Psoriasis

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Overview

Psoriasis is a non-contagious inflammatory disease. The main symptoms are reddish, scaly patches of skin that may itch.

It is a chronic condition that is typically associated with periods of more severe skin problems (flare-ups) followed by periods of milder skin problems or none at all. Various treatments can relieve the symptoms, but there is no cure for psoriasis.

Its severity can vary quite a lot. In some people it is bothersome more than anything else, and they can cope with it quite well. Others feel that it has a major effect on their quality of life, since the treatment and skin care can take a long time. Many people are also unhappy about having visible reddened and scaly skin patches – especially if they are on exposed areas of their body.

Sometimes the inflammation that is causing the psoriasis affects other parts of the body too, such as the joints or nails.

Symptoms

Common signs and symptoms of psoriasis include:


A patchy rash that varies widely in how it looks from person to person, ranging from spots of dandruff-like scaling to major eruptions over much of the body

Rashes that vary in color, tending to be shades of purple 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

Cyclic rashes that flare for a few weeks or months and then subside

There are several types of psoriasis, each of which varies in its signs and symptoms:


Plaque psoriasis. The most common type of psoriasis, plaque psoriasis causes dry, itchy, raised skin patches (plaques) covered with scales. There may be few or many. They usually appear on the elbows, knees, lower back and scalp. The patches vary in color, depending on skin color. The affected skin might heal with temporary changes in color (post inflammatory hyperpigmentation), particularly on brown or Black skin.

Nail psoriasis. Psoriasis can affect fingernails and toenails, causing pitting, abnormal nail growth and discoloration. Psoriatic nails might loosen and separate from the nail bed (onycholysis). Severe disease may cause the nail to crumble.

Guttate psoriasis. Guttate psoriasis primarily affects young adults and children. It's usually triggered by a bacterial infection such as strep throat. It's marked by small, drop-shaped, scaling spots on the trunk, arms or legs.

Inverse psoriasis. Inverse psoriasis mainly affects the skin folds of the groin, buttocks and breasts. It causes smooth patches of inflamed skin that worsen with friction and sweating. Fungal infections may trigger this type of psoriasis.

Pustular psoriasis. Pustular psoriasis, a rare type, causes clearly defined pus-filled blisters. It can occur in widespread patches or on small areas of the palms or soles.

Erythrodermic psoriasis. The least common type of psoriasis, erythrodermic psoriasis can cover the entire body with a peeling rash that can itch or burn intensely. It can be short-lived (acute) or long-term (chronic).

Causes

Psoriasis occurs when skin cells are replaced more quickly than usual. It's not known exactly why this happens, but research suggests it's caused by a problem with the immune system.


Your body produces new skin cells in the deepest layer of skin. These skin cells gradually move up through the layers of skin until they reach the outermost level, where they die and flake off. This whole process normally takes around 3 to 4 weeks.


However, in people with psoriasis, this process only takes about 3 to 7 days. As a result, cells that are not fully mature build up rapidly on the surface of the skin, causing flaky, crusty patches covered with scales.


Problems with the immune system

Your immune system is your body's defence against disease and it helps fight infection. One of the main types of cell used by the immune system is called a T-cell.


T-cells normally travel through the body to detect and fight invading germs, such as bacteria. But in people with psoriasis, they start to attack healthy skin cells by mistake.


This causes the deepest layer of skin to produce new skin cells more quickly than usual, triggering the immune system to produce more T-cells.


It's not known what exactly causes this problem with the immune system, although certain genes and environmental triggers may play a role.


Genetics

Psoriasis runs in families, so you may be more likely to get psoriasis if you have a close relative with the condition, but the exact role genetics plays in psoriasis is unclear.


Research has shown that many different genes are linked to the development of psoriasis, and it's likely that different combinations of genes may make people more vulnerable to the condition.


However, having these genes does not necessarily mean you'll develop psoriasis.


Psoriasis triggers

Many people's psoriasis symptoms start or get worse because of a certain event, called a trigger. Knowing your triggers may help you avoid a flare-up.

Common psoriasis triggers include:


an injury to your skin, such as a cut, scrape, insect bite or sunburn – this is called the Koebner response

drinking excessive amounts of alcohol

smoking

stress

hormonal changes, particularly in women – for example, during puberty and the menopause

certain medicines – such as lithium, some antimalarial medicines, anti-inflammatory medicines including ibuprofen, and ACE inhibitors (used to treat high blood pressure)

throat infections – in some people, usually children and young adults, a form of psoriasis called guttate psoriasis develops after a streptococcal throat infection, but most people who have streptococcal throat infections don't develop psoriasis

other immune disorders, such as HIV, which cause psoriasis to flare up or appear for the first time

Risk factors

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.

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Complications

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

Temporary skin color changes (post-inflammatory hypopigmentation or hyperpigmentation) where plaques have healed

Eye conditions, such as conjunctivitis, blepharitis and uveitis

Obesity

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

Prevention

Use Moisturizing Lotions. ...

Take Care of Your Skin and Scalp. ...

Avoid Dry, Cold Weather. ...

Use a Humidifier. ...

Avoid Medications That Cause Flare-Ups. ...

Avoid Scrapes, Cuts, Bumps, and Infections. ...

Get Some Sun, But Not Too Much. ...

Zap Stress.