Introduction
Psoriasis is an autoimmune skin disease that causes scaling of the skin. Its symptoms include itchy skin, scaly patches, and redness, but they can vary from person to person. Psoriasis is a chronic condition and can be painful.
These rashes can appear anywhere but are more common on the elbows, knees, trunk, and scalp. The discomfort affects the sleep schedule and can even cause depression in people having this condition. Injury, Infections, and certain medications are common triggers for psoriasis.
This blog will discuss the prevalence, causes, symptoms, types, and treatments for psoriasis. Lastly, we will explore potential treatment options for psoriasis.
Prevalence of Psoriasis
- According to the American Academy of Dermatology (AAD), 7.5 million people in the United States have psoriasis. It can affect any age group but has the highest prevalence in adults between 45 and 64 years.
- Approximately 30% of people with psoriasis develop joint inflammation similar to arthritis which is known as psoriatic arthritis.
- Most people develop mild to moderate symptoms, but 20% of the cases are moderate to severe. In moderate to severe psoriasis, more than 5% of the body’s surface area is affected.
- Plaque psoriasis is the most common form, characterized by raised and reddish skin patches covered by white scaling.
- The estimated treatment cost of psoriasis in 2013 was 50 to 60 billion dollars.
Causes of Psoriasis
There are no exact causes of psoriasis, but it can result from multiple factors.
Skin cells are replaced every 10 to 30 days in a healthy individual. But in this condition, they are produced every 3 to 4 days which may lead to the buildup of excess skin cells. As a result, immature cells rapidly accumulate on the skin’s surface, resulting in dry, crusty regions with scaling.
Some triggers may cause flare-ups:
- Throat and skin infections
- Cold and dry weather
- External skin injuries such as cuts and scrapes, bug bites, and severe sunburn
- Secondhand smoke and passive smoking
- Heavy alcohol consumption
- Certain medications, such as lithium, antihypertensive, and antimalarial medications
- Sudden discontinuation of oral or injected corticosteroids
Symptoms of Psoriasis
The symptoms appear around 15 years of age and continue into adulthood. These may include:
- Patchy skin or a rash,
- Dandruff-like scaling,
- Color variation in patches,
- Small scaling sites,
- Cracked and dry skin,
- Itching, burn, soreness, and
- Cyclic rashes that come and go.
Types Of Psoriasis
Plaque Psoriasis:
Plaque Psoriasis is the most prevalent type of Psoriasis. It results in scale-covered, dry, and elevated skin patches called plaques. They can range from just a few to numerous and generally show on the scalp, lower back, elbows, and knees. Depending on the skin tone, the patches may have varying colors. On darker skin, the skin may heal with transient color changes (post-inflammatory hyperpigmentation).
Nail Psoriasis:
Psoriasis can cause pitting, irregular nail growth, and discoloration of both fingernails and toenails. The nail bed loosens and separates from psoriatic nails (also known as onycholysis). The nails fall apart if the illness becomes severe.
Guttate Psoriasis:
This type of psoriasis affects young people and children. A bacterial infection, like strep throat, triggers it. Small, drop-shaped scaling lesions on the trunk, arms, or legs are characteristic signs.
Inverse Psoriasis:
Inverse psoriasis damages the groin, buttocks, and breast skin folds. Friction and sweat result in scaly, inflammatory skin patches. Fungal infection is another cause of this type of psoriasis.
Psoriasis Pustular:
Psoriasis pustular is an unusual form of pustular psoriasis resulting in distinct pus-filled blisters. It may appear as little or large patches on the palms and soles.
Psoriasis With Erythroderma:
Erythrodermic psoriasis can cover the entire body in a peeling rash that causes severe itching or burning.
Available Treatment Options for Psoriasis
Psoriasis treatment aims to stop the rapid growth of skin cells. Treatment options for psoriasis may include oral or injectable drugs, light therapy, phototherapy, lotions, and ointments (topical therapy). The severity of psoriasis and its responsiveness to prior therapies will determine which treatments you utilize.
Corticosteroids:
Corticosteroids are frequently prescribed for mild to moderate psoriasis. They can come as oils, ointments, creams, gels, foams, sprays, lotions, and shampoos. Mild corticosteroid ointments (hydrocortisone) are typically advised for treating extensive patches and sensitive areas like the face or skin folds.
Vitamin D Analogs:
Calcipotriene and calcitriol prevent skin cell proliferation. Topical corticosteroids and other medications of this type can be used together. Calcitriol might induce less irritability in some locations.
Retinoids:
Tazarotene is available as a gel or cream administered once or twice. Skin inflammation with hypersensitivity to light is a frequent adverse effect.
Acid Salicylate:
Salicylic acid-containing shampoos may help with scaling caused by psoriasis. Both non-prescription and prescription strengths are available. It can make the scalp more receptive to absorption, so it is used with other topical therapies.
Coal Tar:
Coal tar can help with scaling and inflammation. It is available in many forms, including shampoo, cream, and oil but can irritate the skin. They have a strong smell and stain clothes.
Light Therapy:
Light therapy is the primary line of treatment for moderate to severe psoriasis symptoms, either by itself or in conjunction with medication. It involves exposing the skin to managed doses of artificial or natural light repeatedly.
Sunlight:
Daily exposure to sunlight may also help with Psoriasis.
UVB wideband:
Psoriasis that doesn’t respond to topical medications can be treated using controlled doses of UVB wideband radiation from a light source. Short-term negative side effects include dry, itchy, and irritable skin.
Narrowband UVB:
UVB narrowband has shown more promising results and so it has replaced UVB wideband. However, when compared to UVB wideband, narrowband UVB phototherapy has serious adverse effects.
Other options:
If you are unable to respond to the above-mentioned treatment options for psoriasis, your doctor may recommend oral or injectible medications.
Steroids:
Triamcinolone may help with stubborn patches in psoriasis.
Retinoids:
Retinoids can also stop the growth of new skin cells. The patient may experience muscular discomfort or dry skin.
Biologics:
Injectable biologics are another option. These can alter the cycle of the disease and show improvements within weeks. These medications are used when first-line therapy fails.
Summary
Psoriasis is a genetic condition with no apparent cause. Its symptoms can be bothersome, but treatment options for psoriasis are available.
There are no cures for psoriasis, and it is not a preventable condition. You can reduce the risk by following guidelines from your healthcare provider, taking care of your skin, leading a healthy life, and avoiding triggers. Revival Research Institute is conducting clinical trials near you in Michigan on new potential treatment options for psoriasis.
Also, Read: Understanding UTI: Symptoms, Causes, and Treatment Options