About Psoriasis

Psoriasis is a common, chronic skin disease. A person with psoriasis generally has elevated plaques of raised red skin covered with thick silvery scales. Psoriasis is usually found on the elbows, knees, and scalp but can often affect the legs, trunk, and nails. Psoriasis may be found on any part of the skin.


"PSOROS" means ROUGH

In Greek “psoros” meaning rough. Technically Psoriasis is defined chronic, non-contagious, multisystem, inflammatory skin disorder, an autoimmune disease with a genetic predisposition which involves hyperproliferation of the keratinocytes in the epidermis (upper most layer of skin).



Psoriasis Patients

Patients with psoriasis experience regeneration of the epidermis every two to four days, in contrast to the 28-day cycle in patients with normal skin. Psoriasis is a long-lasting autoimmune disease which is characterized by patches of abnormal skin. These skin patches are typically red, itchy, and scaly. They may vary in severity from small and localized to complete body coverage.


Psoriasis Affects

It typically affects the outside of the elbows, knees or scalp, though it can appear on any location. Psoriasis is associated with other serious health conditions, such as diabetes, heart disease and depression. If you develop a rash that doesn't go away with an over-the-counter medication, you should consider contacting your doctor.


Psoriasis is NOT Contagious

Psoriasis is not an infection and therefore is not contagious. Touching the affected skin and then touching someone else will not transmit psoriasis. However, the red scaly skin can become infected, especially when there are fissures.


Psoriasis Causes and Risk Factors

The immune system plays a key role in psoriasis. In psoriasis, a certain subset of T lymphocytes (a type of white blood cell) abnormally trigger inflammation in the skin as well as other parts of the body. These T cells produce chemicals that cause skin cells to multiply abnormally quickly, as well as producing changes in small skin blood vessels, which result ultimately an elevated scaling plaque of psoriasis.

Environmental factors such as smoking, sunburns, streptococcal sore throat, and alcoholism may affect psoriasis by increasing the frequency of flares. Injury to the skin has been known to trigger psoriasis. For example, a skin infection, skin inflammation, or even excessive scratching can trigger psoriasis. A number of medications have been shown to aggravate psoriasis like eg: β-Blockers, lithium and ACE inhibitors. Stress injury to uninvolved skin, alcohol, red meat can also trigger psoriasis to greater extent.

Psoriasis flare-ups can last for weeks or months. Psoriasis can go away for a time and then return. Plaque psoriasis is the most common type of psoriasis and is characterized by red skin covered with silvery scales and inflammation. Plaques of psoriasis vary in shape and frequently itch or burn.


Psoriasis Statistics

Overall, approximately 2-3% of people are affected by psoriasis worldwide .It can be inferred that in India, the prevalence of psoriasis varies from 0.44 to 2.8%, it is twice more common in males compared to females, and most of the patients are in their third or fourth decade at the time of presentation.
A study shows: The point prevalence in India is 8%. All four zones had equal prevalence. Chronic plaque type psoriasis was the most common type of psoriasis.
Up to 10% of people with plaque psoriasis also have psoriatic arthritis. Individuals with psoriatic arthritis have inflammation in their joints that could result in permanent joint damage if not treated aggressively. Recent information indicates that most patients with psoriasis are also predisposed to obesity, diabetes, and early cardiovascular diseases. It is now becoming apparent that psoriasis is not just a skin disease but can have widespread systemic effects.

Sometimes plaque psoriasis can evolve into more severe disease, such as pustular or erythrodermic psoriasis. In pustular psoriasis, the red areas on the skin contain blisters with pus. In erythrodermic psoriasis, a wide area of red and scaling skin is typical, and it may be itchy and uncomfortable.


Reference

  1. Kumar, et al. : Epidemiology of psoriasis, vitiligo and atopic dermatitis. Indian Dermatology
  2. Online Journal - 2014 - Volume 5 - Supplement Issue 1
  3. Dogra S, Yadav S. Psoriasis in India: Prevalence and pattern. Indian J Dermatol Venereol Leprol 2010;76:595-601.

Psoriasis Types

Plaque Psoriasis

  • It also called as “Psoriasis Vulgaris”
  • Characterized by raised, inflamed lesions covered with a silvery white scale
  • Scale may be scraped away to reveal
  • Plaques exhibit :
    Auspitz sign (bleeding after the removal of scale) and
    Koebner phenomenon (lesions induced by trauma)
  • Most common on the extensor surfaces of the knees, elbows, scalp, and trunk
  • Occurring in about 80% of all psoriasis patients

Pustular Psoriasis

  • Uncommon
  • Sterile pus boils (pustules) appearing on the palms and soles or diffusely over the body
  • Pustules filled with pus that is non-infectious
  • Skin adjoining pustules is tender and red

Nail Psoriasis

  • May cause pits on the nails
  • Often become thickened and yellowish in color
  • Formation of lines across the nails
  • Nails may separate from the nail bed

Erythrodermic Psoriasis

  • Least common type of Psoriasis & can be serious
  • Inflammation and exfoliation of the skin
  • Accompanied by severe itching, swelling and pain in a widespread fashion
  • “Red man”

Guttate psoriasis

  • Presents as small salmon-pink papules, 1-10 mm in diameter, predominately on the trunk;
  • Trigger is often a preceding streptococcal (bacterial) infection.
  • Frequently appears suddenly, 2-3 weeks after an upper respiratory tract infection (URTI).

Psoriatic Arthritis

  • Is a connective tissue inflammation which affects the joints particularly those of the fingers and toes resulting in a sausage-shaped swelling
  • It is autoimmune disorder.

Scalp Psoriasis

  • The scalp may have fine, dry, scaly skin or have heavily crusted plaque areas
  • The plaque can flake off or peel off in crusted clumps
  • Sometimes it is confused with seborrheic dermatitis
  • A key difference is that in seborrheic dermatitis, the scales are greasy looking, not dry


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