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Psoriasis: Overview, Types, Symptoms, Causes, Treatment.

- July 17, 2020
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Psoriasis: Overview, Types,  Symptoms, Causes, Treatment.



Overview



What is Psoriasis ?


Psoriasis is a skin disorder that causes skin cells to grow 10 times faster than normal. It forms skin in a rugged red patch covered with white flakes. Psoriasis is a skin disease that causes red, itchy papular patches, usually on the knees, elbows, trunk, and scalp. Psoriasis is a common, chronic (chronic) disease with no cure.

  •   Psoriasis is not contagious.
  •   Psoriasis becomes better and worse spontaneously and may periodically cause remission (clear skin).
  •   Psoriasis is controllable with medication.
  •   Psoriasis is not curable.
  •   There are several promising new treatments, including new biological drugs.



Types of  Psoriasis



  •   Plaque Psoriasis :  The most common form, plaque causes psoriasis, is dry, bulging, red skin patches (sores) that are covered with silver scales. Plaques may be itchy or tender, and may be few or many. They usually appear on the elbow, knee, lower back, and scalp.

  •   Nail psoriasis: Psoriasis can affect the fingernails and toenails, causing peeling, abnormal nail growth, and discoloration. Psoriatic nails may loosen and detach from the nail bed (onycholysis). In severe cases, the nail may rupture.

  •  Guttate Psoriasis: which often begins in childhood or young adulthood, causes small, red spots, mainly on the torso and limbs. Triggers can cause respiratory infections, strep throat, tonsillitis, stress, skin injuries, and antimalarial and beta-blocker medications.

  •  Inverse Psoriasis: It mainly affects the skin layers of the waist, buttocks and breasts. Inverse psoriasis causes smooth patches of red skin that worsen with friction and perspiration. Fungal infections can trigger this type of psoriasis.

  •  Pustular psoriasis: This rare form of psoriasis clearly defines pus-filled lesions that occur in broad patches (generalized pustular psoriasis) or small areas on the palms of the hands or the soles of the feet.
  
  •  Erythrodermic psoriasis: Due to which the redness of the skin and the layer of scales in the sheets freezes. It prevents the treatment of severe sunburn, infection, certain medications and certain types of psoriasis. It needs to be treated immediately as it can cause serious illness.
 
  •   Psoriatic arthritis: Psoriatic arthritis causes inflamed, painful joints that are typical of arthritis. Sometimes a combined symptom is the first or only symptom or sign of psoriasis. And many times only the nail changes are seen. It can cause stiffness and progressive joint damage that in the most severe cases permanent joint damage can occur.



Symptoms


Symptoms of psoriasis may vary from person to person. Common signs and symptoms include:

  •   Red patches of skin covered with thick, silver scales
  •   Small scaling spots (usually seen in children)
  •   Dry, chapped skin that may bleed or itch
  •   Itching, burning or sore throat
  •   Thick, narrow or protruding nails
  •    Swollen and stiff joints



Causes



In psoriasis, this autoimmune activity leads to excessive growth of skin cells. Typically, the skin cells take about 20 –27 days to transform themselves. However, in people with psoriasis, they take about 3 -6 days.

Triggers will vary from person to person with psoriasis, but common triggers include:

  •   Skin injury
  •   Infection
  •   Hormonal changes

Medications that can trigger psoriasis include:

  •   Lithium
  •   Antimalarials
  •   Quinidine
  •   Indomethacin



Treatment



There are many effective psoriasis treatment options. The best treatment is determined individually by the treating physician and depends, in part, on the type of disease, severity, and amount of skin involved and the type of insurance coverage.

For mild diseases that involve only small areas of the body (less than 10% of the total skin surface), topical treatments (applied to the skin), such as creams, lotions, and sprays, are very effective and safe to use. Can. Occasionally, a small local injection of steroids may be helpful in a difficult or resistant isolated psoriatic plaque.



  •    Corticosteroids:  These drugs are the most commonly prescribed drugs for the treatment of mild to moderate psoriasis. They are available in the form of ointments, creams, lotions, gels, foam, sprays and shampoos. Mild corticosteroid ointments (hydrocortisone) are generally recommended for the treatment of sensitive areas such as folds of your face or skin and extensive patches. Topical corticosteroids may be applied once a day during flares, and only on alternate days or weekends to maintain remission.


