Psoriasis - Causes Symptoms Triggers, Treatments And More

What is Psoriasis?

Psoriasis symptoms include scaly, dry, or itchy skin. There is no cure, but you may manage your symptoms by identifying your triggers, using medications, and making lifestyle changes.

Psoriasis is a chronic autoimmune skin disorder characterized by the accelerated growth of skin cells, resulting in the formation of raised, red patches covered with silvery-white scales. This condition arises from a misdirected immune response, where the body’s immune system attacks healthy skin cells, leading to an inflammatory process that manifests as the distinctive symptoms of psoriasis. The condition is non-contagious but can significantly impact an individual’s physical and emotional well-being. Psoriasis often presents in various forms, with the most common being plaque psoriasis, marked by the presence of well-defined, raised plaques on the skin. Understanding psoriasis involves recognizing its autoimmune nature and the multifaceted challenges it poses for those living with the condition.

There are five types of psoriasis

Plaque psoriasis

Plaque psoriasis is the most common type of psoriasis, affecting about 80-90% of individuals with psoriasis. Raised, well-defined plaques on the skin covered with silvery-white scales. Typically appears on elbows, knees, scalp, and lower back. Can be itchy and may cause discomfort.

Guttate Psoriasis

Guttate Psoriasis more common in children and young adults, often triggered by bacterial infections like streptococcus. It causes small, red, drop-like lesions scattered on the skin. Guttate psoriasis is most commonly seen on the torso, arms, and legs. These areas are rarely dense or raised like plaque psoriasis.

Inverse Psoriasis

Inverse Psoriasis develop under armpits, groin, breasts, and in other skin folds and areas where skin rubs against skin. It causes smooth, red lesions without the typical scaling seen in other types.

Pustular Psoriasis

Pustular psoriasis Less common types of psoriasis, but can be severe, pustular psoriasis causes pus-filled blisters (pustules) surrounded by red inflamed skin. It is usually limited to smaller parts of the body, such as the hands or feet, although it can widespread.

Erythrodermic psoriasis

Erythrodermic psoriasis is a rare but considered a severe form of psoriasis. Widespread redness and scaling of the skin, resembling a severe sunburn. Skin may peel in sheets rather than scales. Can cause severe itching, pain, and fluctuations in body temperature.

Understanding these various types of psoriasis is crucial for accurate diagnosis and tailored treatment plans. Individuals may experience one type or a combination of types over the course of their condition. Consulting with a dermatologist is essential for proper diagnosis and management based on the specific characteristics and severity of psoriasis.

Psoriasis : Causes and triggers

Psoriasis is a complex condition influenced by a combination of genetic and environmental factors. While the exact cause of psoriasis remains elusive, various triggers can exacerbate or provoke the onset of symptoms. Understanding both the underlying causes and potential triggers is crucial for managing and preventing flare-ups. Here’s a closer look:

1. Genetic

Family history plays a significant role, with individuals having a genetic predisposition being more likely to develop psoriasis. Specific genetic markers, especially those related to the immune system, contribute to this hereditary link.

2. Immune System Dysfunction

Psoriasis is fundamentally an autoimmune disorder, where the immune system mistakenly targets healthy skin cells, triggering an inflammatory response. T cells, a type of white blood cell, become overactive, leading to the rapid turnover of skin cells and the characteristic symptoms of psoriasis.

3. Environmental Factors

Various environmental factors can contribute to the development or exacerbation of psoriasis. These include infections, particularly streptococcal infections, which may trigger guttate psoriasis.

Stress

Emotional stress is a common trigger for psoriasis flare-ups. Stress can exacerbate symptoms and contribute to the onset of the condition, stress management techniques, such as meditation and yoga, may be beneficial in reducing the impact of stress on psoriasis.

Infections

Bacterial or viral infections, particularly streptococcal infections (like strep throat), can trigger or worsen psoriasis. Addressing and treating infections promptly may help manage psoriasis symptoms.

Injury to the Skin

Physical trauma to the skin, such as cuts, bruises, or sunburns, can trigger the development of psoriasis lesions. This is known as the Koebner phenomenon.

Medications

Certain medications, such as lithium, antimalarial drugs, and beta-blockers, may exacerbate or induce psoriasis symptoms. It’s important to inform healthcare providers about psoriasis when prescribed new medications.

Hormonal Changes

Changes in hormone levels, such as those occurring during puberty, pregnancy, and menopause, can influence psoriasis symptoms. Women may experience fluctuations in psoriasis severity during different stages of their menstrual cycle.

Weather Conditions

Cold, dry weather is often associated with increased psoriasis symptoms. Conversely, some individuals may experience improvement during warmer, more humid conditions.

Smoking and Alcohol

Smoking and excessive alcohol consumption have been linked to an increased risk of psoriasis and may contribute to more severe symptoms.

Obesity

Obesity is a risk factor for psoriasis, and excess weight can contribute to inflammation in the body, potentially worsening psoriasis symptoms.

What are the symptoms of psoriasis?

Psoriasis manifests in various ways, and the symptoms can vary in severity. Common signs of psoriasis include:

Red Patches (Plaques)

Raised, inflamed areas of skin covered with silvery-white scales.
Plaques are well-defined and often appear on elbows, knees, scalp, and lower back.

Itching and Discomfort

Psoriasis can cause persistent itching, leading to discomfort and potential skin damage if scratching is excessive.

Scaling and Flaking

Silvery-white scales on the skin’s surface due to the rapid turnover of skin cells.
Scaling is a characteristic feature, especially in plaque psoriasis.

Dryness and Cracking

Affected skin areas may become dry, leading to cracking and, in severe cases, bleeding.
Moisturizing is often recommended to alleviate dryness.

