What is it?
Psoriasis is an inflammatory skin disorder commonly appearing on the elbows, knees and scalp, however it can affect many parts of the body and can be widespread.
The patches can be very itchy and sore. It can affect people of any age; however it generally starts under thirty five years of age affecting both men and women equally. Around 2-3% of the population is thought to be affected.
It is not contagious and cannot be spread by coming into contact with someone who has the condition.
What are the symptoms?
Raised, reddened patches, with flaky, crusty areas on the skin, covered with silvery scales
Dry cracked skin
Inflammation and tenderness in joints
There are various types of the condition identified by the shape and spread of the patches:
Psoriasis vulgaris – the commonest form, around 80% of cases
Scalp psoriasis – either in patches or over the entire scalp
Nail psoriasis – causing pitting, discolouration or abnormal growth, needs to be distinguished from fungal nail infections to ensure correct treatment
Flexural psoriasis (inverse) – usually affecting the folds of the skin in the armpits, groin and under the breasts
There are more varieties which vary in the size of patches and location. The most serious type is the rare erythrodermic psoriasis which can cover the entire body and cause severe itching and burning and cause fluid and protein loss which can lead to further infections, dehydration and in the worse cases heart failure – this is very rare.
Psoriatic arthritis – this is where joints can be affected causing pain, tenderness and swelling.
All types of psoriasis are classified as a chronic and can be long term, returning after a clear periods. People will be affected differently with some being affected very mildly whilst for some it can seriously affect your quality of life.
What are the causes?
Epidermal cells increase too rapidly pushing young cells upwards to the surface of the skin too soon. Usually this cell renewal would take place over a three to four week cycle, in psoriasis is reduced to three to seven days. It is widely thought to be an immune system reaction where it attacks healthy cells in error.
Can be hereditary although it is unclear as to how this happens.
May be triggered by:
- Traumatic skin injuries, Sunburn
- Throat infections (a streptococcal infection could lead to guttate psoriasis which is more common in children and teenagers and mostly disappears in weeks after the infection.
- Stress, shock, bereavement
- Smoking and/or excessive alcohol intake
- Medicines – including lithium, some anti-inflammatory medicines and some beta blockers.
- Hormonal changes
- Leaky Gut Syndrome
- Some immune disorders such as HIV
In most cases a Doctor or Dermatologist can diagnose just from looking at your skin. If there is doubt over which type then a biopsy can be done and also this rules out other similar conditions such as lichen planus and seborrheic dermatitis.
- Initial treatments offered are likely to be topical corticosteroids
- Phototherapy may be offered in more serious cases where your skin is exposed to specific ultraviolet light
- Systemic treatments are used where all else is resistant and medications are taken orally or by injection. These drugs can be very strong and include some used in cancer treatment. Hospitalisation may be necessary in very acute attacks, again this is rare.
- It is useful to keep a diary of when you have attacks of psoriasis and see if you can link them to any of the trigger points listed above. If you can see a link then try to eliminate avoidable triggers such as smoking, alcohol, stressful situations and talk to your Doctor about your medications.
- Nutrition - look at your diet and talk to a nutritionist about addressing any inflammatory areas of your diet and looking at supplements that they may recommend. It may be that your psoriasis is caused by an immune response such as that in leaky gut syndrome and a nutritionist can work with you to create a diet plan to alleviate this where indicated, alongside other treatments.
- Stress - look at solutions for stress with therapies such as massage if this is comfortable, reflexology or perhaps looking at hobbies that relax you.
- Sunlight and Vitamin D -some people have found exposure to natural sunlight and/or taking vitamin D supplements can help
Arthritis, Rheumatism and Psoriasis (By Appointment Only)Paperback - by Jan de Vries