This month is about creating awareness about Psoriasis.
What is psoriasis?
It is a chronic non-contagious auto-immune disorder and appears as a red, scaly patch. It itches, cracks and sometimes it also bleeds. If left alone it could develop to Psoriatic arthritis.
For psoriasis to manifest, there should be those genes that cause psoriasis, then the person should be exposed to the triggers, these triggers could be stress, skin injury and sometimes even infections. The trigger sends out a faulty message to the skin cells and its multiplication or growth accelerates.
Though it is perceived as contagious, it is not. All the same, it renders the person embarrassed, and results in higher levels of anxiety and depression. People with psoriasis are also higher risks for heart attacks, Crohn’s disease hypertension, obesity and depression.
As of now there is no known cure, the condition can only be managed.
The name is derived from the Greek word Psora that means itch… it is chronic and non-contagious and is recognizable by red inflamed lesions covered by silvery white scabs of dead skin.
It tends to occur more commonly in people with fair skin.
The physio-pathology is such that the body creates new cells faster than the normal 28-30 days, so shedding of the mature cells has to happen in less than a week instead of the usual 28 -30 day cycle. As the shedding does not occur the dead cells rise to the surface as patches of dead skin, these are particularly seen on the arms, back, chest, elbows, legs nails folds between the buttocks and scalp.
The most common for of psoriasis is psoriasis vulgaris or Plaque psoriasis it is small red bumps that enlarge, become inflamed and then form scales. Though the scales on top flake easily, removal of the scale below could cause bleeding and tenderness. Plaque tends to occur on elbows, knees, scalp and trunk.
Scalp psoriasis is seen in at least 50% of the population. Nail psoriasis begins as pitting of finger nails or toe nails, the size and shape and depth of these marks vary. There maybe thickening, or yellowing or crumbling of the effected nail and the skin around the nail may be inflamed. There are times when the nail peels away from the nail bed. Guttate Psoriasis comes from the word gutta that means a drop… this could emerge, and heal without treatment, or morph into plaque psoriasis. Pustular psoriasis usually occurs win adults, and is blister like lesion with non-infectious pus, it is surrounded by reddened skin, this usually localized though at times it is widespread this is many a times the first symptom of a potentional chronic plaque psoriasis. If this generalized it is then known as Zumbusch pustular psoriasis and develops as painful patches or inflamed skin, this is rapid, pustules appear in few hours, dry and peel off in a day or two, this can make life threatening demands on the heart and kidneys. Plantar Psoriasis manifests at the base of thumb or sides of the heel. The disease gets less active after feeling. Though it can morph into painful disabling lesions on the finger tips or toe tips then it is called acrodermatitis continua of Hallopeau. The nail could become deformed and disease can damage bone in the affected area.
Inverse psoriasis occurs in the armpits and groins, under the breasts and in other areas where skin flexes or folds. This disease is characterized by smooth, inflamed lesions can be debilitating.
Erythrodermic psoriasis disrupts the body’s chemical balance and can cause sever illiness. This is charecterized by sever scaling, itching and pain this effects most of the body. this could either manifest directly or develop in a patient with a history of plaque psoriasis.
About 10% of the Psoriasis patients develop into a complication called psoriatic arthritis. This usually manifests as a combination of the following symptoms
- Joint discomfort, swelling, stiffness or throbbing.
- Swelling in the toes, ankles
- Pain in the digits, lower back, wrists, knees and ankles
- Eye inflammation or pink eye conjunctivitis.
Though the exact cause of psoriasis is not known, immune-system malfunction is what triggers the disease, factors that could trigger the malfunctions are
- Family history
- Exposure to cold temperature extremes
- Steroids and other medications
- Racial tendencies.
The acceleration to psoriatic arthritis could occur with bacterial infection or trauma.
The treatment is done after a complete physical, histo-pathological and biochemical tests are done.