Psoriasis

Psoriasis is a chronic skin condition that causes red, flaky, crusty patches of skin covered with silvery scales. The condition is not infectious and most people are affected only in small patches on their body.

Causes—

  • Alcohol
  • Disorder in the immune system.
  • Drugs (Lithium, Beta-blockers, Anti-malarials, NSAIDs)
  • Emotional stress
  • Family history of Psoriasis
  • Hormonal changes (Disease peaks during puberty and menopause)
  • HIV
  • Injury to the skin (skin infection, inflammation, excessive scratching)
  • Smoking
  • Strong sunlight
  • Streptococcal infections

Symptoms And Signs–

Plaque psoriasis

  • Dry, red skin lesions, known as plaques, that are covered in silver scales.
  • Usually appear on elbows, knees, scalp and lower back(can appear anywhere)
  • Plaques -itchy, sore or both
  • Skin around joints may crack and bleed(in severe cases)

Guttate psoriasis

  • Common among children and teenagers

  • Small drop-shaped sores on chest, arms, legs and scalp
  • May disappear completely,or develop into plaque psoriasis.

Scalp psoriasis

  • occur on parts of scalp or on the whole scalp
  • causes red patches of skin covered in thick silvery-white scales
  • extremely itchy/ no discomfort
  • hair loss( temporary)

Nail psoriasis

  • affects nails
  • develop tiny dents or pits
  • become discoloured

  • grow abnormally
  • nails become loose and separate from nail bed.
  • nails crumble(severe cases)

Inverse (flexural) psoriasis

  • affects areas of the skin that are in folds( armpits, groin and the skin
  • between the buttocks and under the breasts)
  • large, smooth red patches in some or all of these areas
  • worsen by friction and sweating

Pustular psoriasis

  • Generalised pustular psoriasis or von Zumbusch psoriasis.
  • pustules on a wide area of skin developing very quickly
  • pus consists of white blood cells and is not infected.
  • pustules dry and peel off within a couple of days, leaving the skin shiny and smooth
  • fever
  • chills
  • weight loss
  • fatigue

Palmoplantar pustular psoriasis

  • Pustules appear on the palms and soles
  • Pustules gradually develop into circular brown scaly spots and peel off
  • Pustules reappear every few days or weeks.

Acropustulosis

  • Pustules appear on fingers and toes.
  • Pustules burst, leaving bright red areas that may ooze or become scaly;leading to painful nail deformities.

Erythrodermic psoriasis(rare)

  • Intense itching, burning
  • Dehydration
  • Hypothermia
  • Malnutrition 

Investigations—

  • Skin biopsies
  • blood tests
  • X-rays of the affected joints (Psoriatic arthritis)

 Treatment–

Self-Care —

  • Apply heavy moisturizers after bathing.
  • Avoid scratching or excessive irritation.
  • Bath soaks with coal tar or other agents that remove scales and reduce the plaque
  • Do not use irritating cosmetics or soaps.
  • Exposure to sunlight
  • Soak in bath water with oil added
  • Use an ultraviolet B unit at home under a doctor’s supervision

Topical agents

  • Corticosteroids(Clobetasol,fluocinolone, betamethasone)
  • Vitamin D-3 derivatives (calcipotriene)
  • Coal tar
  • Anthralin(tree bark extract)
  • Retinoids(tazarotene)

Phototherapy

UV-B light therapy

PUVA

Psoralen (methoxsalen ,trioxsalen) drug with ultraviolet A (UV-A) light therapy

Ayurvedic Medicines

Cap Gajderma

Tab Tinifat

Cap Fightox

Cap Papagil

Complications–

  • Arthritis
  • Pain
  • Severe itching
  • Secondary skin infections
  • Skin cancer from light therapy

Prevention–

  • Keep the skin clean and moist
  • Take daily baths or showers
  • Avoid scrubbing too hard, because this can irritate the skin and trigger an attack.

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