Psoriasis is a chronic, recurrent, progressive and Inflammatory condition ( CRIP ).
Patient usually presents with dry, itchy, silvery white or slight red and raised skin patches most commonly presents on the elbows, knees and scalp. Some cases present multiple patches widespread all over the body.
Differential diagnosis – Seborrheic dermatitis
where the scalp involvement doesn’t cross the hairline whereas in psoriasis lesions cross the hairline
Psoriasis shouldn’t be considered as a skin disease alone it involves multiple systems. Psoriatic arthritis and sometimes even cardiac muscle is involved.
Good quality of life with Psoriasis is possible with better drugs. Secukinumab Injection, class of monoclonal antibodies, helps in stopping the action of certain cells thereby reducing the symptoms.
Causes of Psoriasis
Usually cause appears to be Multifactorial.
Genetics play a major role
Other aggravating factors include Stress, Injury, Climate, Hormonal
Usually skin cells die and shed away naturally, but in psoriasis body speeds up the skin life cycle by upto 10 times thus accumulating as thick plaques since new cells are being produced rapidly.
Types of Psoriasis
Most common type being Plaque Psoriasis, characterised by raised, thick patches of red skin covered with fine silvery white scales affected mostly on the scalp, knees and trunk.
Palmo-Plantar psoriasis characterised by deep fissures over the soles and also presents as erosions, hyperkeratotic, pustular or with mixed morphologies over the palms and soles
Other types
Scalp psoriasis
Resembles as profuse dandruff and the lesions crosses the hairline. Few people might develop lesions elsewhere on the body later years
Pustular psoriasis
Small pus-filled blisters with redness and swelling, may present as localised lesions or all over the body
Erythrodermic psoriasis
Generalised red, swollen skin suggesting impending complication of improperly treated or untreated condition
Guttate psoriasis
This type presents as tiny, drop like lesions which are scaly and widespread all over the body
Flexural psoriasis
As the name suggests this type is commonly seen on the flexural aspects of the skin like armpits, groin and below the breast
Psoriatic arthritis
This affects the joints
Nail involvement is also common in Psoriasis
Myth – Excessive scalp dandruff will lead to psoriasis
Fact- However extensive it is until unless the lesions cross the hairline, it is not considered as Psoriasis
Rule out Seborrheic dermatitis or Pityriasis capitis
Fact – Psoriasis doesn’t spread by touch. Psoriasis affected persons may not restrict themselves from playing with kids
Treatment options
Mositurizers
Creams and ointments
Photochemotherapy ( UVA or UVB light)
Oral medications- Disease modifying agents
Injectables – Secukinumab, Etanercept- Biologicals, Rituximab etc