Psoriasis is a common autoimmune disease caused by overreaction of the immune system. This chronic condition is characterized by flaking, inflammation and formation of thick, silvery, white or red patches of skin due to a buildup of skin cells. It affects both males and females equally. It is considered to be a genetic disease triggered by environmental factors. Though it is usually onset as an adult, 15% of its cases result before the age of 10. Its duration could be for a few years or can last a lifetime as well, depending on severity of its occurrence. It does not subside on its own and requires medical diagnosis. In India itself, it affects 10 million people while in the U.S. 7.5 million people are affected each year.
What causes Psoriasis?
Being an autoimmune disease, psoriasis takes place when problems occur in the functioning of the immune system triggering an effect in the T cells present in it. It causes the T cells to react the same way as it would while fighting an infection or during healing of a wound. The chemicals produced by the T cell causes inflammation and extensive growth of skin seen in Psoriasis.
It is still unclear what is the cause of this triggered reaction but many doctors believe that its occurrence takes place due to anxiety, stress, infection, hormonal changes or injury to skin. Medication such as antimalarials, indomethacin, lithium and quinidine too may trigger the offset of Psoriasis.
Certain factors are known to increase the likelihood of this disease. These include:
– Trauma to the skin
– Metabolic syndrome and cardiovascular disease
Statistics show that 1 in every 3 persons having a relative with the disease later begin to show symptoms of Psoriasis. A parent that had or has this disease has a 10% chance of their child developing it. If both parents have it, this percentage increases to 50%.
What are its symptoms?
Due to the continuous swift skin growth and replacement process during Psoriasis, dead and living cells collect on the skin’s surface. Common symptoms of Psoriasis include:
– Red skin patches
– Itching, soreness or burning sensations
– Small red spots
– Swollen joints
– Dry cracked skin
– Thickened and ridged nails
It must be noted that the symptoms of each type of Psoriasis differs and the above are the common among them. The various types are:
● Plaque Psoriasis: The most common form of psoriasis that appears as dry inflamed red skin plaque with silver or white scales. It might cause an itching or painful sensation and plaque can affect small or large areas of the body including hands, elbows, scalp, mouth, knees and genitals.
● Guttate Psoriasis: Primarily affecting children and young adults, Guttate psoriasis is seen as drop shaped scaly lesions triggered by bacterial infection such as strep throat. These lesions are not as thick as those of the common psoriasis and an outbreak of it may affect you just once or make way for repeated episodes that infects arms, legs, scalp and trunk.
It is triggered by stress, injury to skin, stress, tonsillitis and the use of lithium, beta-blockers, antimalarials and other types of drugs.
● Erythrodermic Psoriasis: The most uncommon form of psoriasis, this can cover one’s body completely with an itchy flaking red rash caused by imbalance of body homeostasis leading to fluid and protein loss and possibly trigger heart failure and pneumonia.
● Pustular Psoriasis: It is an uncommon form of psoriasis that affects the hands, feet or fingertips. It develops swiftly from red tender skin to pus filled blisters causing outbreaks of fever, itching and diarrhea. It is known to affect adults more than children and accounts for less than 5% of psoriasis outbreaks.
● Inverse Psoriasis:Causing smooth red patches of skin under the armpit, groin, breast or genitals, inverse psoriasis spreads through friction and sweating.
● Nail Psoriasis: It is a psoriasis that affects the finger and toe nails leading to abnormal nail growth, discoloration and loosening or crumbling of nails.
● Psoriatic Arthritis: Apart from inflammation, psoriatic arthritis causes swelling, pain and damage in joints present anywhere in the body, causing stiffness and may lead to severe permanent deformity.
Patches of psoriasis range in size. While some are small scaly and dandruff-sized, other eruptions could cover one’s whole body. The National Psoriasis Foundation had defined that:
– When 3% of the body is covered, it is termed as mild psoriasis.
– When 3 to 7% of the body is covered, it is termed as moderate psoriasis.
– When more than 10% of the body is covered, it is termed as severed psoriasis.
20% of recorded cases have been of mild to severe psoriasis while the bulk 80% have been of mild psoriasis.
Any person suffering from a persistent rash that fails to subside after over-the-counter medication must consult their doctor as it could be Psoriasis. Once diagnosis is confirmed there are 4 main types of treatments that could be used, depending on the type of Psoriasis and severity of the condition. The main aim of treatment of this disease is to remove the upper lying scales and prevent the rapid growth of the skin cells.
● Topical Treatment: This is usually the first treatment method used. It is aimed to slow down skin cell growth and reduce inflammation. Topical treatment is applied directly to the skin and is available over the counter or on presentation of a prescription. It could be steroid or non-steroid based. While calamine, benzocaine, menthol, hydrocortisone and camphor can be used to dry the skin, keratolytic products help remove the flaking layers of skin.
● Systemic Therapy: This therapy is used for patients that have moderate to severe psoriasis and can either be orally used or by digestion. Systemic Therapy includes use of cyclosporine, acitretin and methotrexate. Protein based drugs known as biologic drugs can also be used as systemic therapy. They are made of lab created living cells that target specific T cells associated with psoriasis.
● Phototherapy: It involves regular exposure of the skin to ultraviolet light under medical supervision.
Though psoriasis cannot be avoided, there are lifestyle adjustments that could be used to cope with it such as yoga to reduce stress, maintaining a balanced diet, avoiding food triggers, and regulation of cigarette and alcohol consumption.