Psoriasis is a persistent autoimmune disease that triggers skin inflammation. Plaques are one of the most common symptoms of psoriasis, which are thickened areas of the skin covered in scales. Since there is no cure for psoriasis, it is a chronic condition that can unexpectedly flare up.
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What Are the Types of Psoriasis?
Psoriasis is a skin condition that comes in various types. Here are the different types of psoriasis:
- Plaque psoriasis: Plaque psoriasis is the most common type of psoriasis and is experienced by 80% to 90% of people with the condition. It causes plaques with scales, which can be thick, raised, and reddish.
- Inverse psoriasis: This type of psoriasis emerges in skin folds and causes thin plaques that lack scales.
- Guttate psoriasis: Guttate psoriasis typically appears after a streptococcal infection and mostly affects children and young adults. It appears as small, red, and drop-shaped scaly spots.
- Pustular psoriasis: Pustular psoriasis creates small, pus-filled bumps on top of plaques.
- Erythrodermic psoriasis: This is the most severe type of psoriasis that can affect over 90% of the skin. It causes widespread skin discoloration and shedding.
- Sebopsoriasis: This type is a combination of psoriasis and seborrheic dermatitis. It usually appears on the face and scalp as bumps and plaques with a greasy, yellow scale.
- Nail psoriasis: Nail psoriasis changes the color, texture, and appearance of the fingernails and toenails, causing them to pit and become brittle.
What Causes Psoriasis?
Psoriasis is a chronic autoimmune disorder that affects the skin. The condition occurs when the body’s immune system becomes overactive and starts attacking healthy skin cells. This causes inflammation, which leads to the formation of plaques on the skin. These plaques are typically red, raised, and covered with silvery scales, which can be itchy and painful.
The Role of the Immune System in Psoriasis
The immune system’s primary function is to protect the body from foreign invaders, such as viruses and bacteria. However, in psoriasis, the immune system mistakenly attacks healthy skin cells. This process triggers the production of inflammatory chemicals in the skin, leading to the formation of plaques.
The Formation of Plaques in Psoriasis
Normally, it takes about a month for new skin cells to grow and replace old ones. However, in psoriasis, the immune system speeds up this process, causing new skin cells to develop in just three to four days. As a result, the new cells do not have time to mature properly, leading to the formation of thick, scaly patches on the skin.
Genetic Factors in Psoriasis
Psoriasis tends to run in families, suggesting that there may be a genetic component to the condition. Research has identified several genes that are associated with an increased risk of developing psoriasis, including genes that are involved in the immune system’s response to infection and inflammation. However, not everyone with these genes will develop psoriasis, indicating that other factors, such as environmental triggers, also play a role.
What Causes Psoriasis Outbreaks?
Psoriasis is a chronic skin condition that can cause a range of symptoms, from mild to severe. Outbreaks or flare-ups occur when psoriasis symptoms suddenly worsen or reappear after a period of remission. This can happen as a result of contact with a trigger, which could be an irritant or an allergen. Common triggers for psoriasis flare-ups include emotional stress, an infection like streptococcal infection, a skin injury like cuts or scrapes, certain medications like lithium and beta-blockers, and changes in body temperature due to weather.
A healthcare provider or a dermatologist will diagnose psoriasis after a physical exam to look at your skin and review your symptoms. They’ll ask you questions about your medical history and skin care routine, such as whether you have a history of skin conditions in your biological family, when you first noticed symptoms, or if you have tried any at-home remedies to treat your skin. The appearance of a skin plaque leads to a psoriasis diagnosis, but symptoms can relate to other similar skin conditions, so your provider might offer a skin biopsy test to confirm your diagnosis. During this test, your provider will remove a small sample of skin tissue from your skin plaque and examine it under a microscope.
Several treatment options can relieve psoriasis symptoms. Common psoriasis treatments include steroid creams, moisturizers for dry skin, medication to slow skin cell production like anthralin, medicated lotions or shampoos, Vitamin D3 ointment, and Vitamin A or retinoid creams. Creams or ointments may be enough to improve the rash in small areas of your skin. However, if the rash affects larger areas, or if you also have joint pain, you’ll need other treatments. Joint pain may be a sign that you have arthritis. Your provider will decide on a treatment plan based on the severity of the rash, where the rash is on your body, your age, and your overall health.
Advanced Treatments for Psoriasis
If psoriasis symptoms do not improve after treatment or if large areas of skin are affected, advanced treatments may be recommended. These treatments include:
Light Therapy: Also known as phototherapy, this treatment involves exposing the skin to specific wavelengths of ultraviolet light using LED lights. This can decrease skin inflammation and help slow skin cell production.
PUVA: This treatment involves combining a medication called psoralen with exposure to a special form of ultraviolet light. PUVA can be effective in reducing psoriasis symptoms.
Retinoids: These vitamin A-related drugs can help improve psoriasis symptoms but may cause side effects such as dryness, redness, and peeling of the skin. In addition, retinoids may cause birth defects, so women who are pregnant or planning to become pregnant should not take them.
Immune Therapies: Newer immunotherapy medications such as biologics and small molecule inhibitors work by blocking the body’s immune system so it can’t cause an autoimmune reaction. These treatments can be effective in reducing psoriasis symptoms but may cause side effects such as headaches, diarrhea, and nausea.
Methotrexate: Providers may recommend this medication for severe cases of psoriasis. Methotrexate is a chemotherapy drug that works by slowing down the growth of skin cells. However, it may cause liver disease, so if you take it, your provider will monitor your progress with blood tests. You may also need periodic liver biopsies to check your liver health.
Cyclosporine: This medicine can help severe psoriasis, but it may cause high blood pressure and kidney damage. Providers will monitor your progress with blood tests and other medical tests while taking this medication.