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What is it?

Psoriasis is a chronic inflammatory skin disease that causes scaling and inflammation. Appears very variable way between patients and usually goes through periods of stability and outbreaks throughout life. Each person has a specific and unique type of psoriasis, either for the location and type of injury or for the interaction between the disease and the person, since the degree of impact it has on each person is different.

Who does it affect?

Psoriasis is probably the most common and popular the skin disease with a prevalence of 2-3% of the population. It’s more common between 15 and 35 years or 50-60 years but can affect at any age. It affects men equally than women.

Symptomatology

It’s a chronic condition of the skin that despite not being a serious pathology, if it has a very important implication in the quality of life of the person. It may manifest slowly or appear suddenly, as well as disappear for a while and reappear. Mostly, it’s characterized by the appearance of erythematous and hyperkeratotic plaques (with redness and scabs) of different shape and size depending on the patient. They usually appear on the elbows, knees and scalp. Although it usually affects the skin exclusively, there’s a certain incidence of nail injuries and inflammation in the joints (psoriatic arthritis).

Other less common symptoms than plaques are:

  • Pain
  • Genital lesions in the male sex
  • Nail injuries
  • Dandruff

Cause

Although the specific origin of the condition is unknown, if there is evidence that the inflammatory processes are due to an abnormal immune response caused by an undue T lymphocyte activation. This activation also causes the cells renewal process to occur too quickly.

Usually, the process of cell renewal takes about a month, but in people with psoriasis this process takes about four days. This causes the new cells go up too quickly and accumulate on the surface, causing the appearance of plaques.

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It’s also known to be a genetic and hereditary disease. This doesn’t mean that by having psoriasis the offspring will also suffer. It’s possible to inherit the genetic alteration, but not to develop the disease since also exogenous factors intervene in its appearance.

Exogenous factors that can make the skin of people with psoriasis worse are:

  • Chronic infections
  • Stress
  • Dry weather
  • Obesity
  • Alcohol consume
  • Certain medications
  • Hormonal changes

Types

We can find different classifications according to the gravity, shape and pattern of the scales.

ACCORDING TO GRAVITY:

  • Light psoriasis: plaques are usually insulated and cover 2% or less of the entire body. The treatment that is usually used is topical.
  • Moderate psoriasis: covers between 2-10% of the body and the treatments that are of topical use and the phototherapy.
  • Severe psoriasis: covers more than 10% and is usually treated with phototherapy and oral medications.

ACCORDING TO THE SHAPE AND PATTERN OF THE SCALES:

  • Psoriasis in plaques or vulgaris: is the most common form (80% of cases). The scales are made up of dead cells that are detached from the plaque. Other symptoms that may appear are pain, itching and cracking of the skin.
  • Psoriasis guttata or in drops: usually appears during childhood and is manifested with the appearance of small red drops on the trunk and limbs and sometimes on the scalp.
  • Reverse Psoriasis (in folds): is characterized by not having scales, but redness and inflammation of the skin. Obese people are more likely to suffer from it as it is especially prone to appear as a result of rubbing and sweating. It usually appears in the armpits, English, under the breasts and in the folds of the genitals and buttocks.
  • Erythrodermic psoriasis: il est caractérisé par un rougissement de la peau très forte et agressive affecte généralement la majeure partie du corps. It’s inflammatory and infrequent.
  • Postulated generalized psoriasis or of Von Zumbusch: very rare and manifested with the appearance of red areas in large body areas that produce pain and pustules. When these pustules dry they reappear cyclically.
  • Pustular located psoriasis: the pustules only appear on the hands and feet.
  • Acropustulosis: The lesions are located in the tips of the fingers and sometimes in the feet. They can become very painful.

Treatment

Although always considered as exclusively cutaneous disease, it’s now known that the inflammatory phenomena that lead to the appearance of plaques of psoriasis favor the manifestation of other systemic diseases (comorbidity).

It’s for this reason that the early diagnosis of psoriasis and the routine monitoring of other diseases that coexist in the patient is very important. The presence of this comorbidity often determines the treatment to be prescribed to treat psoriasis and the patient’s overall prognosis.

Frequently, the use of topical preparations is advised and in the case of severe psoriasis it’s usually co-administered oral drugs. However, it should be noted that it is common for psoriasis to affect a large part of the body or to have a chronic course, which contraindicates the use of these drugs because of their adverse effects. For this reason it is especially useful to treat it with phototherapy, which consists of the application of ultraviolet radiation of type A and/or B.

Psoriasic arthritis

It affects between 10-30% of patients with psoriasis. It’s characterized by chronic inflammation of the joints, with redness, pain and inflammation. It can appear at any time although it usually appears between 30 and 50 years.

It mainly affects the fingers and toes, the wrists, the lumbar spine, the sacrum and knees. It’s very important to take this disease in time to avoid complications.