Introduction: 

It is a chronic disease where bodies immunity acts against self to cause the skin to multiply at a much faster pace which causes new skin to form in 3-6 days rather than 30-40 days.

The newly formed cells are stacked up in areas as patches which causes the scaling in psoriasis. The main reason to get psoriasis in genetic.

It is a non-communicable disease and is not spread by touch or through the air.

Types of psoriasis:

  • Most common variant is plaque type called Psoriasis Vulgaris  
  • Localized variants like:
    - Nail and Scalp psoriasis
    - Palmoplantar psoriasis in the palms and soles
    - Inverse psoriasis in the flexures 
  • Widespread like:
    - Guttate
    - Pustular
    - Erythroderma 

Some people get a combination of these. Some have a transformation of types. 

Causes of psoriasis: 

  • Usually, people who get psoriasis have a family history.
  • Research has shown that it is a persons' immune system and genes that play an important role in getting psoriasis.  
  • It is an interplay of genes that causes psoriasis.  
  • There are certain triggers for psoriasis:
    - A sore throat with streptococcal bacteria
    - Stress
    - Cold dry weather as in winters
    - Certain medications like lithium, antimalarials
    - Certain areas of cuts.

Age Group:

  • It can affect people of any age group although it usually is seen before 40’s mostly between 15 and 30’s.
  • Another common time is between 50 and 60 years.
  • In infancy and childhood, guttate psoriasis is more common.

Signs and Symptoms:

What you see and feel depends on what type of psoriasis you have -

  • Plaque Psoriasis: Raised thick red or brown patches with scales usually whitish or silvery. It can appear anywhere on the skin but most commonly on the elbows, knees, scalp, lower back. There can be itching. Patches can vary in size and shape.In some cases nail can be involved with small pits, nails breaking, nails thickening.              
  • Guttate Psoriasis: Smaller lesions on the face neck, scalp, trunk, arms legs and sometimes in children. It is more common in children and most cases occur after a sore throat infection. It clears in some without treatment. 
  • Pustular psoriasis: When small pus-filled lesions on reddish base and fever in some.
  • Inverse psoriasis: When there is red patches sometimes raw in the flexures like the groins, armpits under the breasts in women. 
  • Erythrodermic psoriasis: In some, the entire body gets involved with redness and scaling over almost the entire body. The body temperature increases in some individuals. This is one type of psoriasis which can be dangerous to life.  
  • Rarely patients can have psoriatic arthritis.

Diagnosis:

It is sometimes clinically very evident although a confirmatory diagnosis can be done by removing a small piece of skin from the diseased skin.

Treatment:

Treatment is mainly aimed at improving the quality of patient life by improving the symptoms and keeping the skin clear.

The treatments range from:

  • Topicals which can be applied to skin to bring relief and clearing of lesions
  • Phototherapy and lasers which help in disease control but along with topicals mostly. 
  • Systemic treatments ranging from weekly one tablets to biologicals which help in the treatment of the disease.

There is a lot of research going on about this disease and its medications. 

Although psoriasis is a disease that can be kept under control, there is a need for the doctor and patient to work together to help design a treatment that will help the patient lead a healthy disease free period.