Understanding Psoriasis From A Medical Perspective

Psoriasis is an autoimmune disease that causes plaques, thick, red skin lesions that can be itchy and painful. The plaques develop on the skin of the elbows, knees, scalp, lower back, face, or any other body part. In Psoriasis, the immune system attacks healthy skin cells by mistake. This speeds up the growth of skin cells which results in scaly patches on your skin. The severity of Psoriasis varies from person to person. It may be mild to severe depending upon how often they occur on your body and how widespread they are on your body. The plaques are the result of skin cells multiplying at an extremely rapid rate. Plaque psoriasis can be genetic or may develop due to medications that suppress the immune system, such as those used for cancer or rheumatoid arthritis. People with Psoriasis have a defect in their immune systems. A deficiency leads to abnormal inflammatory response and defective shedding of dead cells from the epidermis (outer layer of your skin). The buildup of these dead cells forms a plaque which further leads to itching and discomfort. Sometimes certain factors like stress, injury to your skin, infection, etc., can trigger Psoriasis on previously unaffected areas.

Who gets Psoriasis?

Anyone can develop Psoriasis. However, it is most often seen in men and women between 15 to 25 years old. It affects 2% to 3% of the population worldwide. In some cases, a person may first develop Psoriasis during childhood or as a young adult. It also tends to run in families, but not all people who have a family member with this skin condition will develop it themselves. One out of every five people who have psoriasis will develop psoriatic arthritis. Psoriatic arthritis causes inflammation and stiffness in and around the joints, especially fingers and toes.

What causes Psoriasis?

The exact cause of Psoriasis is not known. Still, it is believed to be caused by a combination of genetics and environmental factors such as infections or injuries to your skin. People with certain conditions like HIV/AIDS, hepatitis C or lupus are more likely to develop Psoriasis. Some medicines that suppress your immune system may also trigger the symptoms of Psoriasis if you already have this condition. Here are the exact causes of Psoriasis:

Genetic: –The tendency to develop Psoriasis can be inherited from your parents. About 50% to 80% of people with psoriatic arthritis have a family history of the disease. Psoriasis tends to run in families.

Environment: –Sunlight is known to worsen the symptoms of this skin condition. Humidity, changes in temperature, and stress are also responsible for worsening or triggering Psoriasis. It is more common in areas regularly exposed to these elements, such as arms, legs, etc.

Medications: - Certain medications are known to trigger this condition on previously unaffected areas too. This is usually temporary and subsides when medication is stopped/ tapered off. A few examples are Actonel, aspirin, beta-blockers, diuretics, lithium, and iodides.

Stress: - Stress has been observed to worsen Psoriasis. It is not clear if it triggers it to start a new area of plaques or worsens the severity of Psoriasis in an existing plaque.

Injury: - Injuries can trigger Psoriasis on previously unaffected areas. Injuries such as severe burns, cuts, scrapes, etc., can lead to this skin condition.

Infection: –Infections such as viruses, bacteria, and fungi may trigger Psoriasis in some people.

Viruses- This skin condition can also be triggered by viruses like hepatitis C, herpes simplex virus, etc.

Physical injury to the skin - Injury or trauma to your skin that results in bleeding can trigger Psoriasis on previously unaffected areas too. This is usually temporary and subsides within a few weeks of injury.

Dry Skin: – Psoriasis is more common in the dry areas of your body, such as elbows and knees. It means that people with Psoriasis are more likely to develop it in winter. Dry skin can cause itching, which makes this condition worse.

What are the types of Psoriasis?

There are five main types in which Psoriasis can present itself in a person depending upon where they have developed the plaques. These include-

Plaque Psoriasis- The most stress is known to trigger this condition in previously common areas too. It is not clear if it begins starting a new place of plaques or worsens the severity of Psoriasis in an existing plaque.

Psoriatic arthritis- Inflammation and stiffness in and around the joints, especially fingers and toes.

Erythrodermic Psoriasis- This is the most severe form that certain diseases or infections may trigger. Around 30% to 40% of people with this condition develop it on their whole body, which requires hospitalization.

Guttate Psoriasis- It affects children (usually aged between 5 to 15) and young adults. The symptoms often resolve before adulthood, after which there is a tendency towards plaque psoriasis.

Inverse psoriasis usually occurs in skin folds such as under your arms, below your breasts, around your groin area, etc. It is more common in obese men than women.

What are the symptoms of Psoriasis?

• Psoriasis can vary from person to person. Some of the most common symptoms include-
• Red patches that may be scaly, dry, or itchy with silvery scales on top. These plaques may be filled with pus and blood in severe cases.
• Patches in different stages of development simultaneously, especially when you have plaque and inverse type combined.
• Patches affect specific areas of your skin, such as your elbows, knees, scalp, and lower back. In some cases, people may get patches on their faces too.
• In rare cases, pustular Psoriasis is characterized by tiny bumps filled with pus that tend to produce a thick liquid when squeezed. Their appearance can resemble that of blisters or boils. These patches are usually very painful because they form deep within the skin, with nerve endings. They can be triggered by certain medications, infections, and stress too.

For how long does Psoriasis stay?

