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Psoriasis

Psoriasis is a chronic, immune-mediated skin disease that accelerates the growth cycle of skin cells. In healthy skin, cells regenerate every few weeks; in psoriasis, this process occurs in just a few days. This rapid turnover results in the accumulation of immature skin cells on the surface, forming thick, red, scaly patches known as plaques. While it is a skin condition, it is systemic in nature and can be associated with other health issues, including psoriatic arthritis and cardiovascular inflammation.

Eczema, clinically known as atopic dermatitis, is a chronic inflammatory condition characterized by a compromised skin barrier. This leads to patches of dry, red, and intensely itchy skin, most commonly appearing on the face, hands, and the creases of the elbows and knees. While it frequently begins in early childhood, the severity and presentation can vary significantly between patients. The condition is complex, resulting from an interplay of genetics, immune system sensitivity, and environmental triggers.

Key Points

  • Psoriasis is a chronic autoimmune condition, not an infection.
  • It is characterized by red, raised patches of skin covered with silvery scales.
  • It affects men and women equally and often appears between ages 15–35 or 50–60.
  • It is not contagious.
  • Management focuses on slowing skin cell turnover and suppressing immune overactivity.

What is psoriasis?

Psoriasis is a long-lasting (chronic) disease of the immune system. It occurs when T-cells (a type of white blood cell) mistakenly attack healthy skin cells. This triggers an inflammatory response that causes the body to produce new skin cells too quickly. These extra cells pile up on the surface, creating the characteristic scaly plaques.

Who gets psoriasis?

Psoriasis affects approximately 2-3% of the population. It has a strong genetic component; if one parent has psoriasis, a child has about a 10% chance of developing it, which increases if both parents are affected. It can occur at any age but typically presents in a bimodal distribution: usually appearing in late teens/early 20s or later in life (50s-60s).

Contact Smooth Skin Clinic for a comprehensive assessment and management plan.

Clinical features

The most common symptoms include:

  • Plaques: Red patches of skin covered with thick, silvery scales.

  • Location: Commonly found on elbows, knees, scalp, and lower back.

  • Itch & Pain: The skin can be dry, cracked, and may bleed or itch intensely.

  • Nail Changes: Pitting, thickening, or crumbling of nails.

  • Joint Pain: Swollen and stiff joints (indicative of psoriatic arthritis).

Diagnosis and differential diagnosis

Dermatologists typically diagnose psoriasis by examining the skin, nails, and scalp. A skin biopsy may occasionally be performed to rule out other disorders that look similar, such as eczema, lichen planus, or tinea (fungal infection).

Impact and complications

Beyond the physical discomfort, psoriasis can have a profound psychological impact, leading to embarrassment and depression. Systemic Complications: Psoriasis is associated with "metabolic syndrome," increasing the risk of cardiovascular disease, obesity, diabetes, and hypertension. Approximately 30% of people with psoriasis also develop psoriatic arthritis, which causes joint pain and stiffness.

Causes and triggers

    • Genetics: Specific genes (such as HLA-Cw6) make individuals more susceptible.

    • Stress: Emotional stress is a major trigger for flare-ups.

    • Infections: Strep throat or other infections can trigger guttate psoriasis, particularly in children.

    • Injury: The "Koebner phenomenon" occurs when psoriasis appears at sites of skin injury (cuts, bug bites, or sunburn).

    • Medications: Certain drugs (e.g., lithium, beta-blockers) can worsen the condition.

Treatment Options

  • Topical Treatments Corticosteroids, Vitamin D analogues, and Coal Tar preparations to reduce inflammation and scaling.
  • Phototherapy (Light Therapy) We offer Narrowband UVB phototherapy, which is highly effective for widespread plaque psoriasis.
  • Systemic Oral Medications Drugs such as Methotrexate, Acitretin, or Cyclosporine are used for moderate to severe cases.
  • Biologic Therapies For severe or resistant psoriasis, we can prescribe advanced injectable medications (biologics) that target specific parts of the immune system (e.g., IL-17 or IL-23 inhibitors) to clear the skin.
  • Lifestyle Weight management, smoking cessation, and stress reduction are critical for long-term control.

Frequently Asked Questions

Have questions about scheduling or what to expect? Here are answers to common inquiries to help you feel fully prepared.

No. You cannot catch psoriasis from someone else, nor can you spread it. It is an autoimmune disease, not an infection.

There is no specific "psoriasis diet" that cures the disease. However, because psoriasis is inflammatory, a healthy diet (low in processed foods and alcohol) helps reduce systemic inflammation. Weight loss is particularly effective in improving psoriasis severity and the response to medication.

Not everyone with psoriasis develops arthritis, but about 1 in 3 patients do. If you experience joint stiffness (especially in the morning), swollen fingers/toes, or lower back pain, please inform your dermatologist.