From healthcentral.com
Learn about the causes, triggers, and treatment options for the most common type of psoriasis
It’s no surprise that when most people hear “psoriasis,” they immediately picture plaque psoriasis (one of the seven types of psoriasis). Characterized by the rapid build-up of skin cells, plaque psoriasis is the most common kind of psoriasis, according to the Cleveland Clinic. Not only are these plaques itchy and uncomfortable, but the red, scaly flare-ups that appear on visible parts of your body can also take a toll on your confidence and self-esteem. We checked in with dermatologists to help us understand the ins and outs of plaque psoriasis, its common causes and symptoms, and the tried-and-true ways to find some relief.
What Is Plaque Psoriasis?
Plaque psoriasis (scientifically known as psoriasis vulgaris) is a chronic skin condition that features thick, raised, red patches covered with silvery scales (aka plaques) that form on various body parts. In a healthy skin cycle, skin cells are replaced about once a month. However, for the 6.7 million people living with plaque psoriasis, this process accelerates to a matter of days. This excessive skin cell build-up results in the plaques. Mild plaque psoriasis covers less than 3% of the body, while moderate to severe plaque psoriasis covers 3% to 10%.
According to Vinod Vij, M.D., a skin researcher and cosmetic surgeon at Apollo Hospital in Mumbai, India, the most common characteristics of plaque psoriasis include:
Dry, cracked, itchy, painful, or bleeding plaques
Rashes that vary in size, shape, and colour, depending on the skin tone and the severity of the condition
Red, brown, grey, or purple plaques with a white or silvery surface
Symmetrical rashes that appear in the same areas on both sides of the body
While “plaques can occur anywhere on the body,” says Dr. Vij, they most often appear in these locations:
Back
Elbows
Knees
Torso
In more severe cases of plaque psoriasis, it’s not uncommon for plaques to also appear in these areas:
Face
Feet
Hands
Genitals
Legs
Plaque psoriasis can affect people of all ages, according to the National Psoriasis Foundation, but its onset is often seen between the ages of 15 and 35. Both men and women, and people of all races and ethnicities can get psoriasis. While the exact cause is not fully understood, there appears to be a genetic component, as people with a family history of psoriasis have a higher risk of developing the condition. Factors such as stress, infections, certain medications, and lifestyle habits (like smoking and drinking alcohol) may also trigger or exacerbate plaque psoriasis.
Types of Plaque Psoriasis
Plaque psoriasis lesions usually begin as papules and eventually come together to form plaques of various sizes. For diagnosis and treatment purposes, doctors typically categorize plaque psoriasis into two subtypes, per the Journal of Investigative Dermatology:
Common in Asian populations, small plaque psoriasis is a type of plaque psoriasis characterized by lots of little lesions. Plaques in this subtype often measure less than 3 centimetres in diameter. Despite their size, these plaques can still be itchy, painful, and cosmetically bothersome.
Large-Plaque Psoriasis
Predominant among Western populations, large plaque psoriasis is characterized by thicker, larger lesions with clear edges. In large plaque psoriasis, the affected areas typically have plaques that measure more than 3 centimetres in diameter, and the crusty parts of the lesions are more red.
How Common Is Plaque Psoriasis?
Plaque psoriasis is the most common form of psoriasis. According to the National Psoriasis Foundation, 2% to 3% of the global population (or 125 million people worldwide) have psoriasis. Of those, 80% to 90% experience plaque psoriasis. The second most common type of psoriasis is guttate psoriasis.
Plaque Psoriasis Symptoms
Symptoms of plaque psoriasis vary from person to person, but these are some of the condition’s hallmark characteristics, according to the National Psoriasis Foundation:
Dry, cracked skin: The affected skin may become dry and prone to cracking. This can be particularly uncomfortable, especially in areas that bend or flex.
Itching or burning sensation: Psoriasis lesions can be itchy or may cause a burning sensation, leading to discomfort for affected individuals.
Joint pain (psoriatic arthritis): In some cases, individuals with plaque psoriasis may develop psoriatic arthritis, causing joint pain, stiffness, and swelling.
