Psoriasis is a common, chronic relapsing skin disease caused by an overactive immune system and also tends to run in families. It is characterized by red and thick, white, silvery scaly patches, which itch. Though psoriasis is mainly a cutaneous disorder affect the area like head/scalp, hands, back, elbows, knees/feet, also involves hair & nail. However as it is an autoimmune condition, it can involve joints and cause arthritis. In recent studies, it has been found that the psoriasis can be associated with metabolic syndrome that involves the increased cardiovascular diseases and heart stroke, hypertension, obesity (abdominal), glucose intolerance, dyslipidemia and the diabetes type 2.
Factors that worsen psoriasis are:
- Excessive smoking
- Consumption of alcohol/ tobacco
- Infections such as sore throat, cough, swollen gums, cavities
- Anxiety or emotional stress
5 Consumption of drugs like some antihypertensive, pain killers (NSAIDS), antifungals and antimalarials
- Physiological stressor like pregnancy, surgery, sunburn
Treatment: The modern-day dermatology has found many effective treatments to enable minimizing psoriasis and prevent it. On the basis of the type of Psoriasis, its severity, your age and comorbidities, we at our Clinic provide various treatments like topical treatments, oral medications, Phototherapy, injectable biologics to help you diminish this skin problem.
Topical therapy- Topical therapy are recommended for smaller areas in the form of creams, lotions, and ointments usually consist of Salicylic acid, Anthralin, Tar, Topical Vitamin D3 analog and Topical Retinoids etc. These help in reducing the cell proliferation and decrease the severity, redness as well as the itching in psoriasis lesions.
Oral medications- The patients with larger skin areas affected by the psoriasis, oral medications are prescribed. Usually, a thorough check-up is done to understand the patient’s medical condition before prescribing any oral medications. The oral medications used for treatment of psoriasis are calcineurin inhibitor, Anti Proliferative Medicines and Retinoids.
Phototherapy- Phototherapy also known as the light therapy, includes the exposure of the psoriasis affected skin to the ultraviolet light. The treatment can be done either at a clinic or home and should always be carried out under the supervision of a Dermatologist. The affected areas should be exposed to the sun in order to receive UVA & UVB, as both are present in sunlight. However,a sunscreen suggested by your dermatologist should be applied on the other unaffected areas. UVB is more effective and if you are using UVA, it is advised to use it with psoralen( a light sensitizing medication) orally or topically. This is known as PUVA which decreases the excess of skin cell activity and reduces the symptoms of psoriasis.
Biologics- Unlike traditional drugs that focus on the complete immune system; Biologics focus only on the specific parts of it. This works by blocking the specific immune system activity of cells and the proteins which play major role in the development of psoriasis. These are either injected or IV infused. The commonly used biologic is secukinumab. The biological are a convenient option for the patients who were not able to get rid of symptoms through other treatments or may have risks of side effects from other treatment modalities.
Diet and psoriasis- The diet with low energy, vegetarian or rich in poly-unsaturated fatty acids from fish oil helps in reducing the irritation and redness to minimize the symptoms of psoriasis. It has been proved scientifically that the gluten free diets and diets rich in maize help improving the psoriasis.
Frequently asked questions
- What causes psoriasis?
The cause of psoriasis is unknown but overactive immune system plays a major role. It also tends to run in families. Stress, infection, alcohol, smoking and certain medications like lithium, beta-blockers may trigger flares of psoriasis.
- Is psoriasis curable?
Psoriasis is unpredictable in its behaviour, it remits with treatment and recurres. It’s not curable but at our clinic we use combination of treatment to achieve longer period of remissions.
- Can a person die of psoriasis?
Two types of severe psoriasis like generalised pustular psoriasis and erythrodermic psoriasis are capable of causing death due to involvement of various organ systems and cardiovascular system. With modern medication, intensive care, there risks are significantly reduced.
- Does psoriasis involve other organs?
Psoriasis is mainly a cutaneous disorder, but also involves the hair and nail. As it is an autoimmune condition, it can involve joints causing joint swelling and join pain.
- How do you prevent psoriasis?
By avoiding your known triggers, you can prevent psoriasis. Avoid stress, medications that cause psoriasis, take good care of your skin to avoid injury, manage your weight by regular exercise and healthy diet. Consult your dermatologist for suggestion regarding trigger identification and reduce your outbreaks.
- Is it true that alternative systems of medication can cure psoriasis?
Many alternative systems have effective medicines for remissions of psoriasis, but none can cure it, immaterial of what is promised.