Your skin is the only organ of the body which is completely exposed to the environment on an external basis. It is also the largest organ and is also highly sensitive. Sensitive because, as you might have noticed your skin or anyone else’s for that matter it can be affected by various kinds of skin conditions.
Dry patches of skin, vitiligo, eczema, rashes and so many other skin conditions which affects it at some point in your life. It can be genetic in nature or it can also be due to the environment or it can be due to your own immune system which can become more active that normal.
Amongst all these skin conditions, there are a few of them which are highly unpredictable and also irritating at the same time. One of them is Psoriasis.
What is Psoriasis?
You must all know that skin cells die and new ones are produced in your body which replaces the dead cells. That is normal. But what is not normal is when your skin cells multiply at an abnormal speed, 4-5 times faster than its actual speed. Due to this speed, the underlying cells come up to the skin’s surface and die, but due to this fast multiplication, the volume of the dead skin cells are at a great number and that is what reflects on your skin when you have psoriasis. Excessive dead skin cells which form red plaques and are covered with white scales.
Which parts of the body is usually affected by Psoriasis?
The condition of psoriasis most commonly is seen on the lower back, knees, torso, elbow, scalp, flexures, soles of your feet and your palms as well.
How do you know if you have Psoriasis?
The symptoms of this condition completely depend on the type of psoriasis you have. It is however generalized to some extent where the symptoms look like:
- Red skin and plaque which are often covered with loose white coloured scales. The lesions might be painful and itchy as well. In some cases, they might crack and there is pin point bleeding. However, in the severe cases of psoriasis, these plaques can grow and merge with one another and cover larger areas of the skin.
- Apart from red skin, fingernails and your toes can get affected in various ways such as discoloration and also the pitting of the nails. The nails might also crumble or detach from the nail bed.
Studies have shown that often when people are affected with psoriasis, they also eventually suffer from a condition called as psoriatic arthritis. This condition leads to swelling of joints and pain.
Coming to the types of psoriasis, each one of them is categorized based on how the condition presents itself on the skin.
Other forms of psoriasis include:
- Pustular psoriasis is the type of psoriasis which can be characterized by appearance of red, scaly skin on your palms or on your feet accompanied with tiny pustules.
- Guttate psoriasis, often which starts during childhood or young adulthood. The symptoms of this type are the small, red spots, mainly on the limbs and the toros. This type of psoriasis might be triggered by stress, strep throat and injury to the skin.
- Inverse psoriasis, is characterized by bright red, shiny lesions that can appear in the folds of the skin such as the area of the groin and under the breasts.
- Erythrodermic psoriasis, can be seen with intense redness of the skin and also shedding of scales. This form of psoriasis requires immediate medical treatment, or else it can lead to severe illness.
What causes Psoriasis?
The causes of this skin disease varies and also depends on the symptoms which are seen. From emotional trauma and stress to streptococcal infection can be the causes. Many cases also show that some kind of abnormality in your immune system can also cause psoriasis.
The condition of psoriasis can also be genetic in nature but it is said to skip a generation according to recent studies. Psoriasis is not harmful to your body but can embarrass and harm self esteem.
Factors that trigger psoriasis are,
Can Psoriasis Affect your joints?
Yes, this condition is associated with inflammation of joints and is seen in 30% of the cases of psoriasis. There have also been cases where joint pains might be the only sign of the disorder, but the skin is unscathed. The joint disease which can be a result of psoriasis is referred to as psoriatic arthritis. You might have an inflammation of any joint (arthritis), although the most commonly affected joints are the hands, knees, and ankles. Psoriatic arthritis is an inflammatory and also destructive form of arthritis and it needs to be treated with medications in order to stop the disease progression to other parts of the body.
30-40 years of age is the average when the onset of psoriatic arthritis is seen in people and usually, the skin symptoms and signs precede the onset of the arthritis.
How common is psoriasis?
Psoriasis is a very common skin condition in India and as well as all over the world. It currently affects roughly 10 million people in India and it is seen to affect worldwide as well in about 125 million people.
Is Psoriasis a contagious disease?
No, it is not. A person cannot catch the condition of psoriasis from someone else, and this disease cannot be passed to anyone else by skin-to-skin contact. Even if you directly touch someone with psoriasis on an everyday basis, it will never transmit the condition.
Is there a particular diet to follow if you have Psoriasis?
Several comorbidities, such as obesity, metabolic syndrome, dyslipidemia, hypertension, atherosclerosis, and diabetes, exhibit a higher than expected prevalence in psoriatic patients.Since there is already a for obese patients to develop any kind of cardiovascular disease and diabetes, it is necessary to maintain a normal body weight with good food habits and exercise.
There is as such no specific psoriasis diet, but few studies have showed fish oil, omega 3 fatty acid,foods rich in vitamin D and B12, gluten free diet had a beneficial role.
What are the treatment options available for Psoriasis?
