Psoriasis is a non-contagious chronic skin disorder that is seen as scaly plaques on the skin. The Psoriasis appears as an elevated red plaque that is covered by a silvery dry scale. It affects 1-2% of the world population.
A normal skin cell matures in 28 – 30 days. In Psoriasis, cells move to the top of the skin in three days. The excessive skin cells that are produced “heap up” and form the elevated red, scaly plaques that characterize Psoriasis. The white scale that covers the red plaque is composed of dead cells that are continually being cast off. The redness of the plaques is caused by the increased blood supply necessary to feed this area of dividing skin cells.
Do not let Psoriasis affect your confidence. Make peace and ensure you have a strong mind and body to deal with the everyday challenges. Empower yourself with knowledge of your condition to enable you to be in control of your condition.
Different Types of Psoriasis
Discoid or Plaque Psoriasis
This is the most common type of Psoriasis. Well defined, coin-shaped patches of skin that are usually red and covered in white, waxy scales that appears on the knees and elbows but plaques can appear anywhere on your body. They can be itchy and may bleed if scratched.
Guttate Psoriasis (Latin gutta, meaning drop)
Guttate Psoriasis usually develops 7-14 days after a severe throat infection or bout of tonsillitis caused by streptococcal infection. The “drop-like” patches are mostly found on the trunk and limbs. It generally occurs in children or young adults and often disappears by itself after several weeks/months.
Flexural (inverse) Psoriasis
Flexural Psoriasis is found in “skin folds” of sites such as the armpits, groin, buttocks or beneath the breast. The skin is red and covered with thin plaque but not scaly.
Well defined glazed areas in nappy area of babies
Scalp Psoriasis is common in Psoriatic patients. About 50% of all Psoriasis patients suffer from scalp Psoriasis. It is clearly defined, infiltrated, very thick, white and scaly plaques over the scalp, especially in occiput and above the ears. Masses of sticky grey-ish white asbestos-like scales on scalp. It can look similar to dandruff and can be embarrassing.
Sebopsoriasis is usually seen on the scalp and also the face (glabella, eyebrows and nasolabial folds), postauricular and pre-auricular areas and sometimes on the central chest. It overlaps with seborrhoeic dermatitis but is distinguished by having more well-demarcated plaques. The face is usually not affected when it comes to psoriasis. Psoriasis of the scalp can extend down over the forehead, temples and sometimes over the eyebrows and ears.
May only effect palms and or soles. Well-demarcated plaques on palms of hands or soles of feet. More hyperkeratotic types (thickening of skin) tend to form painful fissures. It can be difficult to distinguish palmoplantar Psoriasis from:
- Tinea (scrapings for fungal culture should be routinely ordered)
- Dermatitis eg. Allergic contact dermatitis
Pustular Psoriasis usually exists as a large red area covered with green, tender pustules (blisters), despite their colour the pustules are not infected (the green colour is caused by masses of white blood cells-these cells flood into any part of the skin that is inflamed). After 7-10 days pustules become dispersed and brown scales appear and later fall off. Pustular Psoriasis on the palms and soles tend to be sore rather than itchy. It is uncomfortable, unsightly and can make writing and walking difficult.
The most rare and most severe form is Generalised Pustular Psoriasis. A patient becomes ill, feverish and a sudden onset of tiny pustules all over the skin, within a few hours or days. The pustular change is induced by the overuse of strong cortisteroid application.
This is an independent disorder. Around the pustules the skin becomes red, thickened and painful fissures will form with a distressing itch. It is most common in middle aged females. People with this condition can benefit from UVB treatment.
In 50% of patients with Psoriasis, the nails are affected. Pitting, discolouration and thickening of the nail may occur
It is an inflammatory form of Arthritis which may affect only a few or multiple joints.
90% Or more of skin is inflamed. It may be a slow worsening of chronic plaque Psoriasis or an explosive form of unstable psoriasis. The skin becomes red, hot and continually scales. They lose the ability to control their body temperature and experience the loss of fluids and proteins. Psoriatic Erythroderma may be provoked by too intense topical treatment, by infections, the sudden withdrawal of topical corticosteroid therapy as well as anti-malarial therapy