CONDITIONS
Psoriasis
Psoriasis is a skin disease that causes a rash with itchy, scaly patches, most commonly on the knees, elbows, trunk and scalp. The patches may look red or pink. This skin disorder may cause the skin cells to multiply up to 10 times faster leading to a build up of bumpy patches.
Psoriasis is a common, long-term (chronic) disease without any cure and could be painful, causing interference with sleep and difficulty concentrating.
In India, the prevalence is around 0.44-2.8% with males being twice more affected than females.
What are the symptoms of Psoriasis?
There are several types of psoriasis with different signs and symptoms. However, following are the common signs and symptoms of psoriasis:
- A patchy rash that varies widely in looks, ranging from spots of dandruff-like scaling to major eruptions over much of the body
- Rashes that vary in color, from a purplish shade with gray scale on brown or Black skin and pink or red with silver scale on white skin
- Small scaling spots (commonly seen in children)
- Dry, cracked skin that may bleed
- Itching, burning or soreness
- Repeated coming and going of rashes (cyclic rashes) – these flare for a few weeks or months and then subside
Signs and symptoms according to the types of psoriasis are:
- Plaque psoriasis:
- Dry, itchy, raised skin patches (plaques) covered with scales few or many in number.
- The affected skin might heal with temporary changes in color (post inflammatory hyperpigmentation), particularly on brown or Black skin.
- Nail psoriasis:
- May affect fingernails and toenails, causing pitting, abnormal nail growth and discoloration and severity may cause nail to crumble
- Guttate psoriasis:
- Primarily affecting young adults and children, it is usually bacterial in nature and is marked by small, drop-shaped, scaling spots on the trunk, arms or legs.
- Inverse psoriasis:
- Mainly affecting the skin folds of the groin, buttocks and breasts causing smooth patches of inflamed skin that worsen with friction and sweating.
- Pustular psoriasis:
- Rare, causes pus-filled blisters.
- Erythrodermic psoriasis.
- Hardly occurs in anyone, it covers the entire body with a peeling rash that can itch or burn intensely. It can be short-term or long-term.
What are the causes and risk factors of Psoriasis?
Psoriasis may cause by a trigger in immune system that causes skin cells to grow faster than usual. Psoriasis tends to run in families, but not compulsorily present in every generation. May people predisposed to psoriasis may be free of symptoms for years until the disease is triggered by following factors such as:
- Infections, such as strep throat or skin infections
- Weather, especially cold, dry conditions
- Injury to the skin, such as a cut or scrape, a bug bite, or a severe sunburn
- Emotional stress
- Smoking and exposure to secondhand smoke
- Heavy alcohol consumption
- Certain medications such as blood pressure medications, antimalarial drugs, lithium and other mood stabilizers, antibiotics, and NSAIDs
- Rapid withdrawal of oral or injected corticosteroids
Is psoriasis contagious?
Psoriasis cannot be spread by touching a person with the disease, meaning not contagious. Since the cause is related to the immune system, psoriasis is an internal disease even though it appears on the outside of body.
How is Psoriasis diagnosed?
The doctor does a full physical exam and generally it is a condition that is easily diagnosed, especially in the presence of plaques in areas such as:
- Scalp
- Ears
- Elbows
- Knees
- Belly button
- Nails
What are the treatment options for Psoriasis?
The treatment in psoriasis aims at stopping skin cells from growing quickly and at removing scales. Treatment options include creams and ointments (topical therapy), light therapy (phototherapy), and oral or injected medications.
Topical therapy (medications applied on skin)
- Corticosteroids – Most frequently prescribed medications for treating mild to moderate psoriasis and available as oils, ointments, creams, lotions, gels, foams, sprays and shampoos. Understand the proper frequency of application, method from the doctor. Treatment may include everyday or alternate day applications; short-term or long-term treatment.
- Synthetic forms of vitamin D (Vitamin D analogues)
- Retinoids – LikeTazarotene. However, it isn’t recommended when you’re pregnant or breastfeeding or if you intend to become pregnant.
- Calcineurin inhibitors — to calm the rash and reduce scaly buildup.
- Salicylic acid – to reduce the scaling of scalp psoriasis.
- Coal tar – Coal tar reduces scaling, itching and inflammation.
Light therapy – first line treatment for moderate to severe psoriasis, either alone or in combination with medications. In light therapy, a doctor shines ultraviolet light on the skin to slow the growth of skin cells. Sometimes, a combination treatment (Psoralen plus ultraviolet-A radiation (PUVA)) is a that combines a medicine called psoralen with a special form of ultraviolet light is also done.
Oral or injected medications – In case of moderate to severe psoriasis, or if other treatments haven’t worked, doctor may prescribe oral or injected (systemic) drugs.
Home remedies or alternative treatment for psoriasis
Different types of natural therapies applied to skin may help with the symptoms of psoriasis. These include:
- Oregon grape topical creams
- Capsaicin topical creams
- Fish oil supplements.
- Omega-3 fatty acids
- Aloe vera
- Oat baths
References
- Thappa DM, Munisamy M. Research on psoriasis in India: Where do we stand? Indian J Med Res. 2017 Aug;146(2):147-149.
- Mayo Clinic. April 2024. https://www.mayoclinic.org/diseases-conditions/psoriasis/diagnosis-treatment/drc-20355845
- WebMD. April 2024. https://www.webmd.com/skin-problems-and-treatments/psoriasis/understanding-psoriasis-basics
