Extending Our Understanding Of Psoriasis Beyond The Skin

What is Psoriasis?

• Psoriasis is an autoimmune disorder that causes the skin cells’ natural growth process to speed up. The knees, elbows, trunk, and scalp are the most common areas affected.

• Psoriasis is prevalent, incurable, and can last for a ery long time (chronic). The condition can be excruciatingly agonizing, can prevent restful sleep, and may impede mental clarity.

• There is currently no treatment for the illness, and “flares” tend to come and go in cycles, worsening for weeks and months, then settling down. Infections, minor skin trauma, and the use of certain medications are common precipitating factors for psoriasis in those who are genetically predisposed to the condition.

Cleveland Clinic. (2022, March 24). Biggest Psoriasis Triggers and How To Handle Them – Cleveland Clinic Health Essentials. Cleveland Clinic Health Essentials. Retrieved from https://health.clevelandclinic.org/psoriasis-triggers/

How is psoriasis diagnosed and treated?

● Although a primary care physician may be able to recognize psoriasis on the basis of its distinctive characteristics, a dermatologist is generally the best choice for providing a definitive diagnosis because the condition can easily be mistaken for other skin illnesses like eczema.

● There is currently no treatment for psoriasis. Applying a topical medication like topical cream or ointment to the affected area can only help alleviate the patient's symptoms temporarily.

● The affected area, severity (such as the number and extent of pain of the skin patches), and location (especially the face) of psoriasis all play a role in determining the best course of treatment.

● Topical creams and ointments, UV light therapy, and medications (such as methotrexate) are some of the available options for treatment .

● There are treatments available only for symptom management. Psoriasis patients may find some relief from adopting certain lifestyle changes and utilizing coping mechanisms.

Psoriasis is a common ailment, and many people who have it also suffer from other serious illnesses like diabetes, heart disease, and depression. Psoriatic arthritis is an inflammatory disorder that impacts the joints and can be present in certain patients with psoriasis.

Because of the similarity between psoriatic arthritis and other forms of arthritis, a rheumatologist (arthritis specialist) is often the best medical professional to make the diagnosis. To alleviate the symptoms of psoriatic arthritis, medication is typically prescribed (such as methotrexate).

Johns Hopkins Medicine. (n.d.). Psoriatic Arthritis. Johns Hopkins Medicine. Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/arthritis/psoriatic-arthritis

Common psoriasis treatment

● Steroid creams.

● Moisturizers for dry skin.

● Medication to slow skin cell production (anthralin).

● Medicated lotions or shampoos.

● Vitamin D3 ointment.

● Vitamin A or retinoid creams.

● Creams or ointments may be enough to improve the rash in small areas of your skin.

● If your rash affects larger areas, or if you also have joint pain, you’ll need other treatments. Joint pain may be a sign that you have arthritis.

NHS. (n.d.). Overview: Psoriasis. NHS. Retrieved from https://www.nhs.uk/conditions/psoriasis/

Signs and Symptoms of Psoriasis

● A patchy rash that varies widely in how it looks from person to person, ranging from little areas of dandruff-like scaling to widespread outbreaks over much of the body

● Rash colors range from pink to red with a gray scale on white skin or purple with a gray scale on brown or black skin.

● Small scale-like spots (commonly seen in children)

● Skin that is dry and cracked and may bleed

● Itching, burning or soreness

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

Types of Psoriasis

Plaque psoriasis

• Plaque psoriasis is the most prevalent form of the skin condition, and it manifests as red, scaly patches of skin that are dry and itchy. The amount could be little or large. Elbows, knees, lower back, and the scalp are common areas for their occurrence. Depending on your natural pigmentation, the patches may be a different shade. Post-inflammatory hyperpigmentation is a transitory change in skin color that can occur when the damaged area heals, especially on people with darker skin tones like brown or black.

Sullivan, D. (2018, October 1). Plaque psoriasis: Pictures, symptoms, and severity. Medical News Today. Retrieved from https://www.medicalnewstoday.com/articles/323225

Nail psoriasis

• Nails on fingers and toes can be affected by psoriasis, which can lead to pitting, unusual nail development, and discoloration. Nails affected by psoriasis are more likely to become dislodged from the nail bed (onycholysis). In extreme cases of illness, the nail may crumble.

