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29th October is observed as World Psoriasis Day every year. 

Psoriasis is a chronic inflammatory skin disorder that predominantly involves the skin, nails, and joints. It is characterized by thick, silvery scales and itchy and dry patches on the skin that are red in color. It occurs due to a change in the normal life cycle of skin cells which is thought to be triggered by the immune cells. Psoriasis is a chronic and persistent disease.  Patients with this disease can have periods when their symptoms improve followed by periods when their symptoms worsen. According to a 2016 study[1], the worldwide prevalence of psoriasis is estimated to be approximately 2–3%. A higher prevalence in males has been reported with a peak age at onset is in the third and fourth decade of life.

SIGNS AND SYMPTOMS

The signs and symptoms of this disease can differ from person to person. The most common ones are

-Red patches of skin covered with silvery scales

-Dry, cracked skin

-Itching, burning or soreness 

-Thickened, pitted or ridged nails

-Swollen and stiff joints

The patches can range from a few spots of dandruff-like scaling to major eruptions that cover large areas. Psoriasis has several types these include plaque psoriasis, nail psoriasis, scalp psoriasis, guttate psoriasis, inverse psoriasis, pustular psoriasis, erythrodermic psoriasis, and psoriatic arthritis. The most common type is plaque psoriasis which is characterized by dry, raised, red skin lesions (plaques) covered with silvery scales.

CAUSES AND TRIGGERS

The exact cause of psoriasis is not fully known. It is thought to be related to problems with the immune system, precisely the T cells. The function of T cells is to detect and destroy any foreign bodies like viruses and bacteria. But in people with psoriasis, the T cells attack healthy skin cells by mistake leading to the formation of skin lesions.

Psoriasis can worsen by various factors. These include infections, stress, dry skin, cold weather, smoking, heavy alcohol consumption and certain medications including lithium and high blood pressure medications.

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COMPLICATIONS

People who are diagnosed with psoriasis can develop various complications such as psoriatic arthritis. This is a common complication of psoriasis and causes joint damage and a loss of function in some joints. Other complications include eye complications like conjunctivitis, blepharitis, and uveitis, obesity, high blood pressure, heart diseases, stroke, Parkinson’s disease, and kidney disease.

DIAGNOSIS

In most cases, the diagnosis of psoriasis is fairly straightforward. Diagnosis is established by:

–Physical Examination

Your doctor can diagnose psoriasis by taking your medical history and examining your skin, scalp, and nails.

–Skin Biopsy

Your doctor may take a small sample of skin (biopsy) to determine the exact type of psoriasis and to rule out other skin disorders. It is a painless procedure done on an OPD basis.

TREATMENT

The treatment is aimed at:

-Stopping the skin cells from growing quickly

-Removing scales and softening the skin

Creams and ointments are used for mild to moderate psoriasis. In more advanced stages of the disease, topical creams are combined with injectable medicines, oral medicines and light therapy (phototherapy).

-Topical Medicines

These include topical steroids, Vitamin D analogues, anthralin, topical retinoids, calcineurin inhibitors, salicylic acid, coal tar, and moisturizers.

-Light Therapy (Phototherapy)

This psoriasis treatment uses natural or artificial ultraviolet light. It involves exposing your skin to controlled amounts of natural sunlight. Other forms of light therapy include the use of artificial ultraviolet A (UVA) or ultraviolet B (UVB) light either alone or in combination with medications.

-Oral And Injectable Medications

When psoriasis becomes severe, the doctor may prescribe oral or injected drugs. These include retinoids, methotrexate, cyclosporine and drugs that alter the immune system.

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LIFESTYLE CHANGES

Since psoriasis is a chronic disease, there are various measures that can be taken to keep the disease in control and to improve the quality of life. Here are some simple things that you can do:

– Take Daily Baths

Having a bath daily helps to remove scales and also calms inflamed skin. You can add bath oil, colloidal oatmeal, Epsom salts or Dead Sea salts to the water and soak. Avoid hot water and harsh soaps and use lukewarm water and mild soaps.

– Use A Moisturizer

Make sure you apply a heavy, ointment-based moisturizer while your skin is still moist. For very dry skin, oils may be preferable. During cold, dry weather, you may need to apply a moisturizer several times a day.

– Talk To Your Doctor About Sun Exposure

Exposing your skin to a controlled amount of sunlight can significantly improve lesions. But remember that too much of the sun can trigger or worsen outbreaks and increase the risk of skin cancer. Always consult your doctor for advice on sun exposure.

– Use Sunscreen

It is very important that you protect your healthy and unaffected skin from sun damage. Make sure that you apply a sunscreen with an SPF of 30 and above. Apply sunscreen generously, and reapply every two hours.

– Tackle Triggers

Try and figure out your triggers and then take steps to minimize their occurrence. For example, if smoking is causing the flare-ups, consider quitting it, if sun exposure makes your lesions worse avoid going out during peak hours or wear protective clothing.

– Avoid Alcohol

Since alcohol intake can worsen the symptoms, it is best to restrict your alcohol intake or give it up altogether.

It is important to understand that although psoriasis is a chronic disease, with the latest treatment modalities and with some personal care, you can lead a healthy and fulfilling life. Be regular with your appointments, take your medications on time and avoid triggers, and you can enjoy your life to the fullest. Stay Healthy, Stay Happy!

Recommended Reads: 

Top 10 Common Myths On Psoriasis Busted!

Living With Psoriasis: 7 Practical Ways To Manage It

References:

1. Dogra S, Mahajan R. Psoriasis: Epidemiology, clinical features, co-morbidities, and clinical scoring. Indian Dermatol Online J. 2016 Nov-Dec;7(6):471-480.

2. Sarkar R, Chugh S, Bansal S. General measures and quality of life issues in psoriasis. Indian Dermatol Online J. 2016 Nov-Dec;7(6):481-488.