Psoriasis

Psoriasis is long-lasting autoimmune disorder characterized by red, itchy, scaly patches over the skin, which varies in severity from small, localized patches to complete body coverage. Psoriasis is generally thought to be a genetic disease that is triggered by environmental factors. Psoriasis is not contagious. It is characterized by an abnormally excessive and rapid growth of the epidermal layer of the skin; skin cells are replaced every 3 to 5 days rather than the usual 28 to 30 days.

Five main varieties of classification are

Plaque psoriasis/ psoriasis vulgaris: This variety makes up about 90% of affected cases, typically presents with red patches with white scales on top. The lesion appears as raised areas of inflamed skin with silvery-white scaly skin. Commonly affected areas are back of forearms, shins, scalp and naval area.

Guttate psoriasis: Presents with drop shaped lesions; commonly affected areas are trunk, but also the limbs and scalp

Inverse psoriasis/flexural psoriasis: Presents with red patches in skin folds, especially between thigh and groin, and armpits and skin folds of overweight abdomen.

Pustular psoriasis: Presents as small non-infectious pus filled blisters.

Erythrodermic psoriasis: Presents with widespread rash and can develop from any other type of psoriasis.

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Related terms:

Napkin psoriasis: common in infants characterized by red papules with silver scale in the diaper area that may extend to the torso or limbs; often misdiagnosed as diaper rash

Psoriatic nails: psoriasis can affect the nails and produces a variety of changes in the appearance of fingers and nails. These changes include pitting of the nails, whitening of the nails, small areas of bleeding under the nails, yellow-reddish discoloration of the nail, thickening of the skin under the nail and loosening and separation of the nail.

Psoriatic arthritis: Most individuals develop the skin problem first and then the joint issues. Typical features are continuous pain with stiffness and swelling, recur with periods of remission

Diagnosis: Is mostly based on signs and symptoms; Specific signs are Auspitz’s sign, koebner phenomenon.

Management: With lifestyle modifications, avoiding triggering factors and proper medications.