Psoriasis is a condition that affects your skin and causes thick red marks that look like scales to form. The thick scaling is due to an increase in the number of skin cells. Sometimes pus-filled blisters form. Most of the time, the skin on the elbows and knees is affected, but psoriasis can occur anywhere on the body, including the scalp, fingernails and mouth, and even the skin over the joints. Psoriasis tends to run in families and it usually appears between the ages of 15 and 35.

Types of Psoriasis

The main types of Psoriasis are as follows :-

Inverse psoriasis - A smooth, red lesions form in skin folds.

Flexural psoriasis - Smooth well-defined patches in body folds. This form of psoriasis appears as smooth, dry areas of skin that are red and inflamed but do not have the scaling associated with plaque psoriasis (the most common type of psoriasis).

Erythrodermic psoriasis - There is widespread redness, severe itching, and pain.

Guttate psoriasis - There are small, red spots on the skin.

Plague Psoriasis - It is the most common type of psoriasis. About 70 to 80% of people who develop psoriasis, which appears as patches of raised, reddish skin covered by silvery-white scale.

Pustular psoriasis - White pustules surrounded by red skin.

Nail psoriasis - Psoriasis can affect toenails and fingernails. It usually appears as pits in the nails and the nails may change to a yellowish colour and become thick or crumble easily. They may also be surrounded by inflammation. In some cases the nail may break away from the nail bed.

Causes of Psoriasis

From a medical perspective, the cause of psoriasis is unknown. It probably has a genetic component which increases the chances for developing the disorder. Approximately one-third of all persons suffering from psoriasis report a family history of the illness.

Psoriasis is an excellent example of the concept of "diathesis/stress." Some individuals are born with a genetic predisposition toward psoriasis, which is "triggered" into the clinical manifestation of the disease by stressors, such as systemic infections, injury to the skin, vaccinations, and certain medications. Flare-ups of the symptoms are often preceded by stressful events.

Whatever the source of the illness, the outcome is a growth of too many skin cells. The immune system may play a role in triggering excessive skin cell reproduction which produces the psoriatic lesions.

Treatment of Psoriasis

It depends on the severity and its kind. Some psoriasis is so temperate that the person is unaware of the condition.

Local treatments include creams and ointments containing tar, dithranol, salicylic acid or vitamin D-related compounds (calcipotriol (Dovonex), calcitriol (Silkis) or tacalcitol (Curatoderm)). Occasionally, corticosteroid-containing ointments are used for a short time. Combining a corticosteroid with another topical treatment, either as separate products used at different times of day, or as a combination product, eg Dovobet (calcipotriol and betamethasone) or Alphosyl HC (coal tar and hydrocortisone), may be beneficial for chronic psoriasis vulgaris. Special lotions are available for scalp treatment. These often contain salicylic acid, coal tar, sulphur or corticosteroids.

Phototherapy (ultraviolet B, UVB) and photochemotherapy (psoralent ultraviolet A, PUVA) are both used for widespread psoriasis. Many patients find that natural sunlight also helps.

Oral treatment with immunosuppressants such as ciclosporin (Neoral), or methotrexate (eg Maxtrex) or the vitamin A derivative acitretin (Neotigason) may be used for patients with severe, widespread or unresponsive psoriasis.

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