Psoriasis (銀屑病, 牛皮癬 ) is a skin condition characterised by red flaky or crusty patches covered with white or silvery scales. Sometimes the affected area will also experience itching and discomfort. Psoriasis is caused by inflammation of the skin and a dysfunction in the turnover of skin cells, where the skin regenerates a lot faster than normal, leading to a buildup of old skin which causes thickened plaques. Although it is a skin condition, it can also affect the fingers nails and joints can also become involved giving symptoms of arthritis. Psoriasis is not a contagious condition.
It is not known exactly what causes people with psoriasis to develop this increased rate of skin cells turnover, but it is thought to be an autoimmune condition (where the body’s own immune system inappropriately attacks a part of the body). About 1 in 50 people may go on to develop psoriasis in their life, and it most commonly appears in patients younger than 30 years old.
There are a few different types of psoriasis:
The most common type of psoriasis, affecting up to 80% of patients. The plaques can appear anywhere on the body and appear red or purple with silvery white scales, most commonly on the scalp, knees, belly button and lower back.
Affecting about 8% of patients, it appears to be small, round red spots. Most commonly on the arms, legs, and trunk.
Affecting about 3% of patients, the symptom is the development of pus-filled blisters, sometimes only on the hands and feet, but may also cover the entire body
Some patients get psoriasis of the scalp, which can look like severe dandruff and cause irritation of the scalp.
Psoriasis can also affect other parts of the body:
Nail shape will change for half of the people. And nail psoriasis is more common for people who have psoriatic arthritis
Psoriatic arthritis encompasses the coexistence of psoriasis and arthritis, characterised by joint inflammation. In over 80% of instances, individuals experience psoriasis for an average duration of 12 years before developing psoriatic arthritis. Approximately 90% of those affected by this condition also exhibit nail changes.
At present, there is no complete cure for psoriasis and the treatments mainly focus on controlling symptoms. Patients may need to receive different treatments throughout their life.
For example, moisturises, vitamin D analogues, topical corticosteroid creams, coal tar preparations, diathranol or salicylic acid. These treatments all work by reducing inflammation, hydrating the skin and helping to slough away some of the excess skin cells.
Some patients will be recommended to have a course of ultraviolet light therapy, which can help to suppress the overactive immune system locally. It can be divided into UVA and UVB treatment courses suitable for moderate to severe patients, and sometimes you will be required to take a medication to enhance the effect of the UV light depending on which type of UV therapy you have.
Sometimes patients will require stronger medications to help their condition, such as immune system suppressants such as methotrexate and cyclosporine.
A breakthrough in treatment in recent years is the use of subcutaneous or intravenous injections of drugs to neutralise some of the inflammatory factors related to psoriasis, thereby stabilising active inflammation without over-supressing the normal immune system function.
If you need help with psoriasis, your GP can help you either with initiating treatment in mild to moderate cases, or in helping to assess you for referral to a specialist dermatologist, an expert in skin conditions, who can help you in more severe cases.
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