Psoriasis: Treatment, symptoms, advice and help
Psoriasis is a long standing autoimmune skin disease characterized by typical skin lesions over several parts of the body. The common body parts affected are the scalp, the knees, the elbows, palms and soles. Typical lesions in psoriasis are oval or circular, scaly, silvery white patches on the body surface which can spread to the entire body surface. Psoriasis is a life-long recurring disorder but may be controlled with appropriate medications.
Psoriasis: Incidence, age and sex
Psoriasis affects both the sexes equally. The disease generally occurs between the ages of 15-30 years and most often family history is found to be positive in the affected individuals.
Signs and symptoms of psoriasis: Diagnosis
The lesions are initially red, small, circular spots which progress to form thick, silvery white patches. These skin lesions can become scaly and sometimes even exhibit bleeding after gentle scraping. The lesions are associated with incessant itching and burning sensation. Usually skin of the knees, the elbows, the back, the palms, the soles, and scalp may get affected. The disease presentation varies greatly from person to person. Initially, it starts as a localised lesion and may later on, spread to the whole body or it may just remain restricted to the affected area. The disease is often associated with frequent recurrence. As the disease progresses in some individual it may even affect the adjoining joints leading to a condition called as ‘Psoriatic Arthritis’. The affected joint becomes painful and swollen leading to difficulty in movement.
Diagnosis of psoriasis is based on medical history and detailed clinical examination of the affected individual. There are no specific tests for diagnosing psoriasis. The skin lesions are characteristic enough to establish the diagnosis.
Causes and prevention of psoriasis
The exact cause of disease process is not known. The disease is an autoimmune disorder wherein the body’s immune system works against its own body cells and destroys them. In this case, the skin cells are affected resulting in accumulation of immature skin cells on the skin surface. Most of the patients have positive family history of disease and hence genetic predisposition is considered to be an important risk factor in development of the disease. Psychological stress also plays an important role and can initiate the disease process or aggravate an existing condition. The individual should ideally avoid sunlight.
The disease complications include joint involvement leading to movement disability. In severe cases of disease, the individual may experience social embarrassment, isolation, aloofness, job stress, emotional distress and depression.
The management of disease entails a multi-dimensional approach. Oral medications such as corticosteroids, methotrexate, retinoids, and psoralens are usually prescribed after confirmation of the disease. Salicylic acid ointment, clobetasol propionate, and betamethasone are generally advised for local application. Patient counselling is done wherein the individual and his family is educated and made aware of the disease. Stress reduction is advisable which can be achieved by performing relaxation techniques. Patient should avoid sunlight whenever possible. The main aim of the management is to reduce the disease severity and improving the overall quality of life.