Psoriasis is a skin condition in which the immune system mistakenly attacks normal skin cells. Psoriasis is characterized by the appearance of silver scaly patches on the skin called plaques, with itching and redness. Almost 2 to 3% people around the world are struggling with psoriasis.
Psoriasis not only causes discomfort but also harms individuals’ self-confidence. People with psoriasis can develop self-consciousness, depression, and anxiety due to the appearance of their skin. It is the reason that psoriasis is not treated as a skin condition. It requires holistic care.
It is imperative for individuals with psoriasis to understand the condition thoroughly to manage it effectively. There is no cure for psoriasis, so it requires palliative treatment through medicines, at-home care, and lifestyle changes.
In this blog, we will discuss in detail the underlying mechanisms of psoriasis, including its causes and risk factors. This blog also covers the signs and symptoms of the condition, with its types and practical treatment recommendations with relief products.
Psoriasis Skin Involvement and Immune System Dysfunction
As stated in the previous section, psoriasis is an autoimmune disorder that is caused by an overactive immune system attacking healthy cells. This results in increased cell turnover, which forms plaques on the skin.
T-cells in the body prevent autoimmune reactions. In psoriasis, they become dysfunctional and are unable to stop autoimmune attacks on the skin cells. Neutrophils are also an integral part of lesions occurring in psoriasis and contribute to inflammation of the skin.
Psoriasis Causes and Genetic Risk Factors
Psoriasis is an immune-mediated, genetic skin disease. The susceptibility of developing is higher in those with defective genetic markers and gene loci. While this condition is primarily influenced by genetics, some triggers or risk factors can predispose to psoriasis. It means that people who already carry the defective genes can develop the disease. Whereas those who do not have these genes and gene markers are unlikely to develop psoriasis, in many instances even by the factors that trigger it. Here are the genetic markers known to susceptibility of Psoriasis:
- Genetic factor HLA-C is strongly associated with early-onset psoriasis.
- Inflammatory cytokine genes such as IL-17, IL-23, and TNF-α also play a vital role in the development and progression of the disease.
Some of the major environmental risk factors associated with psoriasis are listed below.
- Stress
- Alcohol
- Smoking
- Infections such as Strep throat (Streptococcus)
- Cold and arid weather can trigger scaly patches
- Hormonal changes at puberty or after pregnancy
- Medications such as Beta-blockers, lithium, anti-malarial, and some anti-inflammatories
- Koebner Phenomenon (appearance of psoriatic lesions at sites of skin trauma) due to skin injury
Common Psoriasis Symptoms and Visible Skin Changes
Psoriasis is a chronic skin condition that presents with thick scaly patches on the skin. Some of the classical signs and symptoms of psoriasis are discussed below.
- Dry and flaky skin.
- Burning and soreness on the skin patch.
- Itchiness, which intensifies during flare-ups.
- Skin rash with silvery scaly patches, inflammation, and redness.
- Joint pain is also seen in individuals with psoriasis due to a complication called psoriatic arthritis.
- About 50% of psoriasis patients experience nail changes such as yellow discoloration, minor dents, and even loosening from the nail bed.
- Psoriasis runs its course in cycles of flare-ups and remissions.
Psoriasis Skin Rash and Psoriasis Patches
Psoriasis skin rash has distinct characteristics that differentiate it from other skin lesions. The psoriasis skin rash is a well-demarcated, raised, and inflamed patch with scales. Cell turnover is increased in psoriasis, causing the cell cycle to prolong from 3 to 4 weeks to just 3 to 7 days. This change in the cell cycle causes cells to accumulate on the skin, forming plaques with scales. This condition is also commonly seen as psoriasis in babies. Some of the distinct characteristics of psoriasis patches are given below.
- The patches are raised, inflamed, red, and irritated with well-defined borders.
- The skin rash is itchy, sore, or sometimes burns and bleeds as well.
- Psoriasis skin patch is covered in silvery white scales.
- The skin becomes extremely dry and cracked.
- Although these patches can appear anywhere in the body, the most common locations of these patches are the elbows, knees, scalp, trunk, palms, and soles.
Early Psoriasis Indicators and Initial Disease Progression
Psoriasis is a lifelong condition. It peaks at ages 15-25 and 50-60. The most common and earliest signs of psoriasis are dry, cracked, and itchy skin; in some patients, burning and soreness are also seen. Appearance of small, raised, and red papules is often seen before the progression of the disease. The first small papules usually appear in areas like the scalp, knees, and elbows. Another significant early indicators of psoriasis are guttate spots (small drop-shaped papules), Auspitz Sign (pinpoint bleeding from lesions), and nail changes.
Although there is no established progression pathway for psoriasis, it mostly follows a pattern with increasing severity and frequency of flare-ups. At first, the disease establishes itself in the form of the Koebner Phenomenon, when lesions are formed at the site of any skin injury. Over time, the small patches and lesions merge together to form bigger plaques. The condition starts with guttate spots but then progresses to the most common type, chronic plaque psoriasis. Almost 80-90% patients suffer from this type of psoriasis.
As stated earlier, psoriasis is a systemic condition that is not localized to the skin. The skin lesions are early signs of the disease, but as the disease progresses, it affects other parts of the body, such as the heart and joints. Psoriasis is a risk factor for cardiovascular diseases, metabolic syndrome, and inflammatory bowel disease.
Psoriatic Arthritis is also a complication of psoriasis. It develops in the late stage of the disease, almost 10 years after the initial progression of psoriasis. It is a serious complication and causes deformity of the joints.
Types of Psoriasis Identified in Clinical Practice
There are various types of psoriasis. These are differentiated on the basis of location, severity, and appearance. Some of the primary types of psoriasis are discussed below.
