Psoriasis is a chronic and inflammatory skin disease mediated by the body’s immune system. The disease develops when the body’s immune system delivers some defective signals that result in speedy growth of cells of the skin. The disease is not contagious. There are five types of this form of disease; erythrodermic, inverse guttate, plaque and pustular psoriasis. The most prevalent of the disease is the plaque form of the disease that manifests itself as white and red patches on the skin. Plaque psoriasis manifests itself as patches on the skin especially in the scalp and in the feet and genitals. However, some patients do not show any symptoms of the disease on the skin (Christopher 13).
Pustular psoriasis patches appear as raised patches on the skin filed with pus. The skin behind the patches is tender and red. Pustular psoriasis can manifest itself as either localized in the limbs or widespread in every part of the body. Guttate psoriasis manifests itself as many, red small lesions on the skin surface. The many lesions of guttate psoriasis can manifest themselves in any part of the body but they mainly occur in the limbs and the scalp. Guttate psoriasis disease is actually preceded by bacterial infections such as streptococcal infection. Psoriatic erythroderma is a type of psoriasis that involves widespread inflammation of the skin all over the body surface. The disease is characterized by pain, itching beneath the inflamed skin. The disease is a result of the exacerbation of the plaque psoriasis. This form of psoriasis is fatal because extreme inflammation of the skin leads to exfoliation of the skin and the inability of the body to regulate temperature (Kerkhof & Cornelius 17).
Psoriasis is a disease that Recurs frequently in the body. The severity of the disease also varies from patient to patient. Psoriasis can manifest itself as localized patches in the body in some patients while in other patients the disease can manifest itself all over the whole surface of the body. However, in most cases toenails and the fingernails are the parts of the body most frequently by the disease. Psoriasis can also cause inflammation of the joints of the body joints: a condition called psoriatic arthritis. Psoriasis is an incurable and long-term skin disorder its course in the body is variable. Psoriasis is characterized by periods of sudden worsening and periodic improvement for the patient. The disease can disappear for some years then suddenly recur after some years .Psoriasis affects all races and all sexes in the world. It also affects people of all ages, babies and adults but in most cases, it is diagnosed in the early adult years (Kerkhof & Cornelius 18).
Causes of psoriasis
The main cause of the psoriasis is not clear. There is some wide range of factors attributed to the development of the disease. They include genetic predisposition and environmental factors. The immune system is linked to development of the disease although the mechanism in which it mediates the process is unclear (Cole 3).
There are two theories that explain the development of the disease. The first theory explains psoriasis as just a disorder of overgrowth and excess of reproduction of the skin cells. Overgrowth of the skin is attributed to defects in the keratinocytes and the epidermis of the skin. The second theory advanced to explain the causes of psoriasis explains the disease as a disorder of the immune system. According to this theory, excessive division of the cells of the skin is linked to immune system T factor mediated mechanisms. These immune system T factors move to the skin and cause the release of the cytokines, which cause inflammation and rapid division of the cells of the skin. However, psoriasis is not considered an autoimmune disease although the immune system is thought to play a role in its development because the body does not react against its own antigens. The disease is an idiosyncratic disease because it can worsen or improve for no apparent reason.
Management of the disease
There are no specialized blood procedures or diagnostic procedures to diagnose the disease. The diagnosis of the disease is purely based on skin appearance. A skin biopsy may be necessary for diagnosis to differentiate the disorder from other skin disorders (Christopher 24).
A variety of treatment options exist for the psoriasis
Medicated ointments and creams can be applied directly to the affected part of the skin to reduce inflammation of the skin, reduce the turn over of the skin and remove the overgrown plaques. Petroleum jelly, mineral oil and moistures application on the skin can also be applied to soothe the skin and reduce drying that accompanies the scaling of the skin. Other creams and ointments containing vitamin D analogues inhibit cell proliferation. Creams containing desoximetasone corticosteroid and atharaklin are also topically applied in the skin to minimize inflammation (Kerkhof & Cornelius 36).
Phototherapy is another method used to treat psoriasis. This therapy entails the use of strong rays of light of wavelength 311-313nm delivered through special lamps on the affected skin. Ultraviolet light A is another form of phototherapy used where strong ultraviolet A is used on the affected skin surface. Ultraviolet A light therapy can also be used in combination with oral or topical application of psoralen (COLE 6).
The oral agents used to treat Psoriasis include cyclosporine, methotrexate and retinoid. Cyclosporine and methotrexate are drugs that suppress the immune system used to treat psoriasis. Retinoid, which are vitamin A derivatives are also used in the treatment of Psoriasis. Other drugs used to treat psoriasis include adalimubaba and ustekinumab. These monoclonal antibodies based drug that block cytokine production in the skin preventing inflammation (Kerkhof & Cornelius 43).
Most patients of psoriasis experience a resurgence of the disease if they discontinue talking systemic drugs. Treatment in psoriasis is a complicated process because of the disease is not curable but manageable. As a fist line therapy, the medication with the least idiosyncratic reactions to the patient is used first. If the disease does not clear, then treatment with more toxic agents are used .psoriasis is therefore treated with a treatment ladder. Medicated creams and ointments are used as first line therapy. They are first applied topically on the skin and if they fail to achieve the treatment goal, then phototherapy method is used .if this method fails to achieve the treatment goal .then systemic medication is administered orally or intravenously as a management strategy, a lifestyle change also helps in management of symptoms. For example, a health diet, exercise and avoiding smoking and stress also help in relieving symptoms of psoriasis (Cole 4).
Psoriasis exhibits varied symptoms. The most common sign is pinkish red raised dry areas of the skin. The condition can affect any part of the skin but they are more common in areas of frequent abrasion or rubbing like elbows scalp or the knees. The appearance of psoriasis plaques varies from bumps on the skin to white raised skin to dries skin that peel off the skin. Pulling of the psoriasis plaques on the skin reveals blood spots on the body called an auspitz sign (Cole 1).
Lesions on the skin are also common especially on the penis head. In the moist places of the body psoriasis plaques appear as red patches. On the nails, psoriasis appears like white spots on the nail or as brownish yellow spots on the nails. On the scalp, psoriasis appears as dry flakes that peal off the skin. Scalp psoriasis is easily confused with seborrhea. Psoriasis also manifests itself as joint problems in around 35 to ten percent of psoriasis patients. In some instances, joint pains may be the only sign that a patient has psoriasis .Psoriasis that affects the joints is referred as psoriatic arthritis.
Diagrams showing the varIous manisfestatiopns of psoriasis on the body. Diagrams retrived from Medicinenet.com