PSORIASIS GUIDE

psoriasis

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●●●Psoriasis Guide

● What is Psoriasis ? back to top

Psoriasis is a recurrent skin condition and about 2% of the population is affected. Normally skin cells mature in 21 to 28 days during its rise to the skins surface where a constant invisible shedding of dead cells takes place. Psoriatic cells are believed to turn over in two to three days and even live cells reach the surface and accumulate with the dead cells in visible layers. The cause of psoriasis is not fully understood, Psoriasis can appear at any age but it often appears between the ages of 11 - 45.

Psoriasis appears as raised red patches of skin covered with silvery scales. It can occur on any part of the body often on elbows, knees and the scalp. There be irritation and itching but its not infectious. Research suggests that a genetic tendency towards Psoriasis can be triggered by injury, infection, drugs and stress.

● Types of psoriasis back to top

Plaque psoriasis - the most common form of psoriasis. It affects 80 to 90% of people with psoriasis. Plaque psoriasis typically appears as raised areas of inflamed skin covered with silvery white scaly skin. These areas are called plaques.

Flexural psoriasis - appears as smooth inflamed patches of skin. It occurs in skin folds, such as between the thigh and groin, the armpits, under an overweight stomach, and under the breasts. It is aggravated by friction and sweat, and is susceptible to fungal infections.

Pustular psoriasis - raised bumps that are filled with non-infectious pus. The skin under and surrounding pustules is red and tender. Pustular psoriasis can be localised, commonly to the hands and feet or generalised with widespread patches occurring randomly on any part of the body.

Guttate psoriasis - numerous teardrop-shaped spots. These spots of psoriasis appear over large areas of the body, such as the trunk, limbs, and scalp. Guttate psoriasis is associated with streptococcal throat infection.

Nail psoriasis - discolouring under the nail plate, pitting of the nails, lines going across the nails, thickening of the skin under the nail, and the loosening and crumbling of the nail.

Psoriatic arthritis -joint and connective tissue inflammation. Psoriatic arthritis can affect any joint but is most common in the joints of the fingers and toes. This can result in a sausage-shaped swelling of the fingers and toes known as dactylitis. Psoriatic arthritis can also affect the hips, knees and spine (spondylitis). About 10-15% of people who have psoriasis also have psoriatic arthritis.

Erythrodermic psoriasis - inflammation and exfoliation of the skin over most of the body. May be accompanied by severe itching, swelling and pain. It is often starts as plaque psoriasis, particularly following the withdrawal of treatment. This form of psoriasis can be fatal, as the extreme inflammation and exfoliation can disrupt the body's skin to perform barrier functions.

● Psoriasis treatments back to top

Topical treatments

First-line treatments include a variety of topical treatments available emollients, skin softeners When used correctly they can be very effective without the possible side effects of steroids. Keeping the skin lubricated is an important part of psoriasis care because it helps reduce redness and itching and helps the skin heal. Apply moisturizers on a daily basis to keep the skin lubricated.

Salicylic acid
Salicylic acid (see Salises) helps remove scales and is often combined with topical steroids, anthralin or tar to enhance effectiveness. Lactic acid (see Latemol) Lactic acid helps to soften the scale so moisturizing ingredients can penetrate.

Topical drug therapy

Drugs applied to the skin, such as vitamin D derivatives, tar preparations, steroids, dithranol preparations and vitamin A derivatives.

Steroids
Corticosteroids are often used in treatment for psoriasis. Topical steroid medications are easy to use, often work quickly and can be very effective in controlling mild to moderate psoriasis lesions.

Steroids are referred to as anti-inflammatory because they reduce the swelling and redness of lesions. Topical steroid medications may clear psoriasis but may not be long-lasting. When psoriasis returns there is a temptation to use a steroid for too long or improper use can increase the common side effects associated with topical steroid medications. Steroids may cause skin damage if used too often, over a long period of time but it is important not to abruptly stop steroids as this may cause the psoriasis to worsen.

Possible Steroid side effects -

Skin thinning, changes in skin pigmentation, easy bruising, stretch marks, redness and dilated surface blood vessels may occur.

Rebound Psoriasis may get worse if topical steroids are discontinued suddenly. This can be prevented by tapering off or reducing the strength of Steroids, Sesderma Lactemol can be used to slowly replace the steroid cream.

Internal absorption: Steroids can be absorbed through the skin and affect a person's whole body, including internal organs. This happens if a topical steroid is extremely misused, i.e., applied to widespread areas of skin, used over long periods of time, or with excessive occlusion of potent steroids.

Ultraviolet UVB light therapy

Phototherapy involves exposing the skin to wavelengths of ultraviolet light under medical supervision. Present in natural sunlight, ultraviolet light is an effective treatment for psoriasis. UVB penetrates the skin and slows the abnormally rapid growth of skin cells associated with psoriasis. UVB treatment involves exposing the skin to an artificial UVB light source for a set length of time on a regular program. UVB may be used alone or in combination with topical treatments. During UVB treatment psoriasis can become worse temporarily before getting better.

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