Psoriasis

Psoriasis is a constantly reoccurring autoimmune skin condition that causes rapid skin cell turnover, leading to the buildup of cells on the skin’s surface. This results in thick, scaly patches that are often red, itchy, and sometimes painful. Psoriasis can affect any part of the body, but it commonly appears on the scalp, elbows, knees, and lower back. The severity of psoriasis varies from person to person, ranging from small patches to large, widespread areas. Psoriasis is not contagious, but it can have a significant impact on quality of life.

What causes psoriasis?

Although the exact cause of psoriasis is not fully known at the moment, it is believed to have links with a combination of genetic, immune, and environmental factors. There have been several studies and research on the disease, and the highlights have been centered around these factors. 

Immune System Dysfunction

Psoriasis is primarily an autoimmune condition. That is, that the immune system mistakenly attacks the body’s own tissues. In psoriasis, T cells (a type of white blood cell) become overactive and trigger inflammation in the skin. This causes the skin cells to multiply rapidly, hence the resulting plaques and scales.

Another thing to know is that the overactive immune system’s response leads to chronic inflammation, which is responsible for both the skin symptoms of psoriasis and its association with other health conditions, such as psoriatic arthritis and cardiovascular disease.

Genetic Factors

Genetics play a significant role in the development of psoriasis. If a close family member, such as a parent or sibling, has psoriasis, the risk of developing the condition increases. Also, certain gene mutations have been linked to psoriasis, particularly those that affect immune system regulation and skin cell turnover. Researchers have identified several genes, including those in the HLA (human leukocyte antigen) complex, that are associated with an increased risk of psoriasis.

Environmental Triggers

Infections, especially streptococcal throat infections, can trigger the onset of psoriasis or cause flare-ups in those who already have the condition. This is especially true for guttate psoriasis, a type of psoriasis that is visible by small, drop-shaped lesions.

There is a condition called “Koebner phenomenon” that occurs when psoriasis develops at the site of skin trauma, such as cuts, burns, or sunburns. Cold, dry weather can worsen psoriasis symptoms by drying out the skin, while sunlight and warm weather often improve symptoms. However, excessive sun exposure leading to sunburn can trigger flare-ups.

It is important to watch out for our tendency for emotional stress because it is a well-known trigger for psoriasis flareups. Stress can weaken the immune system, leading to increased inflammation and exacerbation of psoriasis symptoms. Certain medications, such as beta-blockers (used for high blood pressure), lithium (used for bipolar disorder), and antimalarial drugs, can trigger or worsen psoriasis.

Lifestyle Factors

Smoking is a risk factor for the development of psoriasis and can make the condition more severe. It is also associated with an increased risk of developing psoriasis-related conditions, such as cardiovascular disease. This also goes for excessive alcohol consumption, which can trigger psoriasis flare-ups and may interfere with the effectiveness of treatments.

While diet does not directly cause psoriasis, certain dietary factors, such as a diet high in processed foods and low in fruits and vegetables, may exacerbate inflammation and worsen symptoms.

Symptoms of Psoriasis

Psoriasis symptoms can vary depending on the type of psoriasis, but common symptoms include:

• Raised, inflamed red patches covered with silvery-white scales (plaques). These plaques can be itchy, painful, and may crack or bleed.
• The affected skin may become dry, leading to cracks that can sometimes bleed.
• Psoriasis can cause intense itching and a burning sensation in the affected areas.
• Psoriasis can affect the nails, leading to thickening, pitting, or separation from the nail bed.
• Some people with psoriasis develop psoriatic arthritis, which causes joint pain, stiffness, and swelling.

Types of Psoriasis

Plaque Psoriasis: 

This is the most common form of psoriasis. It is formed as raised, red patches, covered with a silvery-white buildup of dead skin cells. These patches often appear on the elbows, knees, scalp, and lower back.

Guttate Psoriasis: 

They are usually small, drop-shaped lesions and often appear after a streptococcal infection. They primarily affect children and young adults.

Inverse Psoriasis: 

This type typically affects areas where skin touches skin, such as the armpits, groin, and under the breasts. Inverse psoriasis causes smooth, red patches that are worsened by friction and sweating.

Pustular Psoriasis: 

This type manifests via white pustules (blisters of noninfectious pus) surrounded by red skin. It can be localised to certain areas, such as the hands and feet, or widespread.

Erythrodermic Psoriasis: 

A rare but severe form of psoriasis that causes widespread redness, shedding of the skin, and intense itching and pain. It can be life-threatening and requires immediate medical attention.

How can psoriasis be managed?

Psoriasis is a chronic condition that cannot be cured, but it can be effectively managed with a combination of treatments and lifestyle changes. The goal of treatment is to reduce inflammation, slow down the rapid turnover of skin cells, and relieve symptoms.

Topical Treatments

• Corticosteroids are some of the most used treatments for psoriasis. These anti-inflammatory creams or ointments are commonly used to reduce redness, itching, and inflammation. They are often the first line of treatment for mild to moderate psoriasis.
• Another class of treatments are vitamin D analogues. They are topical treatments like calcipotriene that slow down skin cell growth and reduce plaque formation.
• Retinoids are very active in managing the disease. Since vitamin A derivatives help normalize skin cell turnover, topical retinoids can be effective for treating mild to moderate psoriasis.
• Other topical treatments are coal tar and salicylic acid. Coal tar is a traditional treatment that reduces scaling, itching, and inflammation. The keratolytic agent in salicylic acid helps remove scales and smoothen the skin, making other treatments more effective.

There are other major ways psoriasis can be managed. These are:

• Phototherapy (Light Therapy)
• Systemic Treatments
• Lifestyle Modifications
• Etc. 

Psoriasis is a chronic autoimmune condition that requires long-term management. While there is no cure, many treatment options are available to control symptoms and improve quality of life.