Psoriasis is a skin condition characterized by itchy, red, and sometimes scaly patches. The condition is chronic and typically comes and goes throughout a patient’s lifetime.
Patients will experience flare-ups, or exacerbations of the rashes, and then other times the patches will be less noticeable or non-existent. Some patients may even go a year without any flares. The frequency, extent, and severity of the condition varies greatly amongst patients. This skin condition is quite common, as it is estimated to affect approximately 3% of adults in the United States.Types of Psoriasis
Read More- Most common type of psoriasis
- Characteristic red, scaly patches, or plaque
- Plaques can occur anywhere on the body
- Guttate psoriasis
- Mainly affects younger patients (adolescents)
- Often triggered by an illness (streptococcal infection is a common cause)
- Pustular psoriasis
- Uncommon subtype
- Involves pus-filled blisters, rather than scaly, dry patches
- Inverse psoriasis
- Mainly found in areas of the body where there are skin folds such as the genitals, under the breasts, and underarms
- Sweating is a main cause of irritation
- Erythrodermic psoriasis
- Rare subtype
- Large areas of the skin are often involved
- Affected skin will shed in sheets
- Â If not treated, can be severe or life-threatening
- Psoriatic arthritis
- A significant complication of psoriasis
- One in three people who have psoriasis will progress to joint swelling and soreness.
- Nail psoriasis
- Can affect the nails of both fingers and toes
- Discoloration and pitting of the nail itself may occur
- Nails can loosen from the nailbed and lift off completely
Psoriasis: Symptoms & Flare-ups
In between flare-ups, psoriasis is typically asymptomatic, meaning negative symptoms are not experienced. Exacerbations typically first start to appear between the ages of 15 and 25 years. The plaques themselves may vary slightly in appearance, so a patient should always consult with their healthcare team if they are unsure of the rash type. Plaques will typically appear as scaly, red rashes that may also cause itching. The scaly areas may appear somewhat silvery in color. Sometimes the plaques are raised slightly. Patients may complain of a burning or stinging sensation around the patches, while other times the lesions may just resemble dry skin. More atypical (less common) symptoms of this skin condition include thickened nails and/or joint stiffness.Besides physical symptoms, there is also a significant impact on a patient’s mental health. Psoriasis flares are often accompanied by feelings of embarrassment, stress, and discomfort. Some patients even report feelings of shame regarding their appearance. The mental and emotional burden of the disorder can be addressed with support and counseling.
Where does Psoriasis Usually Start?
Some patients only experience rashes in a few spots, while other patients may see the skin condition affect large portions of the body. Plaques can occur on any location of the body. Common sites for psoriasis include the following:
- Knees, legs, and soles of feet
- Elbows and palms
- Lower back
- Scalp, face, and inside the mouth
- Genital area
How Does Psoriasis Occur?
Psoriasis is considered an autoimmune disorder. It is thought to occur when skin cells begin to multiply much faster than normal. This causes the skin to shed abnormally quickly, leading to the development of red, itchy patches on the skin's surface. These patches are a build-up of shedding skin cells.
The immune system is the driver behind this condition. Immune dysfunction triggers an inflammatory response that causes skin cells to proliferate abnormally quickly. Some flares of psoriasis plaques occur randomly, but often there is a trigger. Some common triggers of psoriatic rashes include the following:
- Illness or infection
- Stress/injury
- Sun damage
- Tobacco and/or alcohol consumption
- Heat or cold
- Certain medications
Is Psoriasis Hereditary?
Psoriasis is hereditary. The gene, or genes, that cause the disease are still being investigated and the exact mechanism by which they cause the skin condition is currently not well understood. The manner in which these genes are passed down between generations is not completely known. However, there is evidence that the skin condition does run in families. If one parent, or both parents, experience psoriatic rashes, their offspring will have about a 10% or 50% chance of developing the disease, respectively.
Is Psoriasis Contagious?
Psoriasis is not a contagious disease. It cannot be passed to other people through touch. It is an immune-mediated skin reaction. It may appear like a contagious skin infection with a viral or bacterial component. However, there is no associated infectious process.
How Does Psoriasis Impact Other Conditions?
Psoriasis does not directly impact other conditions. However, some patients may see an increased incidence of other inflammatory diseases, such as ulcerative colitis or Crohn’s disease. There also may be an increased incidence of other conditions, like type 2 diabetes, heart disease, obesity, metabolic syndrome, or depression. However, it is unknown how psoriasis is related to these conditions. The scientific community is still coming to understand what predisposes a patient to more psoriasis flares, and whether the autoimmune component of psoriasis makes a person more susceptible to other immune-related diseases.
What are the Treatment Options for Psoriasis?
This skin condition has no cure, but there are many treatment options. Some patients may have to try a few different therapies before they find one that works best for them. Since flares can vary in severity, a treatment that works for some rashes may be insufficient for more severe flares. In a nutshell, treatment options for psoriasis include the following:
- Topical Therapies
- Commonly used to manage mild flares
- Corticosteroid creams are a typical first-choice option
- Salicylic acid topicals, retinoids, and synthetic vitamin D topicals are other common therapies
- Systemic Therapies
- Reserved for patients not able to manage their symptoms with topical medications alone
- Available in oral and injectable formulations
- Injectable options target different parts of the immune system to are the underlying cause of the plaques, rather than the plaques themselves
- Phototherapy
- Exposes patients to a very specific band of light, narrow band UVB
- Can be used alone or with other topical or systemic therapies
- Â Rarely used as a first-line therapy, but a viable non-pharmacologic option
Understanding How to Cope with Psoriasis
People with psoriasis often report increased stress and anxiety. In most cases, psoriasis causes more than just cosmetic symptoms. The majority of people with psoriasis report that the condition negatively impacts their quality of everyday living. Patients should be reminded that psoriasis is a very common condition. There are a variety of treatment options available to ease the burden of the disease, as well as support groups to emotionally connect with others who also struggle with the disease.
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