Psoriasis is an inflammatory disease that affects the skin. It usually begins as a small scaling papule (pimple-like spot without pus) and when several papules coalesce, they form scale-like plaque which tends to occur on the scalp, elbows, and knees.
These usually appear as red or pink patches of raised, thick, dry, scaly skin. Although psoriatic plaques can be limited to a few small areas, the condition can involve vast areas of skin anywhere on the body. These plaques can be itchy, and when the scale is peeled away, small bleeding points may appear.
Psoriasis tends to occur in areas of trauma (injury). This condition often grows and fades spontaneously.
Who can get psoriasis?
Anyone can have psoriasis and it occurs equally in men and women. Psoriasis can occur at any age but is most often diagnosed between the ages of 15 to 25. It is considered a non-curable, chronic skin condition and there will be periods where the condition will improve, and at other times, it will worsen.
The symptoms can range from mild, small, faint dry skin patches where a person may not suspect they have a skin condition to severe psoriasis where a person’s entire body may be covered with thick, red, scaly skin patches.
What Causes Psoriasis
According to Dr Edward Ogwang, a dermatologist in Wandegeya, Kampala, psoriasis is a genetically determined condition, with about 30 per cent of patients (about one in every three patients) reporting a positive family history of the disease.
“The body’s immune system produces chemical components called cytokines. These stimulate the skin cells called keratocytes to grow so fast leading to formation of thick scaly rashes,” Dr Ogwang adds.
Appearance of the condition may be triggered by a past bacterial (streptococcal) sore throat infection, trauma to the skin, certain drugs or alcohol in excess.
Common forms of psoariasis
1. Psoriasis vulgaris is the most common form of psoriasis. It is also referred to as plaque psoriasis because of the well-defined patches of raised red skin that characterise this form. These raised red plaques have a flaky, silver-white buildup on top called scale, made up of dead skin cells. The scale loosens and sheds frequently.
2. Guttate psoriasis has small, pink coloured papules on the skin.. This type of psoriasis is triggered by a streptococcal (bacterial) infection.
About two to three weeks following a bout of sore throat (streptococcal) infection, a person’s lesions may erupt.
3. Inverse psoriasis appears as red lesions in skin folds, commonly under the breasts, in the armpits, near the genitals, under the buttocks, or in abdominal folds.
Sweat and skin rubbing together irritate these inflamed areas and a yeast overgrowth, which is common in skin folds, triggers this type of psoriasis.
4. Pustular psoriasis consists of well-defined, raised white pustules on the skin. These are filled with pus that is, however, non-infectious. The skin around the bumps is reddish and large portions of the skin may redden as well. It can follow a cycle of redness of the skin, followed by pustules and scaling.
5. Erythrodermic psoriasis is a rare type of psoriasis that is extremely inflammatory and can affect most of the body’s surface causing the skin to become bright red and inflamed. It appears as a red, peeling rash that often itches or burns.
Psoriasis of the scalp may cause fine, dry, scaly skin or heavily crusted plaque areas. This plaque may flake or peel off in clumps.
Scalp psoriasis may resemble seborrheic dermatitis, another skin condition in which the scales are greasy and not dry.
6. Psoriatic arthritis is a type of arthritis (inflammation of the joints) accompanied by inflammation of the skin (psoriasis).
Psoriatic arthritis is an autoimmune disorder where the body’s defenses attack the joints of the body causing swelling and pain.
Psoriatic arthritis usually develops about five to 12 years after psoriasis begins and people with psoriasis will often develop psoriatic arthritis
7. Nail Psoriasis Many patients with psoriasis have abnormal nails. Psoriatic nails often have a horizontal white or yellow margin at the tip of the nail (distal onycholysis) because the nail is lifted away from the skin. There can be small pits in the nail plate, and the nail is often yellow and crumbly.
Psoriasis is not contagious. You cannot get it from touching someone who has it, nor can you pass it on to anyone else if you have it.
However, it can be passed on from parents to children and this family history is helpful in making a diagnosis.
Extensive psoriasis can have a very significant negative effect on a person’s self-image and emotions, especially in social situations. Inverse psoriasis, which affects the genital skin, and scalp psoriasis can be particularly troubling.
Dr Edward Ogwang stresses that treatment of psoriasis requires a doctor. Non pharmacological treatment may involve exposure to sunlight (phototherapy), applying moisturisers after bathing to keep skin soft, avoid irritating cosmetics or soaps. Do not scratch itchy parts to the point that you cause bleeding or excessive irritation.
Also add oil to your baths to moisturise skin. Drugs that can be used in treatment, according to the dermatologist, target the cytokines produced for example cortisone (steroid)reams can be used to reduce itching in mild psoriasis.