Psoriasis is a common condition affecting about 3 per cent of the global population. It is an autoimmune disorder that leads to excessive skin growth, resulting in itchy, cracked, and bleeding scales or red patches. These patches typically appear on the scalp, arms, legs, chest, hands, or feet.
During flare-ups, individuals with psoriasis may feel self-conscious, as others might mistakenly believe it is a contagious or infectious skin condition. However, it's important to understand that psoriasis is neither contagious nor transmissible to other people.
In this article, we will delve into what psoriasis is, its causes, and potential treatment options. We'll also address how it spreads from one part of the body to another but emphasise that it does not spread to other individuals.
Psoriasis is a chronic skin condition believed to be caused by an overactive immune system. It leads to accelerated growth of skin cells, resulting in itchy, burning, cracked, and occasionally bleeding patches.
Psoriasis can manifest in various body parts, and different types of psoriasis are named after the affected areas. It's possible to experience multiple types simultaneously.
In addition to affecting the skin, psoriasis can also impact organs and cause psoriatic arthritis, affecting the joints. Psoriasis is generally classified as either non-pustular or pustular, with the former being the most common type.
There are several subtypes of non-pustular psoriasis, including:
● Psoriatic arthritis (joints)
● Guttate psoriasis (arms, legs, and chest)
● Palmoplantar psoriasis (palms of hands and soles of feet)
● Inverse psoriasis (folds of the skin)
● Scalp psoriasis (head, ears, neck)
● Erythrodermic psoriasis (whole body, the most severe type)
Pustular psoriasis, although rare, is a distinct form of the condition. Instead of the typical patches or scales, it presents with sudden outbreaks of pustules. These pustules often accompany other symptoms such as high fever, pain, and severe fatigue. Pustular psoriasis can occur independently or as a secondary condition to non-pustular psoriasis. It is crucial to seek immediate medical attention for most forms of pustular psoriasis.
If left untreated, these pustules can give rise to complications that can potentially be life-threatening or even fatal.
Psoriasis pustular has different subtypes:
● Generalized pustular psoriasis
● Barber's pustular psoriasis
● Impetigo herpetiformis
● Acrodermatitis continua of Hallopeau
Psoriasis is not a contagious condition. It cannot be transmitted to others, even during pregnancy or through sexual contact.
While psoriasis may have a genetic component, it does not mean that family members can "catch" psoriasis from one another. If multiple individuals in a family develop psoriasis, it is due to shared genetic and immune-related factors rather than direct transmission between family members.
Psoriasis can spread within an individual's own body. Once someone develops psoriasis, the condition can affect different areas beyond the initial site. This spread is attributed to immune dysfunction.
However, it is essential to note that psoriasis does not spread from person to person. It is not contagious and cannot be transmitted from one individual to another.
Psoriasis is primarily driven by inflammation and various triggers, including stress, certain medications, and other factors. Similar to other autoimmune conditions, the exact cause of psoriasis may not always be clear or fully understood.
Genetics and immune function are significant factors in psoriasis, and individuals with other autoimmune disorders may have an increased risk of developing it.
Within the immune system, there are different types of cells, including T cells. T cells are responsible for fighting bacterial infections and viruses. However, in people with psoriasis, T cells mistakenly attacMobi Doctory skin cells.
This erroneous immune response leads to an overproduction of skin cells as the body tries to replace the damaged ones. Consequently, an excess of skin cells is formed, but the shedding of old cells does not occur at the same rate.
This accumulation of skin cells results in the formation of scaly patches that appear on the surface of the skin.
Psoriasis flares can be triggered by lifestyle-related events or by other medical conditions, such as:
● Sedentary lifestyles, whether through choice or disability, are not healthy
● Infections or illness
● Skin injuries like cuts, bites, or burns
● Nutritional deficiencies or problems fully digesting or absorbing nutrients
● Alcohol use
● Celiac disease
● Sun exposure
Psoriasis flares can also be triggered by medications. These can include:
● Arthritis medications
● Monoclonal antibodies
● Antimalarial drugs, like chloroquine
● Medications for skin conditions
● Oral steroids
● Antiviral medications
● Chemotherapy drugs
Psoriasis has no specific risk factors, but some factors may increase your chances of developing it:
● Family history and genetics
There is also an increased risk of developing other health conditions due to psoriasis.
