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Psoriasis: Treatment, symptoms, advice and help

About psoriasis

Psoriasis is a long standing autoimmune skin disease characterized by typical skin lesions over several parts of the body. The common body parts affected are the scalp, the knees, the elbows, palms and soles. Typical lesions in psoriasis are oval or circular, scaly, silvery white patches on the body surface which can spread to the entire body surface. Psoriasis is a life-long recurring disorder but may be controlled with appropriate medications.

Psoriasis: Incidence, age and sex

Psoriasis affects both the sexes equally. The disease generally occurs between the ages of 15-30 years and most often family history is found to be positive in the affected individuals.

Signs and symptoms of psoriasis: Diagnosis

The lesions are initially red, small, circular spots which progress to form thick, silvery white patches. These skin lesions can become scaly and sometimes even exhibit bleeding after gentle scraping. The lesions are associated with incessant itching and burning sensation. Usually skin of the knees, the elbows, the back, the palms, the soles, and scalp may get affected. The disease presentation varies greatly from person to person. Initially, it starts as a localised lesion and may later on, spread to the whole body or it may just remain restricted to the affected area. The disease is often associated with frequent recurrence. As the disease progresses in some individual it may even affect the adjoining joints leading to a condition called as ‘Psoriatic Arthritis’. The affected joint becomes painful and swollen leading to difficulty in movement.

Diagnosis of psoriasis is based on medical history and detailed clinical examination of the affected individual. There are no specific tests for diagnosing psoriasis. The skin lesions are characteristic enough to establish the diagnosis.

Causes and prevention of psoriasis

The exact cause of disease process is not known. The disease is an autoimmune disorder wherein the body’s immune system works against its own body cells and destroys them. In this case, the skin cells are affected resulting in accumulation of immature skin cells on the skin surface. Most of the patients have positive family history of disease and hence genetic predisposition is considered to be an important risk factor in development of the disease. Psychological stress also plays an important role and can initiate the disease process or aggravate an existing condition. The individual should ideally avoid sunlight.

Psoriasis: Complications

The disease complications include joint involvement leading to movement disability. In severe cases of disease, the individual may experience social embarrassment, isolation, aloofness, job stress, emotional distress and depression.

Psoriasis: Treatment

The management of disease entails a multi-dimensional approach. Oral medications such as corticosteroids, methotrexate, retinoids, and psoralens are usually prescribed after confirmation of the disease. Salicylic acid ointment, clobetasol propionate, and betamethasone are generally advised for local application. Patient counselling is done wherein the individual and his family is educated and made aware of the disease. Stress reduction is advisable which can be achieved by performing relaxation techniques. Patient should avoid sunlight whenever possible. The main aim of the management is to reduce the disease severity and improving the overall quality of life.

The psoriasis information advice that you find here is written for the benefit of non-medical laypersons by a psoriasis specialist who is part of a team of 100 practising UK consultants and GPs. The content is in keeping with UK guidelines and based on current best practice for the management and treatment of psoriasis.

Psoriasis: Definition

Psoriasis is a non-infectious skin condition characterized by red scaly patches. Within these patches there is a rapid increase in cell turnover resulting in scaling of the skin. The condition is often inherited.

Psoriasis: Incidence/Age/Sex

Psoriasis affects all races but is often more apparent in races where there is less sun exposure.

2% of the U.K population suffer from psoriasis which is visibly apparent. 5% of the population have psoriasis which is detectable upon close inspection of the skin.

It occurs equally in men and women at any age, although it commonly presents in late teens and early adult life for the first time.

Psoriasis: Causes and Prevention

Although the exact cause of psoriasis is not known many factors may trigger an episode of psoriasis in a susceptible individual. In children particularly, throat infections can cause flare-ups. Injury to the skin may result in psoriasis breaking out 5 or 6 weeks later at the site of injury. Some individuals going through a stressful time may notice their psoriasis flare-up.

The sun might help to improve the condition, although a few individuals may notice some aggravation.

The role of alcohol and psoriasis is uncertain. Some people believe that psoriasis may be aggravated by alcohol. There does not appear to be any apparent relationship between diet and psoriasis. Within the outer layer of the skin (the epidermis) the cells continually move up and are constantly shed off.

This process normally takes between 3 and 4 weeks but in psoriasis the rate of cell turnover is dramatically increased so that the process may take as little as 3 or 4 days. This then results in a build up of scale on the surface of the skin which can be shed off.

Psoriasis: Signs and Symptoms

Psoriasis typically presents with scaly patches over the outer aspects of the elbows and front of the knees. Mild psoriasis in this site is often attributed to pressure occurring either from leaning on a desk or kneeling. Psoriasis may occur at any other place on the body. In 1% of affected individuals it may occur on the face. Scalp and nails are another common site of involvement. Although psoriasis is stated to be non-itchy some patients do have significant irritation with their skin disease.

Psoriasis: Complications of Disorder

The majority of people suffering from psoriasis may be totally unaware that the problem of dry skin affecting their elbows or knees is in fact psoriasis. The majority of people who are known to have psoriasis may experience occasional flare-ups of their skin condition and reasonable periods of remission. A small percentage of individuals may experience more extensive and disabling psoriasis (see moderate and severe psoriasis). Rarely psoriasis can affect the whole of the skin, this can then result in a situation similar to severe sunburn which can be potentially life threatening.

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