Psoriasis

Psoriasis is a lifelong skin condition characterised by the development of red scaly areas of skin. About 50% of people affected with psoriasis have changes to their nails and about 25% of people have pain, swelling and tenderness of their joints.

Psoriasis can develop at any age. The condition usually starts in young adults in their early 30s, with 75% of affected people developing psoriasis before the age of 45 years.

There is currently no cure for psoriasis. The aim of treatment is to clear the lesions and control symptoms.

Psoriasis is aggravated by infections, injuries such as cuts and abrasions and sunburn, obesity, smoking, excessive alcohol, stressful events, and medications.

It is associated with other health conditions such as inflammatory arthritis (psoriatic arthritis), inflammatory bowel disease, coeliac disease, hypertension, gout, type 2 diabetes, and cardiovascular disease.

It is diagnosed by its clinical features and may be supported by skin biopsy.

Types of Psoriasis

Post-streptococcal psoriasis characterised by widespread small plaque which often resolves after a few months. Most commonly found on the trunk

Small plaque psoriasis

Chronic plaque psoriasis is persistent, and treatment resistant. Plaques are most often found on and around the elbows, knees, and lower back.

Unstable plaque psoriasis is seen by a rapid extension of existing or new plaques and induced by infection, stress, drugs, or drug withdrawal.

Flexural psoriasis affects the body folds and genitals with smooth, well-defined patches.

Scalp psoriasis

Sebopsoriasis, is an overlap of seborrheic dermatitis and psoriasis which affects scalp, face, ears, and chest.

Palmoplantar psoriasis affects the palms and or soles.

Nail psoriasis defined by pitting, yellowing and ridging of nails. It can be associated with inflammatory arthritis.

Erythrodermic psoriasis may be preceded by another form of psoriasis.  It occurs acutely and chronically and may result in systemic illness.

Treatments

Patients with psoriasis should avoid, smoking, excessive alcohol and should maintain optimal weight.

Types of treatments depend on the body site, extent and severity of the psoriasis.

Mild psoriasis is generally treated with topical agents alone. Moderate to severe psoriasis often warrants systemic agents and phototherapy.

Biologics (targeted therapies) are reserved for treatment-resistant severe psoriasis.