Psoriasis is a chronic immune skin condition affecting up to 2% of the population. It commonly involves the skin on the scalp, elbows, knees, hands, feet, trunk and nails. There are many different types of psoriasis:
- Plaque psoriasis is the most common form. These lesions are different sizes and usually symmetrical red plaques with a silvery/whitish scale on their surface. They are often found on the elbows and knees, but can also be found on the scalp, hands, feet, belly button, back and buttock. The area of skin affected can be very itchy and painful and sometimes bleed.
- Guttate psoriasis is less common and affects children more so than adults, usually after an upper respiratory tract infection. Lesions with this type of psoriasis are tear-drop-like, small (3mm-1.5cm) red papules or plaques. The lesions can disappear of their own accord after a few weeks.
- Flexural psoriasis affects the folds of your skin- in the armpits, under the breasts, groin and buttocks areas. Plaques are usually red and shiny, with no scale as the area is constantly being affected by movement and sweat. It can be very painful with cracks forming in the skin, which can also cause fungal infection.
- Pustular psoriasis is very rare, it can be anywhere on the body. It is associated with white or yellow pustules, with red skin behind them. It is often associated with a fever or infection.
- Psoriatic arthritis is a type of arthritis associated with pain, swelling and inflammation of the joints along with psoriasis. There can be swelling of the digits and nail changes. Usually psoriasis develops first, but in some cases pain can come first, and in other both start at the same time.
Psoriasis is a serious immune condition. It can have a huge effect on people’s mental and physical health. If it affects certain areas such as the hands- this can limit a person’s daily functioning. Pain can put a huge burden on your mental health- leading to depression and other psychiatric problems. Social discrimination can also be an issue with people judging the way a person looks, job opportunities can be less.
There are many treatments for psoriasis, depending on the type and severity of the condition. Finding the right treatment options for an individual can be difficult and can often lead to people thinking they have tried everything and wanting to stop. It is important to talk to your GP and be referred to a Dermatologist if you feel a treatment is not working or is causing unwanted side effects.
Treatments fall into four main categories:
- Phototherapy- artificial UV light therapy. This is not the same as sunbeds and is delivered in hospital dermatology departments under specific UVB conditions.
- Topical treatments- creams, ointments, gels, foams applied to the skin. These can be corticosteroids, vitamin D analogues, coal tar, emollients, salicylic acid and calcineurin inhibitors.
- Systemic treatments- tablets or injections e.g. methotrexate.
- Biological treatments- drugs that target specific parts of the immune system- alefacept, etanercept, infliximad, adalimumab, uskenkinumab.
Treatments should be initiated by your Doctor. Not all treatment options are suitable for every patient, depending on many factors such as liver function, kidney function, other medications, pregnancy, medical history, among other factors.
Resources: https://irishskin.ie/psoriasis/
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