PSORIASIS
Overview -
Psoriasis is an immune-mediated disorder that can affect skin, nails, and joints predominantly but can also affect other systems of the body and is associated with a high impact on the quality of life. It presents with red scaly patches over the body. Though its prevalence varies in different parts of the world, it affects 2-3% of the world population. It can affect any gender or age.
what causes psoriasis ?
It is an immune disorder that is also affected by genes and the environment. An interplay of a lot of internal factors leads to malfunction of the immune system which in turn causes the skin to proliferate at a much higher rate than normal (4-5 DAYS AS COMPARED TO 30 DAYS IN NORMAL INDIVIDUALS). This increased rate of skin proliferation causes the dead skin to accumulate in the upper layer of skin which is clinically visible as white scales on red patches.
Genetic factor has an important role to play especially in children. The risk of psoriasis increases to 28% if a parent is affected and to 65% if both parents are affected (vs 4% risk in the general population).
There are a lot of environmental factors which aggravate psoriases such as trauma, infections, cigarette smoking, alcohol, and stress.
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How does it Present?
Psoriasis can affect the skin of any part of the body and nails and can affect one or multiple areas. It mostly presents as red scaly raised lesions which can sometimes be itchy (especially on hands and feet and scalp). The patient experiences shedding of scale which can be seen on clothes and beddings. The lesions are frequently seen at sites of trauma or scratching. Sometimes, there are pus-filled lesions on the red patches, and sometimes whole skin becomes red and scaly.
When it affects the scalp only, it is frequently misdiagnosed as dandruff.
The nails are affected as associated findings and sometimes as an isolated feature. The patient may notice discoloration, ridges, and grooves in nails, and pinpoint depressions or pits.
In children, it might present with sudden onset of a shower of small scaly red lesions on the trunk usually after a throat infection.
The disease course is such that the patient experiences frequent relapses and remissions with worsening of the condition in winters usually.
Does Psoriasis Affect Internal Body Parts?
Psoriasis was conventionally believed to be a disorder of skin only, however, now it is well known that psoriatic patients tend to have concurrent illnesses termed as comorbidities which should always be evaluated and treated appropriately. In fact, evaluating a psoriatic patient in detail for these comorbidities helps in their early detection and treatment, helping improve the overall quality of life of the patient and this is a forte of Sparsh Skin Clinic.
Comorbidities in psoriasis include metabolic syndrome, heart disorders, gut issues like inflammatory bowel diseases, and liver disorder. Metabolic syndrome is a cluster of disorders including obesity, high cholesterol, high blood pressure, and diabetes is increasingly been seen in association with psoriasis. It increases the inflammation seen in psoriasis so its recognition and treatment is an important factor in controlling psoriasis per se and reducing the chances of frequent relapses.
Stress is important comorbidity seen in psoriasis. Patients should talk to the treating physician about the psychological stress rather than avoiding this topic as it is not just a byproduct of the disease but also an aggravating factor for the same. At Sparsh Skin Clinic, we make sure to deal with this aspect of the disease.
Does Psoriasis Needs Biopsy or Other Investigations?
Psoriasis generally needs no biopsy, however, there are times when it presents atypically when we need to do a biopsy to rule out other skin conditions which may look like psoriasis. (especially when it affects palms and soles).
However, blood investigations are a part of psoriasis management to rule out internal issues (as elaborated above) and as part of screening and monitoring of various treatments given.
Can Psoriasis be Treated?
It’s a common misconception that psoriasis cannot be treated. We offer complete treatment and we boast on the fact that our patients usually have adequate disease control. It is important to understand that psoriasis might come back but that would mostly be due to improper or incomplete treatment or when associated comorbidities are not dealt with and lifestyle changes that we recommend are not adhered to.
How is Psoriasis Treated?
There are a lot of application creams, lotions, and shampoos along with oral medicines which are given based on body site involvement, the severity of the disease, and patient profile. These medicines are switched, combined, or rotated based on clinical response.
There is constant research in this field and there are new and safer medicines that are available every now and then. We at Sparsh Skin Clinic update ourselves with the latest and safest treatments available and offer them to our patients.
Biological therapy is injectable therapy for psoriasis that offers a nearly complete cure with a high safety profile. These are particularly useful in patients who have been on conventional psoriasis therapy for a long and are still suffering from the disease. We expertise in biological therapy administration.