Psoriasis is a lifelong skin condition characterised by the development of red scaly areas of skin with nail (around 50%) and sometimes joint involvement in around 25% of people. The global prevalence of psoriasis is around 1-3%. It is NOT contagious and does NOT spread by touch or contact.
Risk or aggravating factors
Although the exact cause of psoriasis is not known, people with the following factors are at a higher risk of developing the condition.
Family history of psoriasis
Stress (both physical or mental)
Skin injury or trauma
Excessive exposure to the sun
Triggered by infection
Smoking or excessive alcohol
Obesity
Certain anti-malarial, hypertension or heart medications
Click to view ACD video on psoriasis
Symptoms and Signs
Psoriasis can develop at any age but there are 2 peaks of onset between the age of 15-25 years and 50-60 years. There are several types of psoriasis with different presentations;
Plaque psoriasis is the most common type and occurs in around 80-90% of people. The skin lesions have a characteristic look; they are red/pink plaques or patches with sharp outline with thick slivery scales and can be seen on any area of the skin but most commonly on the elbows, knees, lower back and scalp.
Guttate psoriasis (can occur in young adults after an infection). The lesions look like the plaque but smaller in size like raindrops/spots and widespread throughout the body. These lesions usually improves within 2-3 months with treatment.
Inverse or flexural psoriasis occurs in the skin fold areas such behind the ears, armpits, below the breasts, the belly button, groin and between the buttocks. These skin lesions usually have little or no scales.
Pustular psoriasis. These lesions look like small pustules in an inflamed skin and can spread quickly.
Erythrodermic psoriasis is a rare form of psoriasis and can be serious. These lesions are red and inflamed which can spread to involve all of the skin. This condition can be triggered by
Sudden withdrawal of steroids
Taking certain medications
Emotional or physical stress
There are also 2 other types of psoriasis which are confined to certain parts of the body namely
Palmoplantar psoriasis occurs on the palms of the hands or soles of the feet and can be mistaken for eczema
Scalp psoriasis where the scaly plaques are found in the scalp area and often mistaken for dandruff
Nail psoriasis causes pitting over the nail plate which may lead to separation of nail plate from the nail bed and even nail disfigurement. Nail involvement is typically very difficult to treat and is associated with increased risk of getting psoriatic arthritis
Diagnosis
Psoriasis can be diagnosed from the history and examination by your skin doctor. Sometimes, a skin biopsy may be required when there is atypical presentation or the disease is recalcitrant to treatment.
Management
Psoriasis can have a huge impact on the emotional and social wellbeing because the lesions can be unsightly. It may affect interpersonal relationships as well as ability to work in stressful environment sometimes leading to feelings of despair. Patients are usually advised to have the following approach;
To be well informed about their skin condition and aggravating factors
To modify their lifestyle such as stopping smoking, avoiding excessive alcohol and maintain an ideal weight for their height and age
Disclaimer. TELEME blog posts contains general information about health conditions and treatments. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. The information is not advice and should not be treated as such.
If you think you may be suffering from any medical condition, you should seek immediate medical attention from your doctor or other professional healthcare providers. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website.
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