Red, inflamed skin: Plaque psoriasis typically presents as red patches of skin that are often covered with silvery-white scales. Psoriasis plaques on darker skin tones may vary in colour from light to dark brown, purple, or grey.
Thickened or pitted nails: Plaque psoriasis can affect the nails, leading to changes such as thickening, pitting (small dents or pinprick-sized holes), or discoloration.
The fundamental issue underlying all forms of psoriasis is an imbalance in the production of skin cells. What happens is the turnover of skin cells occurs at an accelerated rate—10 times faster than the usual pace. Consequently, this rapid cell turnover leads to the accumulation of thick, scaly, inflamed, and itchy skin on the body’s surface. These thick, scaly patches are a hallmark for plaque psoriasis.
Why does cell turnover go rogue? “The exact cause is unknown, but it is believed to be a combination of genetic and environmental factors,” says Dr. Vij. Some of the possible causes and risk factors of plaque psoriasis include:
Genetics
Plaque psoriasis is considered multifactorial or polygenetic, meaning many environmental factors and multiple genes can influence the disease’s development. More specifically, researchers have isolated the CARD14 gene mutation as a direct cause of plaque psoriasis when specific environmental triggers are present.
Immune System
The primary function of your immune systems is to fend off disease and illness. When things are in good working order, the immune system responds with antibodies and T cells to fight off tiny invaders (bacteria and viruses) that have no business being in your body. For some people with autoimmune disorders, however, the body mistakenly attacks healthy cells. In the case of plaque psoriasis, this immune system overreaction leads to skin inflammation and rapid skin cell growth.
Lifestyle or Dietary Choices
Plaque psoriasis can be triggered or worsened by lifestyle factors, including:
Certain medications (including lithium, beta-blockers, and antimalarial drugs )
Heavy alcohol consumption
Infections (like strep throat or skin infections)
Smoking and exposure to second-hand smoke
Stress
Weather (especially cold, dry conditions)
All these plaque psoriasis triggers share a common denominator—inflammation. Another component of the body’s built-in defence mechanisms, inflammation typically kicks in when harmful substances or stimuli come in contact with your body. Normally, inflammation serves to drive out the offending allergen or bacteria. But in people who have plaque psoriasis, the inflammatory response causes a skin reaction that leads to the development of plaques.
Is Plaque Psoriasis Contagious?
Despite its rash-like appearance, “plaque psoriasis is not contagious,” says Dr. Vij. “It cannot be spread from person to person by touching, kissing, unprotected sex, or sharing objects.” Nevertheless, plaque psoriasis can be triggered by contagious infections like strep throat, says Dr. Vij. While it remains unclear why strep infections, in particular, can trigger plaque psoriasis, existing research shows that the T cells that trigger plaque psoriasis may originate in the tonsils.
How Is Plaque Psoriasis Diagnosed?
Diagnosing plaque psoriasis typically involves a combination of medical history review, physical examination, and sometimes additional tests, says Tien Nguyen, M.D., a board-certified dermatologist at Memorial Care Orange Coast Medical Centre in Fountain Valley, CA. These are the tests and assessments your doctor might use to diagnose plaque psoriasis:
Medical history: Review of your medical history, including symptoms, previous skin conditions, and family history of psoriasis.
Physical examination: “[Many times], the diagnosis of plaque psoriasis is clinical,” says Dr. Nguyen. This means that the doctor or dermatologist may do a physical examination and make a diagnosis by looking at the appearance and location of the plaques.
Skin biopsy: “A skin biopsy (examining a small skin sample under a microscope) may be performed to confirm the diagnosis and rule out other skin conditions,” says Dr. Vij.
Psoriasis severity assessment: Evaluation of the extent and severity of psoriasis lesions to determine the appropriate course of treatment.
