Psoriasis is a common inflammatory skin condition that affects the extensor surfaces like elbows, knees, and ankles. Scalp, hands, feet, and nails may also be affected. It usually presents as scaly, red to dark patches of the skin over the affected area. Though it is a common condition, it may cause considerable social discomfort to the affected person.
What causes Psoriasis?
Psoriasis has a multifactorial cause, but the main reason is supposed to be an autoimmune response, where the inflammatory cells cause increased skin turnover. Genetics also play an important role in the manifestation of psoriasis. Conditions such as winter, alcohol intake, obesity, throat infections can suddenly make psoriasis worse.
How does the dermatologist diagnose psoriasis?
Psoriasis is a clinical diagnosis in most parts. This means that your dermatologist can diagnose the disease based on the history, the location of the skin lesions, the classical appearance of the patches. However, if the lesions or the locations are not classical, the diagnosis can be confirmed by dermoscopy or skin biopsy.
What are the different types of psoriasis?
- Localized plaque psoriasis - Usually this kind of psoriasis has few small to moderate round plaques with scales seen over the extensor aspects of elbows, knees, shin, and ankles.
- Scalp psoriasis - Rounded scaly patches over the scalp, sometimes extending onto the hairline or behind the ears.
- Palmoplantar psoriasis - This variation of psoriasis can mimic hand eczema or foot eczema.
- Guttate psoriasis - Guttate psoriasis can present suddenly, as a rash of small, reddish plaques, and many times, there may be minimal or no scaling.
- Nail psoriasis - Sometimes, only the nails are affected in psoriasis. In this case, the nails become separated at their distal ends, maybe thickened and ridged.
- Erythrodermic psoriasis - A very rare but serious variant of psoriasis where the whole body becomes red and scaly. This condition needs hospitals based on inpatient care.
- Pustular psoriasis - A very rare but serious variant of psoriasis where small pinpoint pustules develop over psoriasis. This condition needs hospitals based on inpatient care.
What are the complications of psoriasis?
Psoriasis is a common inflammatory condition, which usually runs a mild course with occasional flares and remissions. However, in some patients, there may be some complications.
- Psoriatic arthritis: This is seronegative arthritis seen in about 10% of all patients with psoriasis.
- Psoriatic Erythroderma and Pustular psoriasis: These are uncommon types of psoriasis that can need hospital-based inpatient treatments.
What are the medical treatments of psoriasis?
There are many treatment options for psoriasis, however, all of them give remission from the condition and not a cure.
- Topical treatments: Creams and lotions containing moisturizer, steroids, tar, salicylic acid, anthralins have been used for significant improvement. These can be used when psoriasis involves small areas of the body.
- Oral treatments: Treatments such as Methotrexate, Cyclosporine, Hydroxyurea, Retinoids, and newer agents such as Biologicals are used to help with moderate to severe psoriasis.
- Phototherapy and excimer: These light and laser-based technologies help to reduce psoriasis without causing side effects.
What are the lifestyle changes needed to improve psoriasis?
Studies now show that exercise and eating healthy improves psoriasis. The reduction of body fat also shows a positive correlation with psoriasis improvement.