Psoriasis is a chronic skin condition where the skin turns red, scaly and itchy. Although Psoriasis affects all age groups, it is mainly seen in adults, affecting men and women equally. Psoriasis is an autoimmune disease that may have genetic & environmental triggers. The patches of affected skin may cover small areas such as the knees, elbows, and scalp, palms, and soles of the feet or completely cover the body. Any skin injury may trigger psoriatic skin changes around the broken skin, known as the Koebner phenomenon. Psoriasis cannot be cured but symptoms can be controlled with the correct treatment. Most cases- around 75% are treated with topical (applied to the skin) creams alone.

What is Psoriasis?

The disease occurs when skin cells rise too fast from their origin below the skin's surface and pile up on the surface before they are mature. Usually skin cells are replaced about once a month, called turnover, but in psoriasis it usually happens within a few days.

Types

Depending on the type of Psoriasis, the symptoms will vary. There are 5 main types:

• Plaque or Psoriasis Vulgaris, makes up about 90%. The typical symptoms of Plaque Psoriasis are red patches with white scales on top. The most commonly affected areas of the body are the back of the forearms, shins, and the scalp.

• Guttate psoriasis often appears in childhood or during the late teens to early twenties. Small, red spots appear on the torso and limbs. The condition may be triggered by respiratory infections, strep throat, tonsillitis, stress, a skin injury, anti-malarial and beta-blocker medicines.

• Pustular Psoriasis is characterized by small non-infectious pus-filled blisters on the palms of the hands, and/or feet with tiny pustules.

• Inverse psoriasis, characterized by bright red, shiny lesions that appear in skin folds, such as the armpits, groin area, and under the breasts

• Erythrodermic Psoriasis develops from any of the other types of Psoriasis, and usually results due to the progress of unstable plaque psoriasis, mostly after the sudden withdrawal of systemic glucocorticoids. As the uncontrolled inflammation and exfoliation disrupt the body's ability to control temperature and barrier function, this condition could be fatal.

Symptoms

The most recognisable signs of Psoriasis are patches of red, inflamed skin, covered with loose, silvery scales. They could crack and bleed, become itchy and painful. In severe forms, the patches grow and join together, forming large areas of irritated skin.

Nails in the fingers and toes may change colour or become pitted, and could crumble or detach from the nail bed.

Scaly patches or crust may form on your scalp (the skin covering your head).

Triggers

Each case of Psoriasis is different. Triggers that cause Psoriatic flare-ups in one person may not affect another. Finding out the triggers helps people control their Psoriasis better.

Cold, Dry, Weather causes chapped, dry skin & is a reason for Psoriasis to worsen. Warm sunny weather and high humidity helps ease dry skin and relieves Psoriasis.

Psoriasis episodes are common when a person is anxious. Staying calm & relaxed helps ease symptoms.

Medicines such as beta-blockers used to treat high blood pressure and heart disease; lithium (for bipolar disorder); and anti- malarial pills cause Psoriasis. Your doctor needs to know if you have Psoriasis & needs to prescribe for these conditions.

Diagnosis

The appearance of the skin is usually enough for a diagnosis. But a few exceptions are other skin conditions such as Discoid Eczema, Seborrhoeic Eczema, Pityriasis Rosea (looks similar to Guttate Psoriasis), nail fungus, and cutaneous T cell lymphoma.

A Skin biopsy gives an accurate diagnosis to rule out other disorders.

Treatment

Medicated creams to be applied on the skin such as Salicylic Acid, Steroid creams or corticosteroids, ultraviolet light, vitamin D3 and immunosuppressant creams are effective in 80% to 90% of the cases. Some doctors may prescribe oral medication such as methotrexate, which dramatically clears Psoriasis. But the prescribing doctor will need to perform regular blood tests as this medicine causes some unpleasant side-effects.