Biomarkers

What is Psoriasis? Causes, Triggers and Treatments

What is Psoriasis?

  • a chronic autoimmune skin disease that causes red, itchy scaly patches, most commonly on the knees, elbows, trunk and scalp.
  • It has no cure. 
  • It tends to go through cycles, flaring for a few weeks or months, then subsiding for a while or going into remission. 

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Psoriasis patches can range from a few spots of dandruff-like scaling to major eruptions that cover large areas. The most commonly affected areas are the lower back, elbows, knees, legs, soles of the feet, scalp, face and palms.

There are clinical variants of the disease, namely guttate psoriasis, psoriasis erythrodermic, pustular psoriasis and vulgar psoriasis representing more than 90% of the cases. 

Guttate psoriasis. This type primarily affects young adults and children. It’s usually triggered by a bacterial infection such as strep throat. It’s marked by small, drop-shaped, scaling lesions on the trunk, arms or legs.

Erythrodermic psoriasis. The least common type of psoriasis, erythrodermic psoriasis can cover your entire body with a red, peeling rash that can itch or burn intensely.

Pustular psoriasis. This rare form of psoriasis causes clearly defined pus-filled lesions that occur in widespread patches (generalized pustular psoriasis) or in smaller areas on the palms of the hands or the soles of the feet.

Plaque psoriasis. The most common form, plaque psoriasis causes dry, raised, red skin patches (lesions) covered with silvery scales. The plaques might be itchy or tender, and there may be few or many. They usually appear on elbows, knees, lower back and scalp.

Nail psoriasis. Psoriasis can affect fingernails and toenails, causing pitting, abnormal nail growth and discoloration. Psoriatic nails might loosen and separate from the nail bed (onycholysis). Severe cases may cause the nail to crumble.

Inverse psoriasis. This mainly affects the skin folds of the groin, buttocks and breasts. Inverse psoriasis causes smooth patches of red skin that worsen with friction and sweating. Fungal infections may trigger this type of psoriasis.

Psoriatic arthritis. Psoriatic arthritis causes swollen, painful joints that are typical of arthritis. Sometimes the joint symptoms are the first or only symptom or sign of psoriasis. And at times only nail changes are seen. Symptoms range from mild to severe, and psoriatic arthritis can affect any joint. It can cause stiffness and progressive joint damage that in the most serious cases may lead to permanent joint damage.

What causes Psoriasis? 

Psoriasis occurs when skin cells are replaced more quickly than usual. It’s not known exactly why this happens, but research suggests it’s caused by a problem with the immune system.

Your body produces new skin cells in the deepest layer of skin. These skin cells gradually move up through the layers of skin until they reach the outermost level, where they die and flake off. This whole process normally takes around 3 to 4 weeks.

However, in people with psoriasis, this process only takes about 3 to 7 days. As a result, cells that are not fully mature build up rapidly on the surface of the skin, causing flaky, crusty red patches covered with silvery scales.

These are potential causes:

  • White blood cells, also called T-cells, are part of the body’s immune system. These cells help prevent us from getting sick by attacking things that can harm us, such as bacteria and viruses. When a person has psoriasis, something goes wrong in the immune system, so T-cells also attack the body’s skin cells. This attack causes the body to make new skin cells more often. The extra skin cells pile up on the surface of the skin, and you see psoriasis. Once T-cells start to attack skin cells, this usually continues for the rest of a person’s life. There is one exception. Some children who get a type of psoriasis called guttate (gut-tate) psoriasis never have it again. 
  • We know that psoriasis runs in families. Scientists have found that people who have certain genes are more likely to get psoriasis. It’s possible to have genes that increase the risk of getting psoriasis and never develop psoriasis. It’s also possible to not have the genetic variants and nonetheless develop psoriasis.

Psoriasis is not contagious, so it cannot be spread from person to person.

What causes Psoriasis outbreaks?

Psoriasis outbreaks differ from person to person. 

Common psoriasis triggers may include:

  • Skin injury (cuts, scrapes or surgery).
  • Emotional stress. Stress is one of the main triggers of psoriasis and has been associated with disease onset and subsequent outbreaks, while outbreaks by themselves they often lead to psychological distress.
  • Streptococcal or other infection that affects the immune system.
  • Certain prescription medications (such as lithium and beta blockers).
  • Cold weather, when people have less exposure to sunlight and humidity and more to hot, dry indoor air.

What are Psoriasis symptoms?

  • Inflammation and redness around the scales is fairly common. 
  • Typical psoriatic scales are whitish-silver and develop in thick, red patches. Sometimes, these patches will crack and bleed.
  • Scales typically develop on joints, such elbows and knees. But scales may develop anywhere on the body, including the: hands, feet, neck, scalp, face, nails, mouth, and the area around genitals.

Other symptoms:

  • Red patches of skin covered with thick, silvery scales
  • Small scaling spots (commonly seen in children)
  • Dry, cracked skin that may bleed or itch
  • Itching, burning or soreness
  • Thickened, pitted or ridged nails
  • Swollen and stiff joints

Possible treatment options:

The treatment of psoriasis is individualized, depending on the severity of the measurable disease. Psoriasis treatments aim to stop skin cells from growing so quickly and to remove scales. 

Options include:

  • creams and ointments (topical therapy), 
  • light therapy (phototherapy), 
  • and oral or injected medication.

Which treatments you use depends on how severe the psoriasis is and how responsive it has been to previous treatment. You might need to try different drugs or a combination of treatments before you find an approach that works for you. Usually, however, the disease returns. Although doctors choose treatments based on the type and severity of psoriasis and the areas of skin affected, the traditional approach is to start with the mildest treatments — topical creams and ultraviolet light therapy (phototherapy) — in people with typical skin lesions (plaques) and then progress to stronger ones only if necessary. People with pustular or erythrodermic psoriasis or associated arthritis usually need systemic therapy from the beginning of treatment. The goal is to find the most effective way to slow cell turnover with the fewest possible side effects.

Disclaimer:

Test results may vary depending on your age, gender, health history, the method used for the test, and other things. Your test results may not mean you have a problem. Ask your healthcare provider what your test results mean for you. 

The information on healthmatters.io is NOT intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice.

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