Skinformation: Psoriasis

Psoriasis is a skin condition that typically causes flaky red patches of skin covered in silver scales. But are who gets it and does it ever go away?

What is psoriasis?

Psoriasis is a chronic autoimmune condition (autoimmune conditions are when the immune system induces it’s immune response when it doesn’t actually need to) that causes the rapid buildup of skin cells. This buildup of cells causes scaling on the skin’s surface.

It is a direct result of a sped-up skin production process. Typically, skin cells grow deep in the skin and slowly rise to the surface. Eventually, they fall off. The typical life cycle of a skin cell is one month.

In people with psoriasis, this production process may occur in just a few days. Because of this, skin cells don’t have time to fall off. This rapid overproduction leads to the buildup of skin cells.

Is psoriasis caused by genetics?

Most probably. After many years of research doctors can only attribute the cause of psoriasis to either genetics and/or the immune system.

In a typical body, white blood cells are deployed to attack and destroy invading bacteria and fight infections. This mistaken attack causes the skin cell production process to go into overdrive. The sped-up skin cell production causes new skin cells to develop too quickly. They are pushed to the skin’s surface, where they pile up.

This results in the plaques that are most commonly associated with psoriasis. The attacks on the skin cells also cause red, inflamed areas of skin to develop.

While this can happen randomly in your immune system, some people inherit genes that make them more likely to develop psoriasis. If you have an immediate family member with the skin condition, your risk for developing psoriasis is higher.

What are the symptoms of psoriasis?

Inflammation and redness around the scales is fairly common. Typical psoriatic scales are whitish-silver and develop in thick, red patches. Sometimes, these patches will crack and bleed.

Scales typically develop on joints, such elbows and knees. They may develop anywhere on the body, including the; hands, feet, neck, scalp and face.

Less common types of psoriasis affect the nails, the mouth, and the area around genitals.

Type of psoriasis

1. Plaque psoriasis

Plaque psoriasis is the most common type of psoriasis.

The American Academy of Dermatology (AAD) estimates that about 80 percent of people with the condition have plaque psoriasis. It causes red, inflamed patches that cover areas of the skin. These patches are often covered with whitish-silver scales or plaques. These plaques are commonly found on the elbows, knees, and scalp.

2. Guttate psoriasis

This type of psoriasis causes small pink spots and is common in childhood. The most common places for guttate psoriasis to occur include the torso, arms, and legs. These spots are rarely thick or raised like plaque psoriasis.

3. Pustular psoriasis

It causes white, pus-filled blisters and broad areas of red, inflamed skin and is more common in adults. Pustular psoriasis is typically localized to smaller areas of the body, such as the hands or feet, but it can be widespread.

4. Inverse psoriasis

Inverse psoriasis causes bright areas of red, shiny, inflamed skin. Patches of inverse psoriasis develop under armpits or breasts, in the groin, or around skinfolds in the genitals.

5. Erythrodermic psoriasis

Erythrodermic psoriasis is a severe and very rare type of psoriasis.

This form often covers large sections of the body at once. The skin almost appears sunburned. Scales that develop often slough off in large sections or sheets. It’s not uncommon for a person with this type of psoriasis to run a fever or become very ill.

Are there a treatment’s for psoriasis?

Yes! Although psoriasis has no cure it can be treated.

Topical treatments

Creams and ointments applied directly to the skin can be helpful for reducing mild to moderate psoriasis.

Topical psoriasis treatments include:

topical corticosteroids

topical retinoids

anthralin

vitamin D analogues

salicylic acid

moisturizer

Systemic medications

People with moderate to severe psoriasis, and those who haven’t responded well to other treatment types, may need to use oral or injected medications. Many of these medications have severe side effects. Doctors usually prescribe them for short periods of time.

These medications include:

methotrexate

cyclosporine (Sandimmune)

biologics

retinoids

Light therapy

This psoriasis treatment uses ultraviolet (UV) or natural light. Sunlight kills the overactive white blood cells that are attacking healthy skin cells and causing the rapid cell growth. Both UVA and UVB light may be helpful in reducing symptoms of mild to moderate psoriasis.

Most people with moderate to severe psoriasis will benefit from a combination of treatments. This type of therapy uses more than one of the treatment types to reduce symptoms. Some people may use the same treatment their entire lives. Others may need to change treatments occasionally if their skin stops responding to what they’re using.

Medication for psoriasis

If you have moderate to severe psoriasis — or if psoriasis stops responding to other treatments — your doctor may consider an oral or injected medication.

The most common oral and injected medications used to treat psoriasis include:

Biologics

This class of medications alters your immune system and prevents interactions between your immune system and inflammatory pathways. These medications are injected or given through intravenous (IV) infusion.

Retinoids

Retinoids reduce skin cell production. Once you stop using them, symptoms of psoriasis will likely return. Side effects include hair loss and lip inflammation.

People who are pregnant or may become pregnant within the next three years shouldn’t take retinoids because of the risk of possible birth defects.

Cyclosporine

Cyclosporine (Sandimmune) prevents the immune system’s response. This can ease symptoms of psoriasis. It also means you have a weakened immune system, so you may become sick more easily. Side effects include kidney problems and high blood pressure.

Methotrexate

Like cyclosporine, methotrexate suppresses the immune system. It may cause fewer side effects when used in low doses. It can cause serious side effects in the long term. Serious side effects include liver damage and reduced production of red and white blood cells

Sources:

NHS England: https://www.nhs.uk/live-well/healthy-body/common-skin-conditions/

National Psoriasis Foundation: https://www.psoriasis.org/about-psoriasis

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