Coming to the treatments of psoriasis, there are many effective treatment choices. The best treatment is determined by the doctor you consult and if you do not have a doctor in mind, visit us at Ambrosia Clinics and we will help you control the condition. The treatment also depends on the type of psoriasis which a person is suffering from, the severity and also the area of the skin involved.
If the disease is mild, it mainly involves only small portions of the body which is less than 10% of the total skin surface, topical treatments such as creams, lotions, and sprays, might be effective and also safe to use only if suggested by the dermatologist.
When it comes to the more moderate or even to the severe form of the disease which involves much larger areas of the body, greater than 10% or more of the total skin surface, then topical treatment might not be effective. In this situation, ultraviolet light treatments, biological or oral medication is prescribed
All in all you must know that with any kind of medical condition, each and every medicine carry possible side effects. No kind of medication is 100% effective or 100% safe for everyone either. The decision to take up any kind of medication requires thorough diagnosis and discussion with your doctor. The benefits and risks of any kind of treatment needs to be considered for each and every type of psoriasis and of course, the patient.
Looking at the treatments, here are the most commonly used treatments for psoriasis:
Topical corticosteroids are highly effective and is often used as initial treatment for limited or small areas of skin affected with psoriasis. The corticosteroids can come in many preparations, including liquids, gels, creams, foams and ointments. Steroids mainly come and are prescribed in different strengths depending on the type of psoriasis. Stronger preparations should be limited as overuse or prolonged use might cause problems like permanent skin thinning and damage which is called atrophy.
other therapeutically active topical agents licensed for psoriasis include, vitamin D analogues, tar, dithranol, and tazarotene (a retinoid).
Light therapy also called phototherapy is an effective treatment for psoriasis. There are several types of medical light therapies which are used as treatments that include PUVA(Psoralen UVA), UVB, and narrow-band UVB. These are artificial light sources which have been used for many years and generally are available at clinics where the physician practices treatment with this method.
Natural sunlight as it is a rich source of ultraviolet rays is also used to treat psoriasis. Short, controlled exposures to natural sunlight on an every alternative day basis might help or clear psoriasis for some patients. While using sunlight as a treatment, the unaffected area of the skin and other sensitive areas of the body such as the face and hands will need to be protected during the exposure.
There are also other newer light sources like lasers and photodynamic therapy which have been used to treat psoriasis such as:
PUVA is a special treatment for psoriasis using a photosensitizing drug and timed exposure of artificial light which are composed of ultraviolet light wavelengths in the UVA spectrum. The photosensitizing drug in PUVA is called psoralen. Both the psoralen and the UVA light needs to be given within one hour of each other for an appropriate response to occur. These treatments are usually given in a clinic and need to be two to three times per week.
Several weeks of PUVA treatment is required before you can see the significant results. The time of the light exposure is eventually increased through the course of the treatment. Psoralens can be taken as a pill or topically as well in the form of a bath or lotion. Patients who are given the treatment of PUVA are generally sensitive to the sun and must completely avoid sun exposure for a while after PUVA treatment.
There are however, a few side effects of this treatment. The common side effects with PUVA are burning and aging of the skin, increased number of brown spots called lentigines, there might also be an increased risk of skin cancer, including melanoma.
PUVA treatment need to be very closely monitored and stopped when the maximum number of treatments has been reached.
Narrow-band UVB phototherapy:
Narrow-band UVB phototherapy is also an artificial light treatment which includes the usage of very limited wavelengths of light. It is given two to three times per week depending on the severity of psoriasis. The dosage of UVB is based on time and exposure is gradually increased depending on the severity and also the toleration of the patient. The side effects of UVB treatment include the burning of skin, premature aging, and also an increased risk of skin cancer.
Oral Medication Like Methotrexate, Acitretin, cyclosporine and Biologics are prescribed depending on the type and severity of psoriasis.
Is there a cure for Psoriasis?
No, the condition of psoriasis is not completely curable. It is Treatable but It can go into remission depending on type of psoriasis.
The condition of psoriasis is majorly uncomfortable and very difficult to treat but that does not mean that if you have the symptoms, you would not visit your doctor or us for a viable option of treatment. Even if there is no cure, we can make your condition more bearable and not entirely affecting your self esteem and make it less embarrassing. Specially due to the ability of this disease to go into remission and can flare up due to various factors and causes, it gets more difficult to understand it. However, we at Ambrosia Clinics are dedicated in using state of the art equipment we have to treat this condition keeping the patient as the first priority.
About the Doctor:
Dr. Sindhuri Reddy specializes in clinical and cosmetic dermatology and dermatosurgery. Her continuous thrive to be updated in recent advances of skincare gives her a unique insight and approach to skincare. She has an MBBS and MD from NTR University of Health sciences and has done observership at Mayo clinic , USA . She has several academic publications to her credit. Her areas of special interest are acne scars, hair transplantations and lasers.