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What is psoriasis?

Psoriasis is a skin disease that affects 2% of the UK population. Psoriasis affects people in many different ways. Some just have dryness of elbows. Others can be covered in large areas called plaques.  Some patients simply have scaling in their ears, scalp or just brittle nails. The most common type is call chronic plaque psoriasis. The areas of skin referred to as plaques are usually well defined with silver scale of skin overlying a red area. Other types include inverse, guttate, erythrodermic and pustular psoriasis.

Sometimes the plaques can be itchy or sore. It can start at any age, but most often develops in adults under 35 years old. The severity of psoriasis varies but this does not necessarily reflect the affect on the persons quality of life. Psoriasis waxes and wanes usually with long periods when you have no symptoms or mild symptoms, followed by periods when symptoms are more severe.

Why does psoriasis form?

Our skin cells are constantly regenerating. Most skin cells are replaced every four weeks. In psoriasis this process is speeded up to about 3 to 7 days. As a consequence the skin in psoriasis is thicker and appears redder. The resulting build-up of skin cells is what creates the patches associated with psoriasis. Although not fully understood, psoriasis is consider to be caused by a problem with the immune system. Psoriasis can run in families, although the exact role genetics plays in causing psoriasis is unclear. Many people’s psoriasis symptoms start or become worse because of a certain event, known as a trigger. Possible triggers of psoriasis include an injury to your skin, throat infections, stress and using certain medicines. It is not contagious, so cannot be spread from person to person.

How is psoriasis diagnosed?

Psoriasis is usually easy to diagnose based on its appearance. Occasionally it can be difficult especially when the usual features are not present or it is located in unusual places. Psoriasis is linked to a disease that can damage joints. This is called psoriatic arthritis. If your doctor thinks you have this you will need to see a specialist called a Rheumatology consultant.

You may need to have blood tests to rule out other conditions, such as rheumatoid arthritis, and X-rays of the affected joints may be taken.

What Treatments are there for psoriasis?

Sadly there is no cure. Treatment options are vast and are dictated by both the clinical severity and the impact on a patient’s life. In most cases, creams and ointments are used two to three times a week. Creams aim to reduce the thickness and redness and remove some of the scale. These ‘topical’ treatments rarely clear the skin. Other more effective treatments include medication that suppress the bodies normal immune cells that are known to ‘drive’ psoriasis. These medications can only be started by a medical dermatologist.

A light treatment called phototherapy may be used. Phototherapy involves exposing your skin to certain types of ultraviolet light. It is very safe. It is however, time consuming requiring two visits each week to the dermatology clinic for several months. Sometimes it can clear the skin of psoriasis for many months other times the psoriasis can recur immediately.

More information:

http://www.bad.org.uk/healthcare-professionals/psoriasis

https://www.dermnetnz.org/topics/psoriasis/

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