What you should know about Psoriasis

What is Psoriasis?

Psoriasis is a common skin disease that causes a rapid buildup of skin cells. This results in scaling on the surface of the skin.

The scales on the skin surface may become red and inflamed. Psoriatic scales have a whitish-silver colour, with characteristic red patches. In some cases, these patches may crack and bleed.

Psoriasis is caused by the fast production of skin cells. Normally, when the skin cells are developing, they grow deep in the skin and rise slowly to the surface, and then fall off subsequently. A skin cell has a life cycle of about one month.

In psoriasis, the process may occur within a few days. Why? Because the skin cells do not have enough time to fall off. So, the overproduction of cells of the skin results in the buildup of skin cells.

Most scales develop on the knee and elbow joints. They may also develop on other parts of the body, such as the:

• Face
• Scalp
• Neck
• Feet
• Hands

Psoriasis may also affect the mouth, nails, and genital area.

According to the British Skin Foundation, psoriasis affects 1 in 50 people. A study published in JAMA Dermatology shows that psoriasis has a prevalence of 1.5% in the UK. This condition is usually associated with other conditions, such as:

• Heart disease
• Anxiety
• Type 2 diabetes
• Depression
• Inflammatory bowel disease
• Psoriatic arthritis

Types of psoriasis

There are five major types of psoriasis:

Guttate psoriasis: This occurs in children. It causes small spots with pink coloration. Guttate psoriasis occurs mainly in the legs, arms, and torso.

Plaque psoriasis: It is the commonest type of psoriasis. It causes inflamed patches that cover the skin. These patches are usually reddish and covered with white-silver plaques or scales, and are commonly found on the scalp, knees, and elbows.

Pustular psoriasis: This type of psoriasis is very common in adults. It causes the formation of whitish blisters. These blisters are usually filled with pus. Pustular psoriasis also causes inflammation and reddening of the skin. It mainly occurs in the feet or hands, but sometimes, can be widespread.

Inverse psoriasis: The skin in this condition is usually inflamed, shiny, and red. Inverse psoriasis develops under the breasts or armpits, around the genital skin folds, and in the groin.

Erythrodermic psoriasis: This is a rare form of the disorder, and usually severe. It usually affects a large part of the body at once. People who have this condition usually have skin that appears near sunburned. Large sheets of scales slough off at the same time. People with erythrodermic psoriasis usually have a fever or may become ill. It may become life-threatening so affected people should see their GP without delay.

What are the causes of psoriasis?

Clinicians are unclear as to the main causes of psoriasis. However, decades of research have revealed that two main factors contribute to psoriasis: the immune system and genetics.

Immune system

Psoriasis is rightly described as an autoimmune condition. An autoimmune condition is one that results from the body’s attack against itself. Psoriasis is an autoimmune condition that occurs when white blood cells attack the skin cells by error. These white blood cells are called T cells.

Normally, white blood cells defend the body against bacteria and infections. When the white blood cells attack, the production of skin cells goes into overdrive. This means that new skin cells are developed too quickly. The skin cells are pushed to the surface where they accumulate.

The result is the formation of plaques that are associated with psoriasis. The attack also causes reddening of the skin cells, as well as inflammation of some areas of the skin.

Genetics

Sometimes, people may inherit genes that increase their risk of developing psoriasis. If there’s a history of psoriasis in your family, then you have a high risk for it. At least 2-3% of people who have the gene usually develop the condition.

What are the triggers for psoriasis?

Psoriasis triggers are not the same for everyone. They differ. Common triggers include:

Alcohol: Alcoholism is a common psoriasis trigger. Excessive intake of alcohol raises the frequency of psoriasis flareups.

Stress: Excessive stress can also trigger a flareup. You’re better off managing your stress as this can help reduce the frequency of flareups, and even prevent it.

Medications: Some medications act as psoriasis triggers. Medications that can trigger this condition include:

• Medications for high blood pressure
• Antimalarial medications
• Lithium

Injuries: A cut, sprain, or even a scrape may trigger psoriasis. Sunburns, vaccines, and shots can also trigger psoriasis outbreaks.

Infection: Psoriasis is partly an immune system disorder. So, if you have an infection, or you are sick, your immune system may go into overdrive to fight the infection. This might trigger another flareup.

Treatment for psoriasis

The goal of treatment is to reduce scales and inflammation. Treatment also removes plaques and slows the growth of skin cells.

Treatment options include:

Topical treatments

Ointments and creams applied to the skin can help treat mild psoriasis. Topical treatments include:

• Anthralin
• Topical corticosteroids
• Vitamin D analogs
• Topical retinoids
• Moisturizer
• Salicylic acid

Systemic medications

Systemic medications are used to treat mild to moderate psoriasis. Systemic medications may be oral or injected. In many cases, systemic medications are prescribed for short periods. They include:

• Biologics
• Methotrexate
• Retinoids
• Cyclosporine

Light therapy

Light therapy for psoriasis uses natural or ultraviolet light. The white cells causing the disturbances are killed by the sunlight. Both ultraviolet A light and ultraviolet B light help reduce mild to moderate psoriasis. People experiencing mild to moderate psoriasis are better off with combined therapy.

Takeaway

Psoriasis has a prevalence of 1.5% in the UK. Because of this high incidence, it is important that you work together with your healthcare provider to get the right treatment.

Access Doctor offers online consultations for psoriasis and other skin disorders. We have well-trained UK doctors in our employ who are willing to help you.

Reach out to us today, and we might just be of help.

References

Rendon A, Schäkel K. Psoriasis Pathogenesis and Treatment. Int J Mol Sci. 2019;20(6):1475. Published 2019 Mar 23. doi:10.3390/ijms20061475

Kim WB, Jerome D, Yeung J. Diagnosis and management of psoriasis. Can Fam Physician. 2017;63(4):278-285.

Gelfand JM, Weinstein R, Porter SB, Neimann AL, Berlin JA, Margolis DJ. Prevalence and Treatment of Psoriasis in the United Kingdom: A Population-Based Study. Arch Dermatol. 2005;141(12):1537–1541. doi:10.1001/archderm.141.12.1537