Psoriasis- Symptoms, Types, Causes, Diagnosis and Treatment Options

The rapid growth of cells on the skin’s surface and the change of skin cells is known as psoriasis. This chronic skin disease affects about 2 to 4% of the Western population. It is a persistent and long-lasting (chronic) disease, forming thick patches called plaques, silvery scales, and dry and itchy red patches on the skin’s surface. The patches can appear in varied sizes, from small to large. They generally appear on the knees, scalp, hands, elbows, feet, or lower back. This skin problem is common in adults, teenagers, and children.

What are the symptoms of psoriasis?

Psoriasis is a skin disease that may attack anyone from childhood to old, and its signs and symptoms may also vary from person to person. These are as follows:

• Red patches on the skin covered with silvery scales
• Itching, burning, or soreness
• Dry skin
• Cracked skin that may bleed
• Small scaling spots (commonly seen in children)
• Thickened or ridged nails
• Swollen and stiff joints

There are five types of psoriasis, which may vary in appearance. These are mentioned below:

1. Plaque psoriasis—This type is the most common form of psoriasis and affects around 80 percent of people, according to a report published in 2012. Plaque psoriasis is characterized by raised, inflamed, red lesions covered by silvery-white scales, and it often appears on elbows, knees, lower back, and scalp.

1. Guttate psoriasis – This skin problem is the second most common form of psoriasis and often starts suddenly in childhood. Small and pink-red spots appear on the skin of the guttate psoriasis-attacked person. Furthermore, spots appear on the torso, limbs, face, and scalp.

1. Inverse psoriasis – An overgrowth of yeast may trigger this type of psoriasis. Inverse psoriasis appears under the breasts, armpits, or groin area as red, smooth, and shiny lesions. Due to the location of inverse psoriasis, the condition may worsen from sweating and rubbing.

1. Pustular psoriasis – This type of psoriasis is characterized by white pustules surrounded by red skin and has different symptoms and severity. Pustular psoriasis is divided into zumbusch, palmoplantar pustulosis (PPP), and acro pustulosis. Pustular psoriasis may affect isolated areas of the body, such as hands and feet, or cover most of the skin’s surface.

1. Nail psoriasis—This type of psoriasis affects up to half of individuals with skin problems. It causes nail pitting, discoloration, loosening or crumbling, and colored patches or spots under the nail. There is no cure for nail psoriasis, but some treatments may improve the appearance of nails.

Causes of psoriasis:

Psoriasis is an incurable and long-term (chronic) skin condition with a variable course from periodically improving to worsening. The causes of this disease have not been fully understood, but some theories have been explained below:

1. Genetics—Genes play an important role in the development of most diseases. Around one-third of people with psoriasis report a family history of the disease. Studies have shown that identical twins have a 70% chance of developing psoriasis if the other twin has the disorder and a 20% risk of developing psoriasis for non-identical twins.
2. Lifestyle – This condition worsens due to a person’s lifestyle changes, like stress, anxiety, and changes in season and climate. People who consume excessive alcohol smoke relentlessly are at a greater risk of getting attacked by psoriasis.
3. Skin injury—There is a risk of psoriasis in areas of the skin that have been injured or traumatized. This problem is also known as the Koebner phenomenon. Moreover, vaccinations, sunburns, and scratches trigger the Koebner response.
4. Infection—If a person’s immune system is not up to par, he is at higher risk of developing psoriasis.
5. Medications—Various medications can trigger a flare-up of psoriasis. Lithium, which is used to treat psychiatric disorders, antimalarials, high blood pressure, and heart medications like Inderal or quinidine, are some of the medications that may trigger psoriasis.

Diagnosis and treatment:

After developing some psoriasis symptoms, you must check with an expert dermatologist. He/she will examine your skin based on characteristics such as scaly, red plaques, bumps, or patches that may be painful and itchy. No special blood tests are needed to make the diagnosis. For diagnosing psoriasis, below are the certain tests:

• Physical exam and medical history – Your health care professional may diagnose psoriasis by taking your medical history and examining your skin, scalp, and nails.
• Skin biopsy—In rare cases, your doctor may take a skin sample under a microscope to determine the exact type of psoriasis. This diagnostic test is performed in severe conditions.

After diagnosing the disease type, your doctor may recommend an immediate treatment plan. The doctor’s main aim is to stop the skin cells from growing quickly and to prevent infection. Psoriasis treatment is divided into three types such as:

1. Topical treatments:

This treatment is followed for mild psoriasis that involves only small skin areas. Various skin creams, lotions, and sprays are effective for this treatment. Further, doctors may use a local injection of steroids to treat psoriasis. Some of the topical psoriasis treatments include:

• Coal tar is one of the best and oldest treatments for psoriasis. It is a by-product of petroleum products. It is widely used to reduce scaling, itching, and inflammation. Some of the common side effects of this product are that it stains clothing and bedding and has a strong odor. Moreover, this product can be used in higher concentrations by prescription for the person affected by psoriasis.
• Vitamin D analogs—Calcipotriene (Dovonex) is a prescription cream or solution containing vitamin D that slows down the growth of skin cells. It is used to treat mild to moderate psoriasis.

2. Light therapy (phototherapy):

In this treatment, the infected person has to expose himself/herself to controlled amounts of natural or artificial ultraviolet light. Some of the other therapies include:

• Narrowband UVB therapy – This is one of the effective treatments; it can be used twice or thrice a week until the skin improves.
• Excimer laser – This light therapy is prescribed to treat mild to moderate psoriasis. This method directs a controlled beam of UVB light to the psoriasis plaques to control scaling and inflammation.

3. Oral or injected medications:

People who have severe psoriasis may be prescribed oral or injected drugs.

• Anthralin – The doctor prescribes this effective medication to normalize the DNA activity in skin cells. These are widely used to remove scales and make the skin look smoother. Sometimes, anthralin can irritate the skin and leave stains on the skin, clothes you wear, countertops, and bedding material.
• Methotrexate—This medication is taken orally and helps the infected person decrease the production of skin cells and suppress inflammation.

If you know anyone struggling with skin irritations, share this blog with them.