Getting under the skin of psoriasis

From pharmafield.co.uk

Psoriasis affects around 2% of the population. Although seen as a skin condition, it is an immune condition which can have a physical and psychological impact.
Psoriasis is an immune condition which affects the skin, and sometimes the joints. It causes the skin replacement process to accelerate meaning that the usual process of skin replacement, which typically takes three to four weeks, can happen in just a few days.

This acceleration results in an excess build-up of skin which usually presents as flaky or scaly patches that can be red, dark, sore, or itchy.

Anyone can experience psoriasis. It affects approximately 1.8 million people in the UK and can occur at any age, although the Psoriasis Association says that there are two ‘peaks’ from late teens to early 30s and between 50 and 60.

Patterns of psoriasis
According to the British Skin Foundation, there are several ‘patterns of psoriasis’.
These are:

• Chronic plaque psoriasis, the most common form of psoriasis. Plaques usually present on the knees, elbows, trunk, scalp, behind ears and between the buttocks, although they can occur elsewhere, too.
• Guttate psoriasis consisting of small spots scattered over the trunk and limbs. The spots can be pink or red on fair skin types and darker on darker skin types. It can be caused by streptococcus.
• Palmoplantar psoriasis which affects the palms of the hands and soles of the feet. It may appear at other parts of the body, too.
• Pustular psoriasis, a rare form of psoriasis where tiny, yellow, pus-filled spots (pustules) appear on top of very red or darkened skin. Pustular psoriasis can be localised or generalised and can flare up rapidly. Flare ups can lead to hospitalisation for treatment.
• Erythrodermic psoriasis is an aggressive and rare type of psoriasis. It affects nearly all of the skin and, in some cases, can also require hospital admission for treatment.
• Nail psoriasis can also present in up to half of people with psoriasis. It can cause nail indentations, areas of discolouration, separation of the nail from the bed, thickening of the nails or destruction of nails.

Some people may also experience psoriatic arthritis which, as the name suggests, is a type of inflammatory arthritis that affects some people who have psoriasis. It can make joints stiff, swollen and painful.

What causes psoriasis?
It is believed that psoriasis begins in the immune system when T cells are triggered and become overactive, although the exact trigger is still unknown. According to the Psoriasis Association, new research has found that T cells act as if they were fighting an infection or healing a wound. They produce inflammatory chemicals which can lead to rapid skin cell growth causing plaques to form.
Psoriasis can, but doesn’t always, run in families, leading some to believe it has its basis in genetics. It is not contagious.

Psoriasis triggers
Psoriasis flare-ups can be caused by a range of factors from environment to health. Understanding what triggers a flare up can help people to manage their condition. Common triggers are:

• Excessive amount of alcohol
• Smoking
• Stress
• Injury to the skin including cuts and scrapes
• Sunburn
• Hormonal changes, particularly in women
• Medication, including some anti-inflammatories, antimalarial medicines, and ACE inhibitors
• Throat infection, such as streptococcal throat infection can cause guttate psoriasis to develop, usually in children and young adults
• Other immune disorders, including HIV.

Source: NHS.UK

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