“The goal of treatment is to reduce the inflammation, slow down the skin cell growth, and relieve the symptoms,” says Dr. Vij. “The treatment of plaque psoriasis depends on the type, severity, and location of the plaques, as well as the preference and response of the person. Some of the medications and treatments that are commonly prescribed for plaque psoriasis include:
Topical Medications
“Creams, ointments, lotions, or gels are the most common treatment for plaque psoriasis,” says Dr. Vij. “Typically applied directly to the skin, these medications can help reduce the scaling, itching, and inflammation of the plaques.” Topical treatments for plaque psoriasis often contain corticosteroids, vitamin D analogs, retinoids, salicylic acid, coal tar, or moisturizers.
Phototherapy
“This type of treatment involves exposing the skin to ultraviolet (UV) light (either natural or artificial) to help slow down the skin cell growth and improve the appearance of the plaques,” says Dr. Vij. “Phototherapy can be done in a clinic or at home, with or without certain medications that make the skin more light-sensitive.”
Systemic Medications
Pills, injections, or infusions, which typically include methotrexate, cyclosporine, acitretin, or biologics, are another option for treating plaque psoriasis. “Systemic medications act on the whole body, and they can help suppress the immune system and reduce the inflammation and skin cell growth,” says Dr. Vij. “These medications can have serious side effects and require regular monitoring, so they’re usually reserved for moderate to severe cases of plaque psoriasis that do not respond to other treatments.”
Dr. Nguyen adds, “Medications can clear up 100% of plaques, but people with plaque psoriasis should understand that it’s largely a genetic condition — there is no cure. It’s a lifelong condition that requires lifelong treatment. If someone uses a particular medication and stops treatment when they see results, their plaque psoriasis will return.”
Home Remedies for Plaque Psoriasis
While moderate to severe cases of plaque psoriasis will likely require prescription therapeutics and medical care, some people may find they can effectively manage symptoms of mild plaque psoriasis with home remedies and a little self-care.
Some of the most common home remedies and self-care practices for managing mild plaque psoriasis, per the National Psoriasis Foundation, include:
Aloe: Research shows aloe vera can help reduce redness and scaling associated with plaque psoriasis. Pure aloe or aloe vera creams can be applied topically (to the skin) as needed.
Apple cider vinegar: Apple cider vinegar can help balance skin pH, stimulate circulation, and reduce the itching associated with plaque psoriasis.
Capsaicin: This is the active ingredient in chili peppers that gives them that unmistakable kick. Capsaicin is also a potent analgesic (pain reliever) and a powerful ally against the inflammation and scaling associated with plaque psoriasis.
Epsom salt baths: The National Psoriasis Foundation says a 15-minute soak in an Epsom salt bath may be helpful for relieving plaque psoriasis symptoms.
Topical tea tree oil: Known for its powerful antiseptic and anti-inflammatory properties, research suggests tea tree oil may offer some relief against plaque psoriasis symptoms.
Turmeric supplements: Research shows that turmeric’s anti-inflammatory properties may be helpful in the treatment of plaque psoriasis.
Early diagnosis and appropriate management can help control symptoms and improve the quality of life for people with plaque psoriasis. If you notice persistent changes in your skin or the plaques are causing significant discomfort, see a doctor. If over-the-counter treatments or lifestyle modifications are not effectively managing symptoms or if the emotional toll of living with psoriasis is affecting your mental well-being and self-esteem, see a doctor. If you’re ever in doubt about your skin, err on the side of caution by scheduling an appointment with a a healthcare provider for guidance tailored to your specific situation.
There’s usually no pain associated with plaque psoriasis, but people with the condition may experience some discomfort due to joint pain and inflammation.
Yes, psoriasis can affect individuals of all ages, including children and adolescents.
Plaque psoriasis is a genetic condition, and while there is no cure, some medications are effective enough to rid the skin of itchy, scaly plaques completely. However, this is a lifelong condition; once medications are stopped, the plaque psoriasis will come back.
Stress is a common trigger for flare-ups, and stress management strategies may be incorporated into treatment plans.
https://www.healthcentral.com/condition/psoriasis/plaque-psoriasis
No comments:
Post a Comment