Thickened or Pitted Nails

Psoriasis can affect the nails, causing changes in texture, thickness, and color.
Pitting (small dents or depressions) is a common nail symptom.

Joint Pain (Psoriatic Arthritis)

Psoriatic arthritis can cause joint pain, stiffness, and swelling.
Joint involvement is more common in some individuals with psoriasis.

Inverse Psoriasis Symptoms

In skin folds and areas where skin rubs against skin, such as armpits and groin.
Smooth, red lesions without the typical scaling seen in other types.

Diagnosis of Psoriasis

Clinical Examination:

A dermatologist typically diagnoses psoriasis based on a physical examination of the skin, nails, and, if applicable, joints.

The distinctive appearance of psoriasis plaques often aids in diagnosis.

Medical History:

Discussing the patient’s medical history, including any family history of psoriasis, helps in determining the likelihood of the condition.

Biopsy:

In some cases, a skin biopsy may be performed to confirm the diagnosis. This involves taking a small skin sample for examination under a microscope.

Nail Examination:

Nail changes characteristic of psoriasis, such as pitting or thickening, can support the diagnosis.

Assessment of Joint Involvement:

If joint symptoms are present, the healthcare provider may conduct imaging studies and other assessments to diagnose psoriatic arthritis.

Rule Out Other Conditions:

Psoriasis can sometimes be mistaken for other skin conditions. Doctors may rule out conditions like eczema or fungal infections.

Importance of Seeking Professional Diagnosis

It’s crucial to seek professional medical advice for an accurate diagnosis of psoriasis. While the visible symptoms may suggest psoriasis, a healthcare provider can confirm the diagnosis, determine the specific type and severity of psoriasis, and develop an appropriate treatment plan. Early diagnosis and intervention improve outcomes and quality of life for individuals living with psoriasis. Regular follow-ups with a healthcare provider help monitor the condition and adjust treatment as needed.

Living Life with psoriasis

Having psoriasis might be difficult at times, but with an appropriate mindset, you can minimize flare-ups. These points will help you cope in both the short and long term.

Daily Skincare:

Establish a gentle skincare routine to soothe the skin and minimize irritation, Keep the skin moisturized to alleviate dryness and reduce scaling.

Use fragrance-free moisturizers to keep the skin hydrated, Avoid harsh soaps and opt for mild, moisturizing cleansers.

Managing Flare-Ups:

Identify and avoid triggers that may lead to flare-ups, learn to recognize early signs of a flare-up to initiate prompt management. Consult with healthcare professionals for effective treatment options.

Diet and Lifestyle:

Maintain a balanced diet rich in fruits, vegetables, and whole grains, consider anti-inflammatory foods, such as fatty fish and turmeric, stay hydrated and limit alcohol intake, engage in regular physical activity to promote overall health.

Stress Management:

Practice stress-reduction techniques like meditation, yoga, or deep breathing exercises, establish a healthy work-life balance, seek support from friends, family, or mental health professionals.

Clothing Choices:

Choose loose-fitting, breathable clothing to minimize friction, consider clothing that covers affected areas if self-consciousness is a concern.

Social and Emotional Well-being:

Educate friends and family about psoriasis to foster understanding, join support groups or online communities to connect with others facing similar challenges, address any emotional impact by seeking therapy or counselling.

Regular Check-ups:

Schedule regular check-ups with a dermatologist or skin care specialist.

Relationships and Intimacy:

Open Communication with Partners: Communicate openly with your partner about your feelings, needs, and any impact on intimacy. Building a Supportive Network: Surround yourself with understanding and supportive relationships.

Treatment options for psoriasis

Psoriasis has no cure. The treatments seek to:

reduce inflammation and scales
slow the growth of skin cells
remove plaques

Topical Treatments:

Corticosteroids: These anti-inflammatory medications help reduce redness, itching, and swelling.
Topical Retinoids: Derived from vitamin A, these creams or ointments help slow skin cell growth.
Calcineurin Inhibitors: These medications reduce inflammation and are often used on sensitive areas like the face and genitals.

Phototherapy (Light Therapy):

UVB Phototherapy: Exposure to UVB light slows the growth of affected skin cells.
PUVA (Psoralen plus Ultraviolet A): Involves combining a light-sensitizing medication (psoralen) with UVA light exposure.

Systemic Medications:

Oral Retinoids: Derived from vitamin A, these medications are taken orally and work throughout the body to reduce cell turnover.
Methotrexate: An immunosuppressant that can slow cell turnover and reduce inflammation.
Cyclosporine: Suppresses the immune system to reduce inflammation and cell turnover.

Biologics:

This group of drugs alters your immune system and inhibits it from interacting with inflammatory pathways. These drugs are injected or administered via intravenous (IV) infusion.

Salicylic Acid and Coal Tar:

Salicylic Acid: Helps to remove scales and promote the effectiveness of other treatments.
Coal Tar: Reduces inflammation, itching, and scaling.

Moisturizers and Emollients:

Regular use of moisturizers helps keep the skin hydrated and may alleviate dryness and itching.

Important Considerations:

Individualized Approach: Treatment plans are often personalized based on the type and severity of psoriasis, overall health, and individual response to medications.
Side Effects: Conventional treatments may have side effects, and regular monitoring by healthcare providers is crucial.
Combination Therapies: Healthcare providers may recommend a combination of treatments for better efficacy.

Always consult with a healthcare professional to determine the most suitable treatment plan for your specific condition. Additionally, ongoing communication with your healthcare team helps in monitoring progress and making necessary adjustments to optimize treatment outcomes.