Huda Basri

1^st Year MBBS, Islamabad Medical and Dental College, Islamabad, Pakistan

Key points:

• What is psoriasis?
• Signs and symptoms
• Types of psoriasis
• Causes
• Treatment

Psoriasis is an autoimmune disease which is a prevalent, chronic (long-term) illness in which the immune system overreacts, causing skin cells to grow excessively and rapidly. It’s a skin condition that affects people of all ages and places and has a significant cost on both individuals and society. Chronic plaque, also known as psoriasis vulgaris, is the most prevalent variety caused by genetic vulnerability.¹

Signs and symptoms

Psoriasis symptoms can occasionally appear in cycles, with flares lasting a few weeks or months before diminishing or going into remission. Some common psoriasis symptoms include: Patches of thick, red skin with silvery-white scales that itch or burn, commonly found on the elbows, knees, scalp, trunk, palms, and soles of the feet. Moreover, dry and cracked skin that itches and bleeds, thick, ridged and pitted nails and poor quality of sleep are also among its symptoms.²

Types of psoriasis

There are several forms of psoriasis: Plaque psoriasis, which is the most common type, and it shows as elevated, red patches of skin surrounded by silvery- white scales. Patches typically form in a symmetrical pattern on the body, appearing on the scalp, trunk, and limbs, particularly the elbows and knees.

Guttate psoriasis is another variety which commonly arises in children or young adults and is characterized by small, red dots on the chest or limbs. Upper respiratory tract infections, such as strep throat, are frequently the source of outbreaks. Pustular psoriasis is characterized by pus-filled pimples called pustules that are surrounded by red skin. It often affects the hands and feet. In Inverse psoriasis, red patches in skin creases, such as beneath the breasts, the crotch, or the armpits. Rubbing and sweating might exacerbate the problem.

Erythrodermic psoriasis, is a rare but severe form of psoriasis marked by red, scaly skin over the majority of the body. It can be provoked by a severe sunburn or by taking certain medications, such as corticosteroids.⁴

Causes

Exact cause of psoriasis remains unknown but experts believe it's a combination of factors such as environment and genes. Something activates your immune system, causing inflammation. This causes new skin cells to form prematurely. Normally, skin cells generally replace themselves every 10 to 30 days but psoriasis produces new cells every 3-4 days. Thus, scales are generated by replacing old cells with new ones.

Psoriasis usually runs in families, but it can skip generations and is not contagious. Psoriasis eruptions may be caused by cuts, scrapes, or surgery and emotional stress. In addition to that, medications including blood pressure, antimalarial, lithium, mood stabilizers, antibiotics, and nonsteroidal anti- inflammatory can also trigger symptoms of psoriasis.⁶

Treatment

There is no current cure for psoriasis, but a variety of therapies can help with symptoms and the skin patches. The treatment approach is defined by the kind and severity of the disease. Mild psoriasis is often treated with lotions or ointments, while moderate and severe cases may require drugs, injections, or light therapy. Managing common stressors, such as stress and skin injuries, can help with symptom control.⁷

References