Psoriasis | چنبل

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Psoriasis | چنبل


Psoriasis is a skin disorder that affects the life span of the skin cells. Psoriasis is a common skin condition, it can happen at any age but it usually begins from 15 – 25 years of age

Skin cells are the building blocks of skin.  Normally, skin cells live for 20-28 days and then they are replaced with new healthy skin cells.

Psoriasis shortens the life span of skin cells to 3-5 days.  The fast maturing psoriatic skin cells do not shed from the skin as the normal skins cells do which results in the buildup of cells on the skin’s surface in the form of patches and lesions. .    The end result is the formation of patches covered with silvery scales that are dry, itchy, and in some cases, painful.  This is a chronic disease (this means that it lasts for a long time) and while the symptoms can improve, there is always the risk of a flare up (a flare up is where symptoms get worse). 

For some people, psoriasis is a manageable though recurring skin irritation whereas for others it could be a regular problem causing painful skin lesions or in the form of psoriatic arthritis.

Psoriatic arthritis is severe type of psoriasis that affects the joints and connective tissue causing fatigue, swelling and pain.

There are several different types of psoriasis and most of these have flare up and remission (get better) cycles. 

The types include:

  • Plaque psoriasis: This is the most common type (almost 90% cases) and it is characterized by skin lesions that are raised, red and have silvery scales.  They are called skin plaques. This type most commonly appears on elbows, knees, scalp and lower back.
  •  Scalp psoriasis: This type appears on the scalp and is characterized by silvery-white scales and itchy, red areas.
  •  Inverse psoriasis: This type affects folds and creases of the skin for e.g.  skin in the armpit, groin area and between the hips. It is characterized by patches of skin that are inflamed (irritated and swollen) and red. Sweating and friction (skin rubbing against skin or something else) can worsen the symptoms.
  •  Nail psoriasis: With this type the nails can become discolored and pitted (tiny grooves), and they may grow abnormally.  The nails can separate from the nail bed and become loose.  Both toenails and fingernails can be affected, and in severe cases, the nail can break or crumble.
  •  Pustular psoriasis: This is characterized by widespread patches on the feet, hands or fingertips that are full of pus-filled blisters. 
  •  Psoriatic arthritis: This is characterized by painful joints, swollen joints, scaly and inflamed skin and nails that are discolored.

Symptoms vary greatly because this condition affects everyone differently.  Common signs and symptoms include:

  • Patches of skin that are red and have silvery scales
  • Skin that is cracked, dry and may bleed
  • Nail with pits and ridges that may be thickened
  • Small scaling spots
  • Burning, soreness or itching
  • Stiff and swollen joints

It is not fully understood what causes psoriasis, however it is believed that the specific cells of immune system mistakenly attack the healthy skin cells. As a result, it is considered as an autoimmune disease (body’s own immune system attacks healthy cells)

The T cell, or T lymphocyte of immune system, is a type of white blood cell that is thought to be related.  These cells normally work to fight off anything that should not be in the body to prevent sickness, but in psoriasis patient it is believed that these T lymphocyte cells actually attack the healthy skin cells, resulting in the various symptoms.  Why these cells malfunction (go bad) with this condition is not really understood.  It is not a contagious disease, which means it cannot be transmitted from one person to other.

It is thought that environmental factors and certain genes may play a role.  Psoriasis runs in families.  Medical research suspect links of genetic factor as cause of this disease.

Triggers of Psoriasis

Many things are thought to trigger psoriasis symptoms, including:

  • Infections
  • Skin injury
  • Cold weather
  • Certain medications
  • Stress
  • Smoking
  • Drinking too much alcohol
  • Some chemicals comes in contact with skin (present in detergent and soaps)

Risk factors of psoriasis may include:

  • A family history of the condition
  • Stress
  • Smoking
  • Bacterial and viral infections
  • Obesity

Diagnosing this condition is a rather straightforward process in most cases. 

The doctor will begin by performing a physical examination and paying close attention to the skin, nails and scalp for the signs and symptoms of psoriasis.  Patient should also let your doctor know if anyone in the family has this condition.  A skin biopsy may be done to rule out other possible conditions that can cause similar symptoms and to figure out the exact type of this condition.  A biopsy means that a small piece of skin is removed and looked at under a microscope.

There are a variety of treatment options depending on the type of psoriasis and severity of its symptoms.  The treatments can help to calm symptoms and improve the appearance of this skin condition. 

Topical (creams and ointments) treatments can include:

  • Topical corticosteroids
  • Vitamin D analogues
  • Retinoids
  • Anthralin
  • Salicyclic acid
  • Coal Tar

 Phototherapy (light therapy):  involves the use of artificial or natural ultraviolet light (the type of light the sun provides).  Brief exposure to sunlight may help to improve symptoms.

Injected and oral medications for psoriasis may include:

  • Retinoids: These may help to reduce skin cell production so that they cannot build up.
  •  Cyclosporine: This works to suppress the immune system so that it does not attack itself.
  •  Methotrexate: This works to suppress inflammation by reducing skin cell production.
  • Biologic medications: These help to reduce the symptoms and helps to stop the immune system from attacking itself.

There are several different potential complications of psoriasis, including:

  • Psoriatic arthritis: This can result from other types of arthritis and can, in some cases, result in loss of joint function.
  •  Obesity: While it is not known why, severe psoriasis appears to increase the risk of psoriasis.

   Other complications reported in psoriasis patients include:

  • High blood pressure
  • Type 2 diabetes
  • Cardiovascular disease
  • Parkinson's disease
  • Autoimmune diseases

There are things you can do at home to make living with psoriasis a bit easier.  First and foremost, know your triggers and do what you can to avoid them.  Other things that can help include:

  • Bathing daily
  • Use soap softer on skin
  • Avoid detergents or wear gloves when use detergents
  • Getting small amounts of sunlight on the skin
  • Using a good moisturizer after bathing
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