Symptoms of psoriasis
- Plaques of red. inflamed skin
- Often accompanied with silvery white scales
- The plaques may be itchy or sometimes sore
- Sometimes the scalp is affected which can cause significant flaking.
- Fingernails can also become thickened and loosened from the nail bed
How do psoriatic plaques develop?
- In psoriasis, the rate of skin proliferation is unusually high
- New skin cells move to the surface before they have had a change to fully mature
- This causes the plaques that are characteristic of psoriasis
- Psoriatic arthritis is an autoimmune disease that occurs in about 30% of people with psoriasis and involves the body's own immune system attacking healthy tissue in the joints and skin
- This results in joint pain, swelling and stiffness
- These symptoms often occur before the red, scaly plaques that are typical of psoriasis although there are some cases when skin symptoms do not develop at all.
Causes of psoriasis
- Poorly understood
- May be some genetic link
- Certain triggers - e.g. stress, smoking, infection
- Lack of sunlight
Treatment of psoriasis
- Emollients - may help moisturise and soothe plaques
- Topical treatments - Corticosteroids can be used to treat smaller areas of skin e.g. on elbows or knees. Vitamin-D based creams, gels, and scalp applications slow the production of skin cells and can be useful in mild to moderate psoriasis. Vitamin-A based topical preparations may also be of some use but often will cause irritation of the skin. Finally, coal-tar based products reduce inflammation and scaling. There are many shampoos available to buy that have value in treatment of psoriasis of the scalp
- Light therapy
- Oral treatments - include ciclosporin, methotrexate, and acetretin. These treatments should only be used in widespread or severe psoriasis. Patients taking these medicines should be advised to watch for signs of infection (e.g. sore throat, fever, or unexplained bruising) and seek prompt medical assistance if these symptoms develop.
- Biological options - includes adalimumab and infliximab. These may be used only if all other treatment options have failed to control symptoms