Psoriasis is a common skin condition which affects men and women of all ages. There are several different type of psoriasis. Psoriasis often goes through cycles. It can flare up for a few weeks or months, and then the symptoms ease or stop.
Plaque psoriasis - the most common form of psoriasis. Around 80% of people with psoriasis have plaque psoriasis. Its symptoms are dry, red skin lesions - known as plaques - that are covered in silver scales. They normally appear on your elbows, knees, scalp and lower back but can appear anywhere. The plaques are normally itchy, sore, or both. In severe cases the skin around your joints may crack and bleed.
Nail psoriasis - this affects your nails causing them to pit, become discoloured and grow abnormally. Often nails can become lose and separate from your nail bed. In some severe cases, nails may crumble.
Guttate psoriasis - this normally occurs following a throat infection (streptococci) and is more common amongst children and teenagers. This causes small (less than 1 cm) water-drop shaped sores on your chest, arms, legs and scalp. There is a good chance that guttate psoriasis will disappear completely, but some young people go on to develop plaque psoriasis.
Scalp psoriasis - this normally affects the back of the head, but it can occur in other parts of your scalp, or on the whole scalp. This causes red patches of skin covered in thick silvery-white scales. Some people find scalp psoriasis, extremely itchy, while others have no discomfort. In extreme cases it can cause hair loss, but not permanent balding.
Inverse psoriasis - this affects areas of the skin that are in folds or creases, such as the armpits, groin, and the skin between the buttocks and under the breasts. This can cause large smooth red patches to occur in some or all of these areas. Inverse psoriasis is made worse by friction and sweating, so it can be particularly uncomfortable in hot weather. Inverse psoriasis is more common in overweight people.
Rarer types of psoriasis
There are rarer types of psoriasis known as pustular psoriasis. These cause pus filled blisters (pustules) to appear on your skin. Different types of pustular psoriasis affect different parts of the body:
Pustular psoriasis (Von Zumbusch) psoriasis - this causes pustules to appear across a wide area of your skin. The pustules develop very quickly. The pus consists of white blood cells and is not infected. The pustules dry and peel off within a couple of days, leaving the skin shiny and smooth.
The pustules may reappear every few days or weeks in cycles. During the start of these cycles, rarer Von Zumbasch psoriasis can cause fever, chills, weight loss, and fatigue.
Palmaplanter pustular psoriasis - this causes pustules to appear on the palms of hands and the soles of the feet. Pustules may reappear every few days or weeks.
Acropustulosis - this causes pustules to appear on your fingers and toes. The pustules then burst leaving bright red areas that may ooze or become scaly. These may lead to painful nail deformities.
Erythrodermic psoriasis is the rarest form of psoriasis. This can cover your body with a widespread red rash that causes intense itching or burning. Erythrodermic psoriasis can cause your body to lose proteins and fluid. This can lead to serious illnesses such as dehydration, heart failure, hypothermia and malnutrition.
Cause of psoriasis
The exact cause of psoriasis is unknown but it is known that your immune system plays a part. With psoriasis, antibodies called T cells attack healthy skin cells by mistake. This triggers other immune responses that increase the production of new skin cells and also T cells. This results in a cycle of skin cell production becoming faster and faster - skin cells are created and then die in the space of 5-6 days, rather than the normal 28 days. The dead skin cells then build on the surface of your skin in thick scaly patches. Psoriasis runs in families - one in three people with psoriasis has a close relative who also has psoriasis. Diseases of the immune system such as the HIV infection can cause psoriasis to flare up or to appear for the first time.
Between 10% and 20% of people with psoriasis develop psoriatic arthritis, which causes tenderness, pain and swelling in the joint and connective tissue with associated stiffness. It commonly affects the ends of the fingers and toes. In some people it affects the lower back, neck and knees.
There is no single test for psoriatic arthritis. It is normally diagnosed using a combination of methods, looking at your medical history, physical examinations, blood tests, X-rays and MRI scans. Psoriatic arthritis can be treated with anti-inflammatory or anti-rheumatic medicines.
Certain events or triggers can cause or trigger psoriasis. Identifying a trigger may allow you avoid flare ups. Common triggers include:
- A skin injury such as a cut, scrape, insect bite, or sunburn (known as 'the Koebner response').
- Certain medicines like lithium, antimalarial medicines, anti-inflammatories including ibuprofen, ACE inhibitors (treats blood-pressure), and beta blockers (treats congestive heart failure).
Free Psoriasis skincare consultation at Psoriasis Clinic
Whelehans Pharmacy offer free Psoriasis skincare consultations at our Psoriasis Clinic on Thursday September 1st with skincare expert Trish Wallace. Learn how to reduce redness and scaling and how to reduce frequency of flare-ups. Whelehans offer a range of effective products that give clearer skin in a safe and effective way without the need for stronger and potentially damaging prescription medicines like steroid creams. Book your free appointment; call Whelehans at 04493 34591 to discover clearer skin.
To be continued...next week I will discuss treatment
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For comprehensive and free health advice and information call in to Whelehans, log on to www.whelehans.ie or dial 04493 34591