It is an autoimmune disease, so it remains for life with few periods of remission in most cases. If you have mild Psoriasis, your symptoms may stay like that throughout the year, but if you have severe Psoriasis, they can worsen during winter (when it gets drier). Some people call this condition on their hands, feet, and nails- This form tends to be more challenging to treat because it is often triggered by nail trauma or injury to the cuticles around the nails. It is also known as “sickness of the hands.”

How does Psoriasis affect people?

The severity of Psoriasis varies from person to person depending upon where they develop plaques on their body. Usually, more than one part of the body is affected. Having Psoriasis on your hands or feet can make it challenging to do your daily tasks (such as cooking, dressing, etc.) because of pain and swelling.

It may also affect your self-confidence, making you feel embarrassed about exposing yourself in public. Studies show that many people with this condition tend to develop other mental health problems such as anxiety and depression. This is because people with Psoriasis face discrimination in society, making them feel lonely, isolated, and frustrated.

Although this condition cannot be cured, you can control its symptoms and prevent it from worsening with proper care. If not managed well, Psoriasis can cause permanent damage to your nails and skin and even lead to severe infections.

How is Psoriasis diagnosed?

After discussing your medical history and performing a physical exam, your doctor may run specific tests to determine if you have Psoriasis or other skin problem with similar symptoms. Some of these include-

* Skin Biopsy- This procedure involves taking out the affected tissue (a small part of the plaques) using a special needle under local anesthesia. The cell structure of this tissue will be examined under the microscope to confirm the diagnosis. This test is usually not recommended unless the plaques are hard to reach or they require specific medication.

* Blood tests- In some cases, your doctor may order special blood tests to rule out other diseases such as thyroid disease, diabetic neuropathy, etc., associated with similar symptoms.

How do Skin doctors treat psoriasis?

In most cases, topical treatments and creams for Psoriasis tend to work well in mild cases. Still, severe forms of this condition need stronger medications called “biologicals” that will suppress your immune system. These drugs have many side effects, so their use should be supervised by a specialist dermatologist who can guide you on how to use them safely. Some common examples include-

* Corticosteroids: They reduce inflammation by suppressing your immune system. These are used to treat various skin conditions- Some of them include allergic dermatitis, sunburn, etc.

* Vitamin D analogs: They work by slowing down the growth of skin cells and are usually used for Psoriasis affecting your palms, soles, or genital area.

* Methotrexate: This is an anticancer drug that may be prescribed to you if other therapies fail to help. It works by blocking cell division in psoriatic tissue, but it can cause serious side effects like nausea, diarrhea, etc. Your doctor may ask you to undergo blood tests regularly while taking this drug because these drugs can affect your liver and interfere with other medicines that you might be on too (such as birth control pills)

* TNF inhibitors: They block a protein involved in the growth and spread of psoriatic tissue. Examples include adalimumab, etanercept, etc.

In rare cases where severe forms of this disease do not respond to treatments, laser therapy or phototherapy can remove plaques. Still, these methods have many possible side effects, so they should only be considered if other therapies fail to work.

What are the possible side effects of Psoriasis medications?

Many topical treatments for Psoriasis have an anti-inflammatory effect on your skin, but they may cause skin dryness, irritation, itching, etc. Some oral medications can cause liver damage, so their usage should be supervised by a specialist dermatologist who will monitor you regularly while prescribing these drugs to you.

What are some ways I can manage my Psoriasis? 

Stay Stress-free: Stress can make the symptoms of Psoriasis worse, so you should try to maintain a healthy work-life balance.

Take proper sleep: Sleep deprivation can also worsen your Psoriasis. For this reason, getting enough sleep will help keep it under control.

Avoid smoking and drinking: Smoking and alcohol consumption speeds up the process of skin aging, which in turn makes your outbreaks more likely when compared to people who don’t smoke or drink.

Eat a balanced diet: Avoiding certain foods like orange juice, tomatoes, etc., might trigger an outbreak, but eating a well-balanced diet with plenty of fresh fruits and vegetables can improve your overall health and reduce flare-ups.

Wear sunscreen: Sun exposure worsens psoriasis symptoms. For this reason, it’s essential to wear sunscreen every day.

Avoid hot water showers or baths: Try taking lukewarm baths instead because hot water can irritate your skin and make it even itchier than usual.

Homeopathic treatment: Opting for homeopathic treatment is one of the best options for people who have Psoriasis. These are natural remedies that do not have any side effects on your skin or other parts of your body. They can be more effective if combined with medications or phototherapy prescribed by your doctor. You will need to take some time out for the treatment because it may take up to two months to see an improvement in symptoms.

* Homeopathic treatment treats the root cause of Psoriasis by purifying the blood and reinforcing the immune system. Thus, it accelerates the rate at which your body can combat Psoriasis through its natural mechanisms instead of suppressing them.

* The homeopathy doctor tries to find an individualized treatment based on your symptoms, physical exam, medical history, etc. This is because various people respond differently to homeopathic remedies making this process unique for every patient- This way, you will receive quick relief from skin issues without worrying about any adverse effects.

You can book an appointment through OHO Homeopathy to manage your Psoriasis and reduce its severity and frequency of outbreaks through homeopathic treatment.