Our skin is a remarkable testament to our overall health and well-being. Unfortunately, some people have to deal with chronic skin conditions that affect their physical and mental well-being. One such condition is psoriasis. Psoriasis is characterised by red, itchy, and scaly skin that can cause great discomfort. While no cure is available, various treatments effectively alleviate symptoms. But what causes it, what does it signify? This article will answer all your questions about psoriasis.
What Is Psoriasis?
So, what is psoriasis? Psoriasis is a long-lasting skin condition with an abnormal multiplication of skin cells, up to 10 times faster than the usual rate. Consequently, this leads to the formation of raised patches on the skin. They can appear red, purplish, or brown and can grow anywhere on the body. It is important to note that psoriasis is not contagious and cannot be transferred from one person to another. However, it can occur among family members.
Symptoms of Psoriasis
Symptoms of psoriasis may range from mild to severe, depending on the type of psoriasis, location, and severity. Listed below are some common symptoms:
This condition features recurring red, inflamed patches covered with silvery scales, often found on elbows, knees, and the torso. These patches can also develop on the scalp, palms, soles, and genital area, causing severe discomfort and irritation. The appearance of lesions may vary based on an individual’s skin tone, ranging from pink or red to purple or dark brown.
Nail psoriasis alters the nails, leading to pitting, discolouration, and thickening, often causing separation from the nail bed and discomfort. This condition may also result in nail ridges and increased brittleness, impacting appearance and physical well-being. These changes may cause pain and difficulty in performing everyday tasks involving the hands and feet.
Other psoriasis symptoms include dry and cracked skin and stiffness, rashes that flare up for a few weeks or months and then subside, and small scaling spots (commonly seen in children). This can be quite painful, interfering with sleep and making it hard to focus on tasks.
Types of Psoriasis
Listed below are the different types of psoriasis, which differ from each other by their signs and symptoms:
Erythrodermic psoriasis, or exfoliative psoriasis, is a rare, severe form of psoriasis causing red or purplish skin and shedding. It’s a medical emergency, often requiring hospitalisation due to potential temperature regulation issues. It can result due to poorly controlled plaque psoriasis, sunburn, infection, alcohol use disorder, stress, or if a person abruptly stops using certain psoriasis medications.
Psoriatic arthritis leads to joint pain, stiffness, and swelling. In India, an estimated 0.25% of individuals with psoriasis also experience this condition, with a higher incidence among those already diagnosed with psoriasis. This condition significantly impacts mobility and quality of life, requiring medical and lifestyle interventions.
- Flexural or inverse psoriasis
Inverse psoriasis occurs in skin folds, appearing red or purple and often shiny, due to reduced skin shedding in moist areas. Frequently mistaken for fungal or bacterial infections, it can cause great discomfort due to skin-on-skin contact. Most individuals with inverse psoriasis also experience another form of psoriasis elsewhere on their body, resulting in discoloured, shiny lesions in skin folds under the breasts, armpits, and groin.
On light skin, lesions appear bright red, while on darker skin, they appear darker than the surrounding skin, often purplish or brown.
Pustular psoriasis, whether affecting specific areas or the entire body, shows white pustules surrounded by red or darkened skin. It can be life-threatening, and individuals may undergo cycles of pustules and remission.
Causes of Psoriasis
Psoriasis is thought to result from a blend of genetic and environmental factors. It is believed to involve a malfunctioning immune system, where the body’s infection-fighting cells mistakenly attack healthy skin cells. Although genetics is implicated in psoriasis, its inheritance pattern is intricate, often skipping generations.
Environmental triggers, such as infections (e.g., strep throat), weather conditions (e.g., cold, dry climates), and skin injuries (e.g., cuts, sunburns), can provoke or worsen symptoms. Lifestyle choices like smoking, heavy alcohol consumption, and second-hand smoke exposure are counted among psoriasis causes. Certain drugs, like lithium, high blood pressure drugs, antimalarials, and specific antibiotics, can exacerbate symptoms. Abrupt withdrawal of oral or injected corticosteroids can also contribute to the development of psoriasis.
Risk Factors Associated with Psoriasis
Psoriasis can affect anyone, but certain risk factors may increase an individual’s susceptibility to developing the condition. Genetics is a significant risk factor for psoriasis. A family history of the condition increases the likelihood of an individual developing psoriasis. Studies have shown that certain genes are associated with psoriasis, although it is not solely determined by genetics.
Additional risk factors for psoriasis include certain medical disorders and lifestyle decisions like binge drinking or smoking. Psoriasis is more common in people with autoimmune diseases, like type 2 diabetes and rheumatoid arthritis. Obesity is also seen to be associated with a higher incidence of psoriasis. Drinking excessively poses a significant risk, particularly for young men. Additionally, alcohol consumption can hinder the effectiveness of treatments. Engaging in smoking can also increase your chances of developing psoriasis by double. Moreover, smoking hampers the ability to alleviate symptoms.