Verywell Health. (2022, August 7). Nail Psoriasis: Causes, Symptoms, Diagnosis, Treatment. Verywell Health. Retrieved from https://www.verywellhealth.com/nail-problems-associated-with-psoriasis-2788327

Guttate psoriasis

• The prevalence of guttate psoriasis is highest in the young adult and pediatric populations. Strep throat and other bacterial infections are common causes. Small, drop-shaped, scaling patches on the trunk, arms, and legs are the strong indication of this condition.

Wightman, C. (n.d.). Guttate psoriasis: Causes, symptoms, and treatment. Medical News Today. Retrieved from https://www.medicalnewstoday.com/articles/314816

Inverse psoriasis

• Skin folds are especially vulnerable to inverse psoriasis, including those of the groin, buttocks, and breasts. It manifests as red, inflammatory spots on the skin that become worse with friction and sweating. Possible causes of this form of psoriasis include fungal infections.

Brannon, H. L. (2022, July 3). Inverse Psoriasis: Causes, Symptoms, Diagnosis, Treatment. Verywell Health. Retrieved October 20, 2022, from https://www.verywellhealth.com/inverse-psoriasis-type-1069491

Pustular psoriasis

• An extremely rare form of psoriasis, known as pustular psoriasis, manifests as well-defined blisters filled with pus. It can cover the entire palm or sole, or it can be localized in only a few spots.

Psoriasis and Psoriatic Arthritis Alliance. (n.d.). What does pustular psoriasis look like and how is it different? Psoriasis and Psoriatic Arthritis Alliance. Retrieved from https://www.papaa.org/learn-about-psoriasis-and-psoriatic-arthritis/further-resources/pustular-psoriasis/

Erythrodermic psoriasis

• Erythrodermic psoriasis, the least common form of the disease, which causes a peeling rash that can itch or burn severely and cover the entire body. Both acute and chronic forms exist.

Science Photo Library. (n.d.). Erythrodermic psoriasis - Stock Image - C046/5306. Science Photo Library. Retrieved from https://www.sciencephoto.com/media/1036387/view/erythrodermic-psoriasis

Frequently asked questions about Psoriasis

Who is at risk for psoriasis?

1. Psoriasis is quite common and can affect anyone. Although it is more common in adults, children are not immune. The risk appears to be the same for men and women.

2. In the United States, psoriasis affects about 3%vpercent of the population.

3. Family history. The ailment seems to be hereditary. An increased risk of developing psoriasis is associated with having a parent who also has the condition. Psoriasis is more likely to run in families where both parents suffer from it.

4. Smoking. Tobacco use not only raises your odds of developing psoriasis, but may also make your condition worse.

Can I get psoriasis from someone who has it?

- Psoriasis is not an infectious disease.As a result, psoriasis cannot be transmitted by direct skin-to-skin contact.

What causes psoriasis?

- Psoriasis has an unknown origin that has yet to be thoroughly explored. It's believed to be an immune system issue in which cells meant to combat infections mistakenly kill healthy skin cells. Researchers think both genetics and the surrounding environment play a role. This is not a contagious disorder.

What triggers psoriasis?

● 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 drugs and antimalarial drugs

● Rapid withdrawal of oral or injected corticosteroids

REFERENCES:

Psoriasis - Symptoms and causes. (2022, October 8). Mayo Clinic. Retrieved October 16, 2022, from https://www.mayoclinic.org/diseases-conditions/psoriasis/symptoms-causes/syc-20355840

Psoriasis | CDC. (n.d.). Retrieved October 16, 2022, from https://www.cdc.gov/psoriasis/index.htm

Psoriasis: What It Is, Symptoms, Causes, Types & Treatment. (n.d.). Cleveland Clinic. Retrieved October 16, 2022, from https://my.clevelandclinic.org/health/diseases/6866-psoriasis