Psoriasis

Psoriasis is a well known skin condition which presents as a red, itchy, crusty rash with silver coloured scales which flakes easily especially when scratched. It affects people of any age although it is more common in people aged between 11 and their mid forties.

Psoriasis varies in severity from one person to another. Some people have a mild form of this disease but others are unfortunate enough to suffer from a severe form which impacts on their day to day living.

It is a chronic disease which is characterised by periods of flare ups and remission. At present there is no cure for psoriasis but the symptoms can be controlled.

What is psoriasis?

This is a fault in the normal skin cell cycle. What normally happens is that your body produces skin cells which move up through the layers until they reach the top layer or epidermis. Once there, they die and then flake off the surface. This process takes 3 to 4 weeks in total.

But psoriasis causes this process to speed up to just 6 days. This means that immature skin cells travel up through the layers and build up on the surface of the skin. These skin cells form a red, crusty, flaky rash which is covered in silver coloured scales. This rash is very itchy and sheds easily.

Causes of psoriasis

This is hard to pinpoint but it is thought to be a fault with your immune system. Your immune system protects you against infection and does this by releasing T-cells to deal with the threat of a germ, virus or bacteria. But in this case, the T-cells turn on healthy skin cells instead. This triggers the release of more T-cells and healthy skin cells.

This process gradually speeds up to the point where the entire skin cell life cycle occurs within 5 days rather than the normal 28 days.

Genetics is another factor. Psoriasis tends to run in families so if a close family member has this condition then you will develop it as well.

Psoriasis is characterised by flare ups and remissions. There are several factors which trigger a flare up which include:

  • Stress
  • Injury
  • Sunburn
  • Insect bite/sting
  • Smoking
  • Alcohol
  • Throat infections
  • Certain medications, e.g. beta blockers, ACE inhibitors
  • Immune system disorders such as HIV/AIDS

Symptoms of psoriasis

Psoriasis produces a red, scaly, itchy rash with a covering of silvery scales. Crusty patches form which flakes off especially when rubbed or scratched.

Did you know there is more than one type of psoriasis? Many people assume that there is a single type of this condition but there are in fact, several types with their own set of symptoms.

The most common form of psoriasis is plaque psoriasis and this is likely to be the one you have. The reason we say this is that 80% of cases are plaque psoriasis. Plaque psoriasis is characterised by red, itchy skin lesions with a silver coating that develop on the scalp, knees, elbows and lower back. These lesions are dry and may crack leading to bleeding.

Other types include:

  • Scalp psoriasis: affects the scalp only
  • Guttate psoriasis: mainly affects children and teenagers and occurs following a throat infection. Develops on the arms, legs, scalp and chest.
  • Inverse psoriasis: develops in skin folds and creases on the body, for example, underneath the breasts and the armpits. This version is worse in hot weather.
  • Nail psoriasis: causes small dents and discolouration on the nails. The nails become loose and in severe cases, start to crumble.
  • Pustular psoriasis: this is a rarer form in which small, pus filled blisters develop on the skin. There is more than one type of pustular psoriasis with accompanying symptoms such as fever, tiredness, weight loss and chills.
  • Erythrodermic psoriasis: a very rare form of psoriasis which develops over most of the skin and causes an itching, burning feeling. This serious version causes the body to lose fluids which increases the risk of dehydration, infection and malnutrition.

Diagnosing psoriasis

If you exhibit any of the symptoms of psoriasis then see your GP. He or she will examine your affected skin and will ask you a series of questions about your medical history. This will also include your family history to see if there is a genetic link.

You may be referred for tests, for example a skin biopsy where a small sample of the rash is sent to a laboratory for analysis. This will help determine the type of psoriasis you have.

Treatment for psoriasis

Psoriasis can be treated by your GP but if you have a severe form then you will be referred to a dermatologist. The dermatologist cannot cure psoriasis but can prescribe a suitable course of treatment. This includes:

  • Topical creams which are applied to the affected areas of skin
  • Injections/tablets which reduces the volume of skin cells produced by your body.
  • Phototherapy

The type of psoriasis you have and the severity will determine the treatment you receive.

The aim is to help you manage the symptoms and lead a normal life.