What you should know about Psoriasis

Skin Conditions occur due to various reasons and psoriasis is one of them. According to the International Federation of Psoriasis Associations (IFPA), more than 125 million people around the world are living with a psoriatic disease thereby making it a global concern. World Psoriasis Day falls on October 29 and this year’s theme focuses on treating Psoriasis seriously as it may affect patients in many ways. Hence we spoke to Consultant Dermatologist Dr. Nayani Madarasingha who shed light on the causes, symptoms and treatments of this condition. 

What is Psoriasis?
Psoriasis is a common skin condition that speeds up the life-cycle of skin cells. It causes cells to build up rapidly on the surface of the skin. The extra skin cells form scales and red patches.  

Psoriasis is a chronic disease that often surfaces and disappears. The main goal of treatment is to stop the skin cells from growing so quickly.  
“Psoriasis is not infectious,” said Dr. Nayani Madarasingha in her opening remarks. “30% of people get Psoriasis through their genes. Those with a family history of Psoriasis have a higher chance of having symptoms. Once the cells from the basal layer moves up they change their shapes during the way and once the nuclei die they become lifeless and shreds off. The entire process spans for about 28 days and it is invisible. But in some people this process happens in an abnormal way and it happens fast. So the dead skin layer accumulate on the skin. It could occur in childhood or later in life,” Dr. Madarasingha said. 

“Some of the common areas where this condition could occur include elbows, knees and even the scalp,” she continued. “Psoriasis that occurs in the scalp could have thicker scales when compared to dandruff. Sometimes it could even affect the entire body including the palms and soles,”she 
went on. 

Symptoms 
Some of the common signs and symptoms include :   

• Red patches of skin covered with thick, silvery scales,  
• Small scaling spots  
• Dry, cracked skin that bleed  
• Thickened, pitted or rigged nails   
• Swollen and stiff joints   

Variants of Psoriasis
According to Dr. Madarasingha there could be variants of Psoriasis and Pustular Psoriasis is one of them. “Here tiny pustules could appear in the form of yellow blisters. Symptoms could include fever, dry skin and it could affect the nails thereby causing discolouration or it may come to a point where nails will fall off from the nail bed,” -the doctor emphasised. 

Other types of Psoriasis include :   
Plaque psoriasis :The most common form, plaque psoriasis causes dry, raised, red skin lesions (plaques) covered with silvery scales.   
Nail psoriasis : Psoriasis can affect fingernails and toenails, causing pitting, abnormal nail growth and discoloration.   
Guttate psoriasis :This type primarily affects young adults and children. It’s usually triggered by a bacterial infection such as strep throat  
Inverse psoriasis : This mainly affects the skin in the armpits, in the groin, under the breasts and around the genitals. Inverse psoriasis causes smooth patches of red, inflamed skin that worsen with friction and sweating.   
Erythrodermic psoriasis : The least common type of psoriasis, erythrodermic psoriasis can cover your entire body with a red, peeling rash that can itch or burn intensely.  
Psoriatic arthritis : In addition to inflamed, scaly skin, psoriatic arthritis causes swollen, painful joints that are typical of arthritis. Sometimes the joint symptoms are the first or only manifestation of psoriasis or at times only nail changes are seen. Symptoms range from mild to severe, and psoriatic arthritis can affect any joint.   

Dr. Madarasingha further said that people having Psoriasis have higher risks of developing obesity and cardiovascular diseases as well. “In Sri Lanka we do find people with mild conditions, but the prevalence rate hasn’t been calculated,” she further said.   

Risk factors
Anyone can develop psoriasis, but these factors can increase your risk of developing the disease:  
Family history : This is one of the most significant risk factors. Having one parent with psoriasis increases your risk of getting the disease, and having two parents with psoriasis increases your risk even more.  
Viral and bacterial infections : People with HIV are more likely to develop psoriasis than people with healthy immune systems are. Children and young adults with recurring infections, particularly strep throat, also may be at increased risk.  
Stress : Stress can impact your immune system and high stress levels may increase your risk of psoriasis.  
Obesity : Excess weight increases the risk of psoriasis. Lesions (plaques) associated with all types of psoriasis often develop in skin creases and folds.  
Smoking : Smoking tobacco not only increases your risk of psoriasis but also may increase the severity of the disease. Smoking may also play a role in the initial development of the disease.  

Treatment 
According to the dermatologist, treatments depend on the severity of the condition. “There is no cure for Psoriasis but it could be treated. If the condition is severe where it has affected a greater surface area of the body we recommend oral drugs. In severe instances we also recommend phototherapy where we use UV light to treat the condition. Even injections could be given. Sometimes it appears during a certain period and then goes off. In such instances people can stop medication once it’s fully recovered,” the doctor said.