About psoriasis

Psoriasis is a chronic, persistent condition. Prevalent among adults, psoriasis varies in severity. According to the Mayo Clinic, psoriasis can range from being a nuisance to a debilitating skin disorder, particularly when it’s associated with arthritis. Between 10 to 30 percent of individuals with psoriasis also have psoriatic arthritis, according to the National Psoriasis Foundation (NPF).

Types of psoriasis

There are many forms of psoriasis that vary based on symptoms, severity and the location of outbreaks. Some forms of psoriasis may affect only the fingernails or scalp, while others may cover larger areas of the body.

Typically, an individual will only have one type at a time, but some people can suffer from multiple types. Also, one type may occasionally transition into another.

• Plaque-type psoriasis: Is the most common form of psoriasis, affecting about 80 percent of psoriasis patients. It’s characterized by large red patches that are covered with a silvery white scale made up of dead skin cells. Commonly affected areas include: the scalp, knees, elbows, lower back and buttocks. It can sometimes transition into pustular psoriasis.

• Pustular psoriasis: Characterized by scattered, pus-filled, white areas surrounded by red skin. It may cover only certain areas, such as the hands and feet, or spread over most of the body. It’s often caused by medications, withdrawal from certain medications, topical treatments, UV light or infections.

• Guttate psoriasis: Usually begins early in life in kids or young adults. It’s characterized by small lesions in a guttate or "raindrop" appearance. These lesions are red and scaly and widely distributed on the skin. Causes include various medications or conditions such as tonsillitis, stress, upper respiratory infections and strep throat.

• Erythrodermic psoriasis: Widespread redness of the body, accompanied by itching, swelling and severe pain. It’s a serious form of psoriasis that may require hospitalization, and can lead to protein and fluid loss and potential infections such as pneumonia or congestive heart failure.

• Inverse psoriasis: Occurs in skin folds that become irritated due to rubbing and sweating, and is particularly common in people who are morbidly obese. It appears red and shiny, without the white scales common in other types of psoriasis. Inverse psoriasis is often found in the skin folds of the groin, armpits or buttocks. Topical steroids may be prescribed to cure the infection and allow the skin to heal.

Primary cause

Psoriasis tends to run in families. According to NPF, a child has a 10 percent chance of acquiring psoriasis if one parent has it, and a 50 percent chance if both parents have the condition.

The exact cause, however, is unknown. According to the American Academy of Dermatology (AAD), “the immune system plays a key role.” It activates a type of white blood cell called the T cells, which initiate inflammation, causing the skin to grow quickly. This results in an entirely new skin surface once every four to seven days. In normal skin, the skin cells are renewed every 28 days. When an area of skin is cut or injured, new skin cells are produced at a much faster rate to facilitate healing, often as quickly as a week.

The accelerated growth of new skin cells in psoriasis can lead to complications. Because new skin cells form so rapidly, they can't be sloughed off quickly enough, causing them to cluster together and develop whitish scales that resemble dandruff.

Triggers

Various triggers can cause an episode of psoriasis. Common triggers include: stress, skin injuries, medications, allergies, diet, excessive sun exposure, alcohol, smoking and weather. Up to 80 percent of patients experiencing episodes report having a recent stressful event, such as a new job or the loss of a loved one, according to WebMD.

Treatment

There’s no cure for psoriasis, but many treatments can effectively reduce the symptoms. Treatment varies widely depending on the specific type of psoriasis, your age, health and lifestyle, according to AAD. Mild to moderate psoriasis typically responds well to topical treatments such as corticosteroids, retinoids and vitamin D derivatives (e.g., Calcipotriene).

For severe psoriasis, dermatologists typically prescribe oral medications (e.g., oral retinoids, Methotrexate and Cyclosporine) along with topical treatments. Other helpful treatments may include the use of antibiotics for guttate psoriasis or ultraviolet light therapy for other types.

If you think you might have psoriasis, consult a dermatologist for a proper evaluation and treatment options.

See also:

Help for Hives

Eczema

Caring for Sensitive Skin

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