Plaque psoriasis
It is the most common type of psoriasis. Almost 80-90% of the patients have this type of psoriasis. It is characterized by the appearance of localized, raised, inflamed, red or purple patches (plaques) covered with a silvery-white scale. These patches are often symmetrical and can be itchy or painful.
Guttate psoriasis
It is often seen in young adults or children after a case of strep throat infection. Guttate psoriasis appears as small drop-shaped pink or red scaly patches. The location of these spots is usually the trunk, arms, and legs.
Inverse psoriasis
Also known as flexural psoriasis. The skin rash of inverse psoriasis is shiny and without scales. These appear as smooth, inflamed, shiny red patches. They appear in the folds of the skin, such as the armpits, under the breasts, the groin, or around the genitals. They are triggered by heat, friction, and sweat.
Pustular psoriasis
Pustular psoriasis is characterized by the development of non-infectious, pus-filled pustules on the skin. These pustules are surrounded by red and inflamed skin. The pustular psoriasis is of the following two types.
- Localized: also known as palmoplantar pustulosis, and is limited to the hands and feet.
- Generalized: It is a widespread condition that shows systemic symptoms. Can be life- threatening and requires immediate medical attention.
Mild Psoriasis versus Severe Psoriasis
| Features | Mild Psoriasis | Severe Psoriasis |
|---|---|---|
| Body Surface Area (BSA) | Less than 3% | More than 10% |
| Appearance | Localized, well-demarcated red scaly patches. | Generalized, widespread, thick, inflamed plaques. |
| Location | Limited to elbows, knees, scalp, or lower back. | Covers a large area and involves sensitive areas like the face, scalp, genitals, palms, or soles. |
| Symptoms | Mild and manageable | Severe with systemic involvement. Severe itching, pain, and bleeding. |
| Management | Topical treatments are often sufficient. | Systemic medications Light therapy |
| Note: Area equal to palm area of patient equals 1% | ||
Scalp Psoriasis
Scalp psoriasis has distinguished red, inflamed, and dry patches. These can be confused with dandruff; however, their silver grey scales differentiate psoriasis from dandruff. Below are some primary manifestations of scalp psoriasis.
- Scalp psoriasis has characteristic silver-white scales.
- Temporary hair loss is also seen with scalp psoriasis.
- It has inflamed red patches that can extend beyond the hairline.
- It causes intense itching and scratching, which sometimes results in bleeding.
Psoriasis Treatments Used in Dermatology Care
Psoriasis is not curable; it is managed by supportive or palliative care, which helps to control or reduce severity of the symptoms. Some of the most commonly used psoriasis treatments for mild cases are discussed below.
- Steroids to alleviate inflammation and slow the cell cycle.
- Moisturizers or emollients.
- Inflammation relief creams like Soteri Skin Eczema relief cream, although it is formulated for eczema, the excellent formulation, which reduces skin irritation, dryness, inflammation, and itching, can be used for psoriasis as well.
- Vitamin D injections.
- Salicylic acid to remove the buildup on the skin and scalp.
- Topical retinoid or Vitamin A.
Extensive Psoriasis Treatments for Severe Cases
The severe cases of psoriasis do not respond to the above-mentioned treatments. Below are some treatment options used for patients with more systemic involvement or who have a BSA (body surface area) involvement of more than 10%.
- Oral medications, including retinoid, methotrexate, and cyclosporine.
- Injections and infusions for immune therapy to alleviate the autoimmune reactions.
- Phototherapy: the patient is exposed to ultraviolet light of specific wavelengths under a dermatologist's supervision.
FAQ's
Is psoriasis contagious?
No, psoriasis is not contagious. It is an autoimmune disorder mediated by genetics. It does not spread through contact or any other means.
How to cure psoriasis permanently?
Psoriasis is a genetic condition that cannot be permanently cured; however, you can manage it effectively through supportive care treatments. It is important to avoid triggers and make lifestyle changes to prevent flare-ups. Usually, using these strategies is enough to manage mild cases of psoriasis.
Is psoriasis an autoimmune disease?
Yes, psoriasis is an autoimmune disease that is caused by defective gene markers and genes. It affects HLA-C and T-cells. The immune system becomes faulty and attacks the healthy cells of the body, causing inflammation and increased cell turnover.
Are light therapy treatments safe for long-term use?
Light therapy treatments are considered safe for long-term use. However, long-term safety data are limited, and therefore, user discretion is advised. It should not be overused without safety protocols.
Conclusion
Psoriasis is a genetic autoimmune disorder that is characterized by the appearance of red, inflamed, irritated, and scaly skin rashes. The skin rash is distinctive with its silvery white scales and is well demarcated.
If you have Psoriasis and you often think is Psoriasis curable? the answer is No. It is a chronic, systemic autoimmune disorder that can cause widespread inflammation and complications. The treatment of psoriasis is usually limited to supportive and preventive care. Additionally, Psoriasis needs holistic care to improve the quality of life in affected patients.
Individuals suffering from psoriasis must identify it early to effectively manage it. Avoiding triggers is one of the most effective ways to keep psoriasis under control. You can use relief creams and treatments to strengthen the skin and decrease inflammation and irritation. Here we would like to highlight the fact that Psoriasis and eczema share common symptoms such as redness, itching, inflammation, and dry, irritated skin. This over lap of symptoms is why; a clinically proven eczema cream can also be used to soothe and hydrate psoriasis-prone skin.
The formulations that are backed by science and designed by dermatologists like those available at Soteri Skin can help nourish the skin and soothe it for lasting relief.