  •    Calcipotrin: Cream is useful in psoriasis due to its effect on calcium metabolism. The advantage of calcitriol is that it is not known to thin the skin like a thin steroid. Calcipotrine has a new combination preparation and a topical steroid called taclonex. Not all patients can respond to calcipotrine. Prolonged use of these types of drugs on more than 20% of the skin surface can cause abnormal increases in the body's calcium levels.
   

  •   Moisturizers:  particularly with therapeutic concentrations of salicylic acid, lactic acid, urea, and glycolic acid may be helpful in psoriasis. These moisturizers are available as prescription and non-prescription forms. These help to reduce scales that inhibit the movement of topical medications into the deeper layers of the skin.  They can be used on the body one to three times a day. Other blender moisturizers, including Vaseline and Crisco vegetable shortening, can also be helpful in reducing the dry appearance of psoriasis.
   


  •  Coal tar: Coal tar reduces scaling, itching and swelling. It is available over-the-counter or by prescription in various forms, such as shampoo, cream, and oil. These products can irritate the skin. They are also messy, smelly clothes and bedding, and can have a strong odor.
  

  •  Anthraline: Anthraline is available for topical use as a cream, ointment or paste. It may be less acceptable for the use of stinging, possible irritation, and skin discoloration. Anthralin can be applied on psoriatic skin for 10–30 minutes.



Light therapy



Mild therapy is the first-line treatment for moderate to severe psoriasis, either alone or in combination with medications.

  •   The sunlight: Brief, daily sunlight exposure (heliotherapy) can improve psoriasis. Before the onset of sunlight, ask your doctor about the safest way to use natural light for psoriasis treatment.

  •    UVB narrowband. UVB broadband light therapy can be more effective than UVB broadband treatment and has replaced broadband therapy in many places. It is usually administered two or three times a week until the skin improves and then less often for maintenance therapy. However, narrowband UVB phototherapy may be the cause of more severe and prolonged burns.

  •    Psoralen Plus Ultraviolet A (PUVA). This treatment involves taking a light-sensitizing drug (Psoralen) before exposure to UVA light. UVA light penetrates deeper into the skin than UVB light, and Psoralen makes skin more sensitive to exposure to UVA.

  
  •    Excimer laser: With this form of light therapy, a strong UVB light only targets the affected skin. Stimulant laser therapy requires fewer sessions than conventional phototherapy because more powerful UVB light is used. Side effects may include redness and blister.



Oral or injection drugs


If you have moderate to severe psoriasis or other treatments that do not work, your doctor may prescribe oral or injectable (systemic) medications. Due to the potential for serious side effects, some of these drugs are used only for brief periods and may be optional with other treatments.

  •     Steroids:  If you have some small, frequent psoriasis patches, your doctor may suggest an injection of triamcinolone into the wounds.

  •     Retinoids:  Acetretin (soriaten) and other retinoids are pills used to reduce the production of skin cells. Side effects may include dry skin and muscle soreness. These medicines are not recommended when you are pregnant or breastfeeding or if you intend to become pregnant.

  •     Methotrexate: Usually administered weekly as a single oral dose, methotrexate (Trexal) reduces the production of skin cells and suppresses inflammation. It is less effective than adalimumab (Humira) and infliximab (Remicade). This can cause stomach upset, loss of appetite and fatigue. People taking methotrexate long term require ongoing testing to monitor their blood count and liver function.

  •     Cyclosporine: Seriously taken for psoriasis, cyclosporine (neural) suppresses the immune system. It is similar to methotrexate in effectiveness, but cannot be used continuously for more than a year. Like other immunosuppressant drugs, cyclosporine increases your risk of infections and other health problems, including cancer. People taking cyclosporine require monitoring of their blood pressure and kidney function.
 
  •    Other medicines:  Thioguanine (tabloid) and hydroxyurea (droxia, hydria) are drugs that can be used when other drugs cannot be given. It is particularly effective in reducing itching. Talk to your doctor about the possible side effects of these medicines.


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