All You Need to Know About Psoriasis

Psoriasis is a chronic disease in which an overactive immune system triggers the rapid production of skin cells. This causes scaly, inflamed patches of skin to develop, often appearing on the scalp, elbows, or knees, though it can affect other areas of the body as well.

You cannot get psoriasis from another person because it is not contagious.

Differentiating Eczema and Psoriasis

Eczema	Characteristics of eczema include red, inflamed, and itchy skin patches that often ooze or crust. It typically occurs on the hands, feet, neck, face, inside of elbows, and behind the knees. Scratching can cause the skin to become thickened and rough.
Psoriasis	Psoriasis presents as red, raised patches of skin covered with silvery-white scales which commonly appear on the knees, scalp, elbows, and lower back. The skin lesions are generally well-defined and exhibit a scaly texture.

Causes of Psoriasis

Psoriasis is classified as an immune-mediated disease, where the body’s immune system becomes hyperactive, leading to various health issues. In individuals with psoriasis, immune cells are triggered to release molecules that accelerate skin cell growth, causing the inflammation and scaly patches typical of the condition.

The exact cause of psoriasis remains unclear, but it is thought to result from a combination of immune system, genetic, and environmental factors. Psoriasis often runs in families, suggesting a hereditary link. Certain genes related to the immune system are believed to contribute to an increased susceptibility to the condition in some individuals.

If your psoriasis flares up unexpectedly, it may be due to one or more triggers. Common psoriasis triggers include skin injury, stress, infection, medication, smoking, tattoos and piercings, shaving, sunshine, warm weather, dry, cold weather, and excessive or high frequency of alcohol consumption.

Psoriasis Symptoms

Depending on the type and severity of the condition, psoriasis symptoms may vary, but common ones include:

Thick, red patches of skin covered with silvery-white scales, often feeling itchy or burning. They usually appear on areas such as the scalp, elbows, trunk, knees, palms, and soles of the feet.
Itchy or bleeding dry, cracked skin.
Thick, ridged, and pitted nails.

Symptoms can be sporadic, with flare-ups, where symptoms worsen, alternating with periods of improvement.

Psoriatic arthritis

Some patients may even develop a related condition known as psoriatic arthritis, which shows symptoms like swollen, stiff, or painful joints, neck or back pain, and pain in the Achilles heel. If you experience symptoms of psoriatic arthritis, it's essential to consult your doctor promptly, as untreated psoriatic arthritis can lead to irreversible damage.

Psoriasis Diagnosis and Treatment

Diagnosis

Psoriasis is usually diagnosed based on a combination of physical examination, medical history, and, in some cases, laboratory tests.

In some situations, a biopsy may be performed, where a small piece of skin is taken and examined under a microscope. This procedure helps rule out other skin conditions and confirms the psoriasis diagnosis. The biopsy can display distinctive characteristics of psoriasis, such as a thickened epidermis, elongated rete ridges, and inflammatory cells.

Although there is no definitive blood test for psoriasis, blood tests may still be ordered to eliminate other potential conditions and evaluate overall health. These tests may involve looking for indicators of inflammation or other autoimmune disorders.

Treatment options

While currently there is no permanent cure for psoriasis, the primary goal of treatment is to reduce inflammation. It slows the rapid turnover of skin cells and clears skin lesions. Customised treatment plans are made based on the severity and the specific type of psoriasis. The patient’s overall health and personal preferences are included in the plan-making process as well.

The aim is to reduce psoriasis to 1% of your body surface area, roughly the size of the front of your hand, or less within three months of starting treatment. Following this period, it is advisable to have regular consultations with your doctor to evaluate the effectiveness of your therapy.

Treatment can lead to clear skin and periods of remission, where psoriasis symptoms are absent. These periods can last for months or even years, although most typically last between 1 and 12 months.

Topical treatments	For managing mild to moderate psoriasis. Typically, this is the first line of treatment. Directly applied to skin. Examples: Salicylic acid to help with skin smoothing and scale removal. Analogues of vitamin D (calcipotriene and calcitriol) to aid in slowing the growth of skin cells. Retinoids derived from vitamin A to help normalise skin cell growth. Corticosteroids to reduce inflammation and relieve itches. Calcineurin inhibitors to reduce inflammation and plaque buildup, particularly effective in sensitive areas of skin. Coal tar to help reduce itching, inflammation, and scaling.
Phototherapy (light therapy)	Can help treat moderate to severe psoriasis. Involves a controlled amount of exposure to natural or artificial ultraviolet light. Examples: PUVA therapy that combines UVA light and psoralen (a light-sensitising medication). UVB phototherapy that involves exposure to ultraviolet B light.
Systemic treatment	For treating moderate to severe psoriasis or psoriatic arthritis. Affects the entire body. Examples: Traditional systemic medications: Methotrexate to reduce inflammation and inhibit growth of skin cell Ciclosporin to suppress the immune system. Biologic agents that target particular immune system components.
Lifestyle and home remedies	Moisturisers to maintain skin hydration to lessen scaling and dryness. Bath solutions to help soothe the skin by adding oatmeal, Dead Sea salts, or Epsom salts to bathwater. Healthy diet, regular exercise, avoiding smoking and excessive alcohol, and stress management to enhance general health and possibly lessen flare-ups.

Preventive Measures

Self-care plays a crucial role in your everyday life. It is about taking responsibility for your own health and well-being, with the support from those involved in your care. This entails prioritising both physical and mental health, taking steps to prevent accidents or illness, and effectively managing minor health issues alongside chronic conditions.

Make an Appointment at Gleneagles Hospitals

Consult a doctor if you notice your psoriasis has worsened or new symptoms are appearing. The team of expert dermatologists at Gleneagles Hospitals is available for consultation, ensuring the best care and support for patients.

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