Psoriasis
1. What is psoriasis?
Psoriasis consists of red, scaly, sharply demarcated, patches, present particularly over outer surfaces of hands & feet, bony prominences and scalp.
2. What are the causes of Psoriasis?
The exact cause of psoriasis is not known. But following factors are proposed to be involved in disease
1. Genetic- high incidence of disease in children of patients having psoriasis
2. Drugs- like antimalarials, antihypertensives, NSAIDS
3. Infection- guttate type is associated with preceding sore throat
4. Sunlight-although generally beneficial, in a small number of patients it can exacerbate disease
5. Trauma
6. Metabolic factors-like hormonal changes, decreased calcium levels can be associated
7. Psychogenic factors-there is strong link between stress & onset or exacerbation of disease
8. Alcohol-can cause exacerbation
9. Smoking- it is strongly linked with pustular forms of psoriasis
3. How Psoriasis patches are formed?
increased turnover of cells in skin(called as keratinocytes) is considered to be cornerstone of disease
increase & dilatation of small blood vessels in skin
Abnormalities of immune mechanism
4. What are the types of psoriasis?
1. Psoriasis vulgaris
2. Guttate psoriasis
3. Pustular psoriasis
4. Erythrodermic psoriasis Specific variants as per site
5. Scalp
6. Flexural
5. How Psoriasis is treated?
Treatment of psoriasis must be individualized depending upon age, sex, severity, general health, occupation, socio-economic background etc
A. General measures
• Counselling forms most important aspect of management apart from drugs. Patient should be explained in simple terms, nature of disease, its course & fears related to disease must be allayed.
B. Drugs
I. Topical/ creams & ointments
1) Coal tar
2) Anthralin
3) Corticosteroids
4) Vitamin D analogues
5) Calcineurin inhibitors
II. Oral/systemic medications
a. Retinoides
b. Methotrexate
b. Cyclosporine
III. Phototherapy- It is a very simple but effective tool in controlling disease, by decreasing skin peeling, itching as well as patches