IS IT JUST A RASH OR DO YOU HAVE PSORIASIS? A CLOSE LOOK AT PSORIASIS AND ITS DIFFERENT TYPES.
Psoriasis is a skin disorder that causes skin cells to multiply up to 10 times faster than normal. This makes the skin build up into bumpy red patches covered with white scales. They can grow anywhere, but most appear on the scalp, elbows, knees, and lower back. Psoriasis can’t be passed from person to person. It does sometimes happen in members of the same family. Psoriasis usually appears in early adulthood. For most people, it affects just a few areas. In severe cases, psoriasis can cover large parts of the body. The patches can heal and then come back throughout a person’s life.
What are the clinical features of Psoriasis?
The symptoms of psoriasis vary depending on the type you have. Some common symptoms for plaque psoriasis — the most common variety of the condition — include:
- Plaques of red skin often covered with silver-colored scales. These plaques may be itchy and painful, and they sometimes crack and bleed. In severe cases, the plaques will grow and merge, covering large areas.
- Disorders of the fingernails and toenails, including discoloration and pitting of the nails. The nails may also crumble or detach from the nail bed.
- Plaques of scales or crust on the scalp.
People with psoriasis can also get a type of arthritis called psoriatic arthritis. It causes pain and swelling in the joints. The National Psoriasis Foundation estimates that around 10% to 30% of people with psoriasis also have psoriatic arthritis.
What are the Different patterns of Psoriasis?
Other types of psoriasis include:
- Pustular psoriasis, which causes red and scaly skin with tiny pustules on the palms of the hands and soles of the feet.
- Guttate psoriasis, which often starts in childhood or young adulthood, causes small, red spots, mainly on the torso and limbs. Triggers may be respiratory infections, strep throat, tonsillitis, stress, injury to the skin, and taking antimalarial and beta-blocker medications.
- Inverse psoriasis, which makes bright red, shiny lesions that appear in skin folds, such as the armpits, groin, and under the breasts.
- Erythrodermic psoriasis, which causes fiery redness of the skin and shedding of scales in sheets. It’s triggered by severe sunburn, infections, certain medications, and stopping some kinds of psoriasis treatment. It needs to be treated immediately because it can lead to severe illness.
What really causes Psoriasis?
No one knows the exact cause of psoriasis, but experts believe that it’s a combination of things. Something wrong with the immune system causes inflammation, triggering new skin cells to form too quickly. Normally, skin cells are replaced every 10 to 30 days. With psoriasis, new cells grow every 3 to 4 days. The buildup of old cells being replaced by new ones creates those silver scales. Psoriasis tends to run in families, but it may be skip generations. For instance, a grandfather and his grandson may be affected, but not the child’s mother.
Things that can trigger an outbreak of psoriasis include:
- 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
- Smoking and exposure to secondhand smoke
- Heavy alcohol consumption
- Certain medications — including lithium, high blood pressure medications and antimalarial drugs
- Rapid withdrawal of oral or systemic corticosteroids
Anyone can develop psoriasis. About a third of instances begin in the pediatric years. These factors can increase your risk:
- Family history- The condition runs in families. Having one parent with psoriasis increases your risk of getting the disease, and having two parents with psoriasis increases your risk even more.
- Stress- Because stress can impact your immune system, high stress levels may increase your risk of psoriasis.
- Smoking- Smoking tobacco not only increases your risk of psoriasis but also may increase the severity of the disease. Smoking may also play a role in the initial development of the disease
How is Psoriasis diagnosed?
Physical exam- It’s usually easy for your doctor to diagnose psoriasis, especially if you have plaques on areas such as your:
- Belly button
Your doctor will give you a full physical exam and ask if people in your family have psoriasis.
Lab tests- The doctor might do a biopsy — remove a small piece of skin and test it to make sure you don’t have a skin infection. There’s no other test to confirm or rule out psoriasis.
Treatment options for Psoriasis
Luckily, there are many treatments. Some slow the growth of new skin cells, and others relieve itching and dry skin. Your doctor will select a treatment plan that is right for you based on the size of your rash, where it is on your body, your age, your overall health, and other things. Common treatments include:
- Steroid creams.
- Moisturizers for dry skin.
- Coal tar (a common treatment for scalp psoriasis available in lotions, creams, foams, shampoos, and bath solutions).
- Cream or ointment (a strong kind ordered by your doctor. Vitamin D in foods and pills has no effect.)
- Retinoid creams
- Light therapy is a first-line treatment for moderate to severe psoriasis, either alone or in combination with medications. It involves exposing the skin to controlled amounts of natural or artificial light. Repeated treatments are necessary. Talk with your doctor about whether home phototherapy is an option for you.
- Oral or injected medications-If you have moderate to severe psoriasis or other treatments haven’t worked, your doctor may prescribe oral or injected (systemic) drugs. Because of the potential for severe side effects, some of these medications are used for only brief periods and might be alternated with other treatments
Complications that may arise as a result of Psoriasis
If you have psoriasis, you’re at greater risk of developing other conditions, including:
- Psoriatic arthritis, which causes pain, stiffness and swelling in and around the joints
- Eye conditions, such as conjunctivitis, blepharitis and uveitis.
- Type 2 diabetes.
- High blood pressure.
- Cardiovascular disease.
- Other autoimmune diseases, such as celiac disease, sclerosis and the inflammatory bowel disease called Crohn’s disease
- Mental health conditions, such as low self-esteem and depression.
Although doctors choose treatments based on the type and severity of psoriasis and the areas of skin affected, the traditional approach is to start with the mildest treatments — topical creams and ultraviolet light therapy (phototherapy) — in people with typical skin lesions (plaques) and then progress to stronger ones only if necessary. People with pustular or erythrodermic psoriasis or associated arthritis usually need systemic therapy from the beginning of treatment. The goal is to find the most effective way to slow cell turnover with the fewest possible side effects.