Diagnosis of Psoriasis
When diagnosing psoriasis, a doctor conducts a thorough physical exam, checking for plaques on specific areas such as the scalp, ears, elbows, knees, belly button, and nails. The family history of psoriasis is also considered. Lab tests, including biopsies, may be performed to rule out skin infections. A dermatologist examines the skin, nails, and scalp for signs of psoriasis, inquiring about symptoms, nail and joint problems, family history, and recent life changes. In some cases, a skin biopsy is taken for microscopic examination. This comprehensive approach helps confirm the presence of psoriasis, guiding the development of an effective treatment plan.
Stages of Psoriasis
Psoriasis can vary in severity, with different levels of involvement observed. In milder cases, psoriasis plaques cover less than 3% of the body. Moderate psoriasis involves 3–10% coverage, while severe psoriasis extends beyond 10%. Recognising the condition’s progression helps guide appropriate treatment strategies for symptom management.
Treatment of Psoriasis
Psoriasis treatments vary, aiming to inhibit new skin cell growth or alleviate itching and dryness. The doctor will personalise a treatment plan, considering factors such as rash size and location, age, overall health, and other pertinent details. Standard therapies encompass a range of approaches tailored to individuals’ needs.
Psoriasis medication options include:
- Steroid creams
- Prescription topical cream
- Moisturisers for dry skin
- Salicylic acid
- Coal tar (used for scalp psoriasis, available in various forms like lotions, creams, foams, shampoos, and bath solutions)
- Vitamin D-based cream or ointment (a potent version prescribed by doctors, as regular vitamin D in food and supplements doesn’t have the same effect)
- Retinoid creams
- Calcineurin inhibitors
- Anthralin treatment
For moderate to severe psoriasis, treatments encompass various options:
- Methotrexate: In severe cases, this medication necessitates close monitoring due to potential bone marrow, liver, and lung issues, requiring regular lab tests, chest X-rays, and possibly a liver biopsy.
- Retinoids: Available in different forms, these drugs, akin to vitamin A, carry significant side effects, including congenital disabilities, making them unsuitable for pregnant or planning women.
- Cyclosporine: Used for severe, unresponsive cases, this immune system suppressant requires vigilant health monitoring due to potential kidney damage and elevated blood pressure.
- Biologic treatments: These therapies offer a specialised approach to treatment by targeting the overactive immune response in psoriasis
Light therapy, also known as phototherapy, involves using ultraviolet light to slow down the growth of skin cells in psoriasis patients. One form of treatment is psoralen plus ultraviolet-A radiation (PUVA), which combines a medication called psoralen with a particular form of UV light.
Some may also consider alternative therapies or home remedies to help alleviate psoriasis symptoms. These include applying aloe vera to affected areas or taking oat baths for skin relief.
Living With Psoriasis and Managing It
Here are a few tips for people with psoriasis:
- Avoid trigger foods
Although no specific foods cause psoriasis, certain ingredients can worsen the condition. This includes dairy, refined carbs, saturated and trans fats, added sugar, and gluten.
- Dealing with high costs
The management and treatment of psoriasis can be extremely costly. Expensive medications, doctor visits, missed work, and therapy can all add up. Due to the unpredictable nature of medical costs, it pays to invest in robust health insurance that can relieve financial worries during times of need and provide the backing required to face health challenges with greater ease.
- Management at home
A person can do a few things to manage this skin condition better. This includes:
- Bathing regularly using a gentle cleanser
- Getting sunlight adequate
- Engaging in daily exercise,
- Get good sleep
- Practicing relaxation techniques like meditation
- Keeping a journal of potential triggers
- Prioritise mental health
Psoriasis can cause anxiety, depression, sexual dysfunction, substance abuse, sleep disturbances, disordered eating habits, and, in even rare cases, psychosis, which can severely impact mental health. Consult your physician, who can recommend approaches for addressing what you may be experiencing.
Conclusion
Psoriasis can be quite difficult to deal with, particularly because it affects the skin, which is often a root source of our insecurities. So, if you’ve been recently diagnosed with it, have been living with it for some time now, or just wanted to know about it better, we hope this article has helped. Understanding the various causes, symptoms, and treatment options for psoriasis is important to cope with this skin disease properly. If you are afflicted with this disease, remember to reach out to healthcare professionals, connect with others who also have psoriasis, and take care of your physical and mental health.
Disclaimer: The information provided in this blog is for educational and informational purposes only. It is not intended as a substitute for professional advice, diagnosis, or treatment. Please consult your general physician or another certified medical professional for any questions regarding a medical condition. Relying on any information provided in this blog is solely at your own risk, and ICICI Lombard is not responsible for any effects or consequences resulting from the use of the information shared.