin A derivate known as retinoids.
Patient on oral medications require frequent follow-ups and laboratory investigations to check for possible side effects. A few of the oral medications are not safe during pregnancy so if you are pregnant, talk to the doctor before taking any medicine. Systemic corticosteroids should not be used as then can worsen the disease process.
New modalities of treatment for psoriasis include biologics. Biologics are similar to or same as proteins made by the body, having a targeted mode of action. They block the harmful response of the body’s immune system that causes the symptoms of psoriasis. They have shown promising results in keeping the patient symptom free for a longer duration of time but long term safety of biologics is not known. The limiting factor for use of biologics is the cost of the drug.
Ways To Cope With Psoriasis
There is no way to prevent psoriasis. Be optimistic and have a positive attitude towards life. Following measures can improve symptoms or help reduce the number of psoriasis flare-ups.
- Keep your skin moist and weight in control as obesity can worsen psoriasis.
- Avoidance of cold and dry climates. Cold weather may make symptoms unsuitable.
- Exposure to sunlight, hot and humid weather may improve symptoms, but hot and humid weather may make certain types of psoriasis worse.
- Prevent scratching or picking of skin and avoid skin injuries (cuts or scrapes).
- Avoid infection, alcohol, and smoking.
- Try to avoid certain medicines. When your doctor prescribes any medicines, tell him or her that you are suffering from psoriasis.