Psoriasis Pronounced "Suh-rahy-uh-sis"
Psoriasis is chronic immune-mediated disease in which scaly, red, raised patches appear on the skin. Psoriasis usually affects the elbows, knees, and scalp though it may involve any part of the skin surface including the nails and genital region. Patches of psoriasis typically become raised (i.e. plaques) with thick white scale causing itch and discomfort. The social stigma of psoriasis may be a source of embarrassment and may lead to depression. It is important to remember that psoriasis is not contagious and you cannot “catch it” from another person. Effective treatments exist and in many cases, psoriasis is completely controllable.
How did I get Psoriasis?
We are not exactly sure why someone develops psoriasis however, we do know that genetics plays an important role. Research has shown that the immune system is overactive and causes the skin cells to grow at an abnormally fast rate. Sometimes there is an obvious trigger such as an infection with group A streptococcus or a medication such as a beta blocker. In many cases, however, the trigger is unclear. You are more likely to develop psoriasis if family members have it too. Approximately 1 in 3 people have an affected family member. On average, psoriasis affects 2-3% of the population. It usually shows up between 15-35 years of age, but can develop at any time. Up to 15% of psoriasis starts during childhood.
How is Psoriasis diagnosed?
Psoriasis is usually diagnosed through examination, although sometimes, fungal culture and skin biopsy are needed to confirm the diagnosis.
How is Psoriasis treated?
A number of factors influence the treatment approach to psoriasis:
Is the psoriasis localized to just a few areas on the body? Or is it widespread?
How much body surface area is involved? Greater than 10% body surface area is considered moderate to severe.
• Are the patches of psoriasis thin or thick?
• Are the patches itchy?
• Is there involvement of the hands and feet?
• Is there involvement in the genital area, groin or armpits?
• How bothered is the person about his or her psoriasis?
•Are the nails involved?
• Is there psoriatic arthritis?
• Does the person have a history of a weakened immune system? Or a history of cancer?
Treatments for Psoriasis
No matter which therapy is chosen, it is important to remember that psoriasis is a chronic condition and that there is no cure. Fortunately, outstanding therapies exist to thoroughly control the disease.
What does Psoriasis
The classic presentation of psoriasis consists of thick white scaly inflamed plaques (i.e raised patches) located on the outer elbows and knees with involvement of the scalp and gluteal cleft. Some people have thicker patches than others. Some have more itching than others. Less common sub types include:
1. Guttate variety (tear drop sized lesions) scattered on the trunk, arms, and legs.
2. Hand and Foot variety consisting of thick skin on the palms and soles with painful splits in the skin.
Many people also experience red patches in the genital region and some develop involvement of the fingernails and toenails. Finally, 10-15% of people with psoriasis also develop arthritis.
Photos Courtesy of DermnetNZClassic red colored plaques
of psoriasis with thick white scales.
Typical thick white scaly
plaque on the elbow
Thick scaly plaque on the scalp with scratches
teardrop sized scaly red.
Patches in the armpit seen with “inverse” psoriasis
Painful thickened and split palms of hand psoriasis
Pitting, separation, and oil drop changes of nail psoriasis
Supplement to The Dermatologist, Special Issue: Psoriasis Treatment Today July 2017, pages 11-37
National Psoriasis Foundation – www.psoriasis.org
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