Psoriasis is an inflammatory condition programmed genetically. In this condition, skin cells proliferate faster than in normal conditions.
Understanding of Psoriasis (1)
Psoriasis is an inflammatory skin condition. About 3% of American citizens are suffering from this condition. In this condition, the proliferation rate of skin cells increases up to 10 times. These cells reach the surface of the skin, die there, and form red plaques with white scales on their surroundings. It initiates as a tiny scaling papule. Multiple papules together become scaling plaques. These plaques are mostly seen on knees, scalp, and elbows.
Symptoms of Psoriasis
Usually, Psoriasis is confined to a small part of the body but in some cases, it can cover the entire body. The symptoms of psoriasis depend upon the type of Psoriasis. The most common symptoms of Psoriasis include:
- Tiny scaling spots
- Dry and cracked skin
- Red skin patches surrounded by white scales
- Itchy plaques
- Formation of Bleeding points upon peeling scales
Causes of Psoriasis
Researchers believe that psoriasis is caused due to some genetic defects. Environmental factors can only trigger this disease if there is any hereditary predisposition. T-cells or white blood cells mediate the growth of psoriatic plaques in the skin. The body of a psoriatic patient is unable to defend invaders. Instead, it enhances inflammation. Skin cells grow rapidly and old cells pile up instead of shedding off. This leads to a psoriatic condition.
Triggers of psoriasis
A person with a hereditary predisposition can have psoriasis with certain triggers. Such as:
- Particular drugs ( antimalarial, indomethacin, beta-blockers, heart medications, antihypertensive, and lithium)
- Skin trauma such as bug bite, cut, scrape, sunburn or infection.
- Infection caused by the streptococcus bacterium
Types of Psoriasis (2)
- Plaque psoriasis
It is a self-explanatory type of psoriasis. It is characterized by the formation of plaques on the skin. It is the most common type of psoriasis. Red patches can be seen on any part of the body but mostly these are seen on the scalp, trunk, elbows, nails, and knees. Plaques are covered by scales, which are white and flaky. Symptoms of plaque psoriasis include skin itching, pain, and cracking. Several over-the-counter drugs can treat plaque psoriasis. Examples include 1% hydrocortisone and lotions that contain tar. Both are effective in curing this type of psoriasis.
- Scalp psoriasis
It is another common type of psoriasis. It is characterized by scaly, reddish, raised patches. This type can either affect the entire scalp or be seen as a single patch on a small portion. It can spread to the neck back, forehead, and behind the ears. Symptoms of scalp psoriasis include fine scaling, flaking like dandruff, hair loss, and dry scalp. Hair loss occurs due to dryness, scratching, and anxiety. This type of psoriasis is treatable with medicated shampoos, oils, gels, creams, soaps, and ointments. OTC drugs that can treat scalp psoriasis include tar and salicylic acid preparations. Phototherapy and steroid injections can cure mild scalp psoriasis.
- Guttate psoriasis
It appears like small pink drops or dots on the skin. “Gutta” is a Latin word, which means a drop. In comparison to plaque psoriasis, scales in Guttate psoriasis are finer. It is triggered by streptococcus and symptoms are generally shown after 2-3 weeks of strep throat. It diminishes on its own within few weeks. Infected skin can be softened by using moisturizers. In some cases, when the disease does not go, antibiotics are prescribed.
- Nail psoriasis
Patients with psoriasis are seen with abnormal nails. Such patients suffer from distal onycholysis in which the nails are lifted away from the finger and show yellow or white horizontal margins on tips. Small pits are also seen on crumbly and yellow nails. The treatment of nail psoriasis is the same as of skin psoriasis. But the slow improvement is seen because nails do not grow rapidly. This type of psoriasis can be treated by systemic therapy, phototherapy, and steroids. If the patient does not show any improvement with oral medications then nails are removed surgically.
- Psoriatic arthritis
Psoriasis connected with fatal arthritis is known as psoriatic arthritis. It can cause damaged formation of joints permanently. Approximately 15 to 25 percent of psoriatic patients suffer from psoriatic arthritis. It affects feet joints, knees, and ankles. A patient can also suffer from inflammation in the sacrum and the spine. Physiotherapy and anti-inflammatory drugs can treat this type of psoriasis.
Psoriasis is primarily diagnosed by physical examination. Sometimes the plaques resemble eczema so further tests are performed to confirm the condition. A biopsy can be done in which a small portion of skin is taken to a lab for examination. In the case of psoriatic arthritis, X-rays are taken to confirm the diagnosis. A patient may be referred to an immunologist, rheumatologist, and dermatologist for a complete diagnosis.
Since Psoriasis targets the skin mainly so topical medications are considered effective and relatively safe. These include lotions, gels, creams, ointment, shampoos, and soaps. These preparations contain tar, calcium, and steroids. The accurate dosage form of medicine and the exact drug to be given depends upon the affected area. If more than 10% body area is affected, then single topical medication therapy is not very much effective.
This method of treatment is suitable in the extensive form of psoriasis. UV light rays are directed to psoriatic parts of the body. It must be considered that phototherapy can cause skin cells mutations or skin cancer. To avoid this problem, a specific type of UV light is used to treat psoriasis known as narrow-band UVB. In this type, a small band of UV light is used that seems less carcinogenic and more beneficial to treat psoriasis. Phototherapy can be used solely or in combination with medications.
Several oral medications are used to treat psoriasis systemically. These drugs mostly target parts of theimmune system. Systemic medicines also have some drawbacks. Drugs such as methotrexate and cyclosporine can affect bone marrow kidneys and liver. Otezla is a medicine that particularly reduces the inflammation of affected cells. It is safe but expensive than other medicines.