Psoriasis may overlap with the following disorders or conditions:
● Type 2 diabetes
● Heart disease or heart attack
● Eye inflammation (uveitis)
● Crohn's disease
● Mild to moderate cases of psoriasis can be treated with prescription creams that contain beneficial nutrients such as vitamin A or vitamin D. Examples of these creams include anthralin, tazarotene, and calcipotriene. They work by slowing down the rapid skin cell growth, aiding in the removal of scales, and relieving itchiness caused by inflammation.
● During flare-ups, topical steroid creams like betamethasone, clobetasol, or clobetasol can effectively reduce symptoms. However, these should only be used for a maximum of 4 weeks, as prolonged use can lead to skin thinning and potential complications.
● In cases where topical creams or steroids do not provide relief, injected steroids may be administered. However, these are typically reserved for severe cases of psoriasis.
If psoriasis does not respond to topical treatments or injectable steroids, or if there are indications of psoriasis spreading to other parts of the body, a healthcare provider may suggest systemic or biologic therapies.
These treatments target the underlying causes of psoriasis flares, such as inflammation and immune system activity.
Systemic therapies are designed to impact the entire immune system. However, they are typically reserved for more severe cases due to the higher associated risks.
● Phosphodiesterase-4 inhibitors
Biologics or biosimilars might have a role in moderate but less severe cases. To prevent overreaction, they target specific immune system cells.
These medications include:
● Secukinumab (Cosentyx)
● Adalimumab (Humira)
● Guselkumab (Tremfya)
There may be side effects associated with these treatments as well as with other treatments for autoimmune disorders, such as:
● Flu-like symptoms
● Increased risk of infection
● Suppressed immune function
For mild cases of psoriasis, there are over-the-counter (OTC) treatment options available. These can include topical creams, shampoos, solutions, or lotions. It is important to rotate the use of these products, as using them less frequently can decrease their effectiveness. It is advisable to consult with your healthcare provider for OTC recommendations tailored to your specific needs.
It is worth noting that not all products labelled or marketed for psoriasis will be effective. When choosing OTC products, look for those with active ingredients such as:
1. Aloe vera: It may assist with discolouration and scale buildup without causing side effects.
2. Capsaicin: It may relieve pain, but long-term use is not recommended as it can cause skin burning.
3. Salicylic acid: It may help reduce scales by exfoliating dead skin cells, but it can lead to hair breakage when used on the scalp. It may also irritate sensitive skin.
Phototherapy is a treatment option available at dermatology clinics and certain hospitals. It can be used as an alternative therapy or with other treatments. During phototherapy, a specialized laser device that emits UVB rays is applied to the affected areas of the skin.
Typically, phototherapy treatments are conducted up to three times per week for a duration of up to 8 weeks.
For individuals with mild psoriasis or those seeking to prevent flare-ups, implementing certain lifestyle changes can be beneficial:
Manage stress: Although eliminating stress entirely may not always be feasible, avoiding major stress triggers can help reduce psoriasis flare-ups. Engaging in stress-relief techniques such as deep breathing, meditation, regular exercise, aromatherapy, or practising yoga can support a healthy stress response.
Avoid smoking and alcohol: Smoking is considered a risk factor for developing psoriasis, and both smoking and alcohol consumption can contribute to flare-ups of the condition.
Consistency with treatments: If using over-the-counter remedies or following prescribed treatment plans, it is important to use them consistently. Adhering to the recommended treatment regimen can help decrease symptoms and manage psoriasis effectively.
Be gentle with your skin: Psoriasis can cause itchiness and discomfort, but excessive scratching can worsen the condition and increase the risk of unrelated infections. It is advised to avoid overusing steroid creams, as this can thin the skin and potentially lead to more cuts and infections.
If you suspect signs of psoriasis, seeking medical attention from a healthcare provider for an accurate diagnosis is essential. Sometimes, certain types of eczema or other skin disorders may resemble psoriasis and vice versa.
Different skin conditions necessitate distinct treatment approaches. Therefore, a proper diagnosis is essential to determine the most appropriate course of treatment for your specific condition.
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