Plaque Psoriasis
Psoriasis is a commonly occurring, multi-factorial, non-contagious, autoimmune skin disease. It affects adults and children alike. Its recurring nature tends to take a toll on your emotions, self-esteem and social life.
Psoriasis occurs when your immune system sends out faulty signals that speed up the growth cycle of skin cells and they replicate at an extremely rapid rate. Psoriasis lesions (psoriatic plaques) are characterized by the development of chronic, well-defined, scaly, reddish lesions on the extensor surface of the extremities, especially elbows, knees, trunk, back and scalp. Nail involvement is not uncommon and is with pitting changes. Psoriasis can also cause inflammation of your joints, which is known as psoriatic arthritis.
This disorder is chronic in nature, and lesions can vary from a minor localized patch to lesions that spread all over your body. Psoriasis is also associated with other serious health conditions, such as diabetes, heart disease and depression.
According to the National Institute of Health, as many as 7.5 million Americans are affected by psoriasis.
Causes Of Psoriasis
The exact cause of psoriasis is unknown. There is evidence of genetic predisposition. Psoriasis, being an autoimmune disorder has an autosomal dominant inheritance. People with dry skin are more likely to develop psoriasis than those with oily or well-moisturized skin.
There are many precipitating and aggravating factors. The following are some common causes of psoriasis:
- Stress – Stress (mental and physical) can cause psoriasis to commence for the first time or aggravate existing psoriasis.
- Injury – Psoriasis can appear at the sight of injury (scratches, sunburns, etc.) to skin; this is known as Koebner effect.
- Medications – Drugs like Beta-blockers, Antimalarials, NSAIDs, Lithium, Indomethacin, etc.
- Infections – It is common after a streptococcal infection.
- Hormonal fluctuations like menses, puberty and pregnancy.
- Endocrine imbalances.
Diagnosis of Psoriasis
Diagnosis of psoriasis is often based on the external appearance of the skin. A classical skin clinical sign (Auspitz’s sign) of psoriasis is that when the plaques are scraped, one can see pinpoint bleeding from the skin below. A skin biopsy, or scraping, may be done to confirm the diagnosis and rule out other disorders. A positive biopsy for psoriasis will show the presence of clubbed Rete pegs.
Psoriasis Symptoms
Lesions of Psoriasis (Psoriasis, Plaque) typically appear as red or pink areas of thickened, raised and dry skin.
They may vary in appearance, from small flattened bumps to large, thick plaques of raised skin, or red patches, pink mildly dry skin or big flakes of dry skin that flake off.
The affected nails show irregular small pits and separation of the nail plate at distal end, ultimately leading to nail dystrophy.
Sites of predilection are extensor body surfaces, scalp, and areas of trauma, like elbows, knees, palms and soles.
Types Of Plaque Psoriasis
- Psoriasis Vulgaris – The most common type, skin lesions seen in psoriasis vulgaris are sharply marginated erythematous plaques, covered with copious silvery-white non-adherent scales. It is typically found on the elbows, knees, scalp and lower back.
- Inverse Psoriasis – This is a condition affecting areas where there is flexural involvement e.g. armpits, groin, under the breasts, and in other skin folds around the genitals and buttocks.
- Guttate psoriasis – It is common in youngsters and is devoid of typical scaling and appears like small drops (gutta = drop) like spots. Lesions are more common on the trunk and limbs.
- Pustular Psoriasis – Pustular psoriasis is characterized by white blisters of non-infectious pus surrounded by red skin. This is found to be prevalent in adults.
- Erythrodermic Psoriasis – An inflammatory form of psoriasis that affects most of the body’s surface. Skin lesions in erythrodermic psoriasis are often accompanied by severe itching and pain, increased heart rate and fever. It causes protein and fluid loss that can lead to severe illness.
- Sebo Psoriasis – A scalp psoriasis, where seborrhoeic dermatitis co-exists with psoriasis.
- Palmoplantar Psoriasis – Psoriatic affection of palms and soles.
- Exfoliative Psoriasis – A very violent form of psoriasis, usually due to abrupt discontinuation of systemic steroids, aggressive coal tar or PUVA therapy and administration of antimalarials.
- Psoriatic Arthropathy – A type of psoriasis in which the joints are affected with inflammation and stiffness.
Daily Tips For Psoriasis Care
Along with your psoriasis medication, we recommend the following psoriasis care tips to help ease your symptoms and keep inflammation, patches, and itchy skin in check. These self-care tips for psoriasis are especially helpful during winter, when psoriasis are often aggravated.
- Shower or bathe with lukewarm water and use a moisturizing body wash. This improves psoriasis lesions by softening and hydrating the thick, scaly patches. Limit baths to 10 minutes to avoid aggravation.
- Avoid scrubbing.
- Apply moisturizer after a shower or bath, as this helps to lock in hydration and minimizes flaking of psoriatic scales.
- Use lightweight clothes made from cotton or linen – they do not trap heat and are not rough on your skin.
- Practice meditation and yoga – they are effective stress busters.
- Avoid or overcome precipitating or triggering factors.
- A warm climate may help to control relapses.
- Avoid smoking.
- There is some evidence to link alcohol with psoriasis. So, alcohol must be avoided altogether.
- Raising your general immunity with a good nutritious diet and regular exercise is also helpful.