Psoriasis

About Psoriasis

Psoriasis is a skin condition caused by unusual production of skin cells that results in skin build-ups. It is a long-term skin condition that leaves your skin dry and inflamed. Psoriasis can be managed by taking psoriasis treatments based on the type of psoriasis you are suffering from.

Types of psoriasis 

Plague psoriasis

Plague psoriasis is the most common type of psoriasis. This type of plaque affects skin areas like the knees, elbows, and lower back. It presents as large patches(plagues), that are inflamed and itchy. The plagues are covered with silver scales and may appear reddish.

Guttate psoriasis

Guttate psoriasis is also known as raindrops or teardrops psoriasis. It presents as a large rash on the skin with small, reddish, scaly, sore, itchy spots.

Guttate psoriasis is commonly found on the limbs, neck, scalp, or trunk. This type of psoriasis is a result of throat infection, medications, injury on the skin, or illnesses. It's most common in teenagers, young adults, and children

Pustular psoriasis

Pustular psoriasis symptoms are small pus-filled pustules that occur on the soles of the feet and palm. The skin around the pus-filled pustules appears reddish and may crack while walking or working with your hands. 

When the pus-filled pustules dry up they turn brown and crusty. Pustular psoriasis is not common like the other types of psoriasis and it is uncontagious.

Scalp psoriasis

Scalp psoriasis occurs on the whole scalp or in patches. It mostly affects the skin around the hairline, the back of the neck, and behind the ears.

Symptoms of scalp psoriasis include inflamed, red, and flaky skin that resembles dandruff. You may experience tight, sore, and itchy skin on your scalp which may lead to hair loss or thinning of the hair.

Nail psoriasis

Nail psoriasis affects the fingernails and toenails. Nail psoriasis symptoms include thickening, crumbling, and discoloration of the nails, nails coming out easily, and pitting and dents on the nail surface.

It's easy to confuse fungal nail infection with nail psoriasis, therefore seek medical advice and get diagnosed by a professional.

Inverse psoriasis

Inverse psoriasis is most common on the armpits and under the breasts. Its symptoms include pain sores under the affected skin areas.

Erythrodermic psoriasis

Erythrodermic psoriasis is a type of psoriasis caused by sunburns, infections, or some medications. Its symptoms include skin shedding and severe redness on the affected skin areas.

Similarities between psoriasis and eczema

• They have no cure 
• They can be treated using topical corticosteroids to relieve symptoms
•  Causes symptoms such as red, flaky, and crusty patches on the skin.

The difference between psoriasis and eczema

Psoriasis

• Causes your skin to appear like silvery scales
• Can appear in any part of your body. This includes elbows, knees, back, scalp, etc
• Causes your skin to become more thick and inflamed 
• Psoriasis is caused by high skin cell production
• Psoriasis affects all ages but is most common in adults under 35 years.

Eczema

• Causes your skin to appear reddish 
• Appears on the skin bends. For example, inner elbows, knees, scalp, or lower back
• You may experience less inflamed skin
• The exact cause of eczema is unknown 
• Eczema is common in children

The main cause of psoriasis is the immune system cell known as the T cell.T cells attack and fight bacteria causing the infection but in people with psoriasis, T cells attack healthy skin cells mistakenly.

This triggers the hypodermis to produce new skin cells quickly therefore causing inflammation and skin thickening. Other environmental and biological factors cause psoriasis. 

Common triggers of psoriasis 

Triggers are factors that result in psoriasis flare-ups. They include:

• Smoking 
• Hormonal changes. (occur in women during puberty and menstruation) 
• Throat infections 
• Medicine interaction
• Alcohol 
• Stress 
• Skin injuries (cuts, scrapes, or insect bites)
• Immune disorders such as HIV

Psoriasis Treatments

Psoriasis has no exact cure but can be managed with psoriasis treatments. Your pharmacist will determine the best type of treatment depending on the severity of your symptoms and the skin area of treatment.

There are several types of psoriasis treatments, they include topical treatments, systematic medications, and phototherapy.

Topical treatments 

Topical treatments are creams and ointments applied on the skin. Psoriasis topical treatments are divided into 4 categories:

Topical steroids 

Topical steroids are short-term use corticosteroids applied in the area of treatments to reduce inflammation. Examples of topical steroids include:

• Eumovate cream&ointment
• Betnovate cream&ointment
• Betnovate scalp lotion
• Betacap 1% scalp application, and Bettamouse foam

Vitamin D preparations 

Topical vitamin D is used to decrease inflammation, redness, dry skin, and scaling. They are applied 30 minutes after moisturizing the affected area of treatment. Topical vitamin D is not applied on the face as it can cause skin thinning and calcium buildup in the blood. 

Your pharmacist may prescribe a topical vitamin D treatment only or combine it with a topical steriod depending on the severity of your symptoms.

Examples of Vitamin D gels include:

• Dovonex ointment
• Enstilar foam, and Dovobet gel and ointment.

Moisturizers and emollients

Moisturizers and emollients are designed to hydrate and protect your skin from drying. Moisturizers can be used as a daily skincare routine to increase their effectiveness while emollients are only used during the day for a natural hydration feeling.

Examples of moisturizers and emollients include:

• Diprobase cream
• Dermalex psoriasis cream, and Cetraben cream.

Coal-tar products:

Coal tar is used to treat various skin conditions, such as scalp psoriasis, eczema, dandruff. however, it is also available in the form of gel, lotion, and ointments. Coal tar contains anti-inflammatory and anti-scaling properties that relieve psoriasis symptoms.

Coal tar is used together with salicylic acid to shed off the thick scaly skin. Examples of products containing coal tar include:

• T/gel shampoo, and polytar shampoo.

Treatment products containing coal tar and salicylic acid include:

• Cocois ointment, Sebco ointment, and Capasal shampoo.

Systematic medications

Systematic treatments work best on severe psoriasis symptoms. Compared to topical treatment, systematic treatments work in the entire body. 

They are available as biological and non-biological treatments. Nonbiological treatments include: injections while biological treatments include tablets and capsules.

Phototherapy 

Phototherapy type of treatment uses ultraviolet light to reduce inflammation in the skin area of treatment. Phototherapy is only performed by a dermatologist. There are 3 categories of phototherapy:

• Combination therapy: This is where you use the topical steroids in combination with the therapy 
• UVB therapy: Ultraviolet B lights are used to reduce skin cell production. Your dermatologist may recommend you take 2 to 3 sessions a week.
• PUVA therapy: A combination of ultraviolet A light and ultraviolet B light is used. You can also be recommended to take psoralen tablets or have psoralen applied to your skin.

Preventions

There are lifestyle changes and skin care routines that can reduce the severity of psoriasis symptoms. These prevention measures include:

• Cleaning and trimming your nails 
• Use a humidifier in your workplace or home to prevent your skin from drying 
• Keeping your skin hydrated by using moisturizers after taking a shower 
• Avoid scratching your skin

Symptoms of psoriasis 

• Dry patches on the skin with scales on top. (Brown and black skin people may experience purple/brown patches covered with grey scales. The patches are either red/pink with silvery scales on white skin)
• Mild Itching 
• Soreness
• Redish inflamed skin
• Hair loss
• Excess dandruff on the scalp