You are probably thinking that less normal and more affected skin is visible, that’s correct because it’s a case of severe psoriasis. The scales were scraped off to reveal what can be seen in the image above.
What is Psoriasis?
Psoriasis is a chronic autoimmune in which skin cells rapidly buildup. Normally skin cells replace every few weeks but in cases of psoriasis it shortens to 3 – 7 days i.e. a high epidermal cell turnover rate, ultimately resulting in raised patches on the skin
The associated skin patches can be scaly, red, raised, dry and itchy, it may appear purplish on dark-skinned patients.
Obesity, diabetes, inflammatory bowel disease and heart diseases have seen to be co-existant with psoriasis.
Are there any types of psoriasis?
Yes,
five in all.
- Plaque Psoriasis/ Psoriasis Vulgaris (the commonest, 80% according to The American Academy of Dermatology (AAD)
- Guttate Psoriasis (common in children, follows a group A beta-hemolytic streptococcal infection of the upper respiratory tract)
- Pustular Psoriasis
- Inverse Psoriasis
- Erythrodermic Psoriasis (most severe and the rarest)
Does it involve the whole body?
It may or may not!
Psoriasis usually involves the extensor surfaces, but flexural psoriasis is
also a variant. Most common sites are the skin of the elbows, knees,
lumbosacral region, scalp, neck and hands. Less commonly it involves the mouth,
nails, intergluteal clefts and glans penis.
the patches may be as small as coin-sized or as big as to cover almost the
entire surface area.
Macules appear initially, progressing to maculopapular rash then to silvery
scales.
Psoriasis can affect nails and joints too. Nails become thick and pitted whereas psoriatic arthritis gives painful and swollen joints with reduced range of motion. Back pain, fatigue morning stiffness are some of the non-specific features that accompany. Skin patches are associated with soreness, burning, drying and itching. Some scales may flake off and bleed.
Is it contagious?
No, it isn’t. You can’t catch psoriasis by touching the affected person or being near them.
Instead, a genetic predisposition has been observed in certain but not all the cases.
Are fancy tests required for diagnosis?
Usually, a typical presentation of psoriasis is the key to diagnosis, therefore no fancy tests are usually required. In rare cases, a biopsy i.e. sample of skin may be required to study under a microscope. That will determine the type of psoriasis.
However, Xray of the joint may be done if a diagnosis of psoriatic arthritis is suspected.
Having said that, psoriasis has no definite treatment. It can be managed. The severity of symptoms and appearances of the skin manifestations can be toned down.
Topical treatment such as creams and ointments with vitamin D analogues like calcipotriene or corticosteroids is the first line. Other options include topical retinoids, coal tar and topical immunomodulators.
Phototherapy may be the next step if symptoms don’t improve or if the case is severe, systemic therapy may be warranted.
Food for thought:
Can Psoriasis be prevented?
References
Psoriasis. (n.d.). Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/psoriasis/index.htm
Psoriasis. (2018, May 9). Retrieved from NHS.UK: https://www.nhs.uk/conditions/psoriasis/
Psoriasis is an immune-mediated disease that causes raised, red, scaly patches to appear on the skin. (2020, January 11). Retrieved from National Psoriasis Foundation: https://www.psoriasis.org/about-psoriasis
WHAT IS PSORIASIS? (n.d.). Retrieved from American Academy of Dermatology: https://www.aad.org/public/diseases/psoriasis/what
