Psoriasis

What is psoriasis?

Psoriasis is a common and often lifelong (chronic), non-contagious disorder of the skin, usually with a genetic component.
It occurs when inflammatory chemicals produced by specialised white blood cells called lymphocytes trigger the proliferation and quick turnover of skin cells.
This commonly results in multiple, red, flaky plaques.
The scalp is one of the commonest areas to be affected and often the first site affected.
Plaques tend to be restricted to hair‐bearing areas, extending a short distance beyond the hairline.
The thick plaques of psoriasis are often itchy, tend to flare for weeks or months then go into remission and crop up again later.
Psoriasis typically has two peaks of incidence, the first occurring between 16-22 years and the second between 57 and 62 years of age.
At Aurora Dermatology one of our signature specialties is providing psoriasis injections and biological treatments for psoriasis.

What are the symptoms of psoriasis?

This skin disorder can appear quite differently from individual to individual but common symptoms include:

Raised and red/silvery flaky plaques
A small scaling spot (commonly seen in children) right through to major eruptions that cover large areas of the body
Many patients have shedding of the skin
Dry cracked skin that may cause burning, soreness, itching, or bleeding
Psoriasis of the nails can make the nails look thick, pitted and ridged and is often accompanied by swelling in the fingers (psoriatic arthritis)
This type of arthritic pain can also sometimes impact the fingers, toes, wrists, knees, lower back or ankles
Pain, stiffness, or both may accompany joint swelling

What are the different types of psoriasis?

There are several types of psoriasis and symptoms including:

Plaque psoriasis Eight out of 10 people with psoriasis have plaque psoriasis.
It causes dry, raised, red lesions, covered by silvery plaques that usually appear on elbows, knees, lower back, and scalp.

Erythrodermic psoriasis is the least common and arguably the most aggressive type of psoriasis.
It can cover the entire body and may cause a peeling rash that can cause intense burning, shivering, fluid retention and needs urgent treatment.

Inverse psoriasis is more common in overweight people with deep skin folds in the groin, breasts, armpits and buttocks. This psoriasis has lesions that generally are minus the scales.

Guttate psoriasis often starts in childhood or adolescence and is marked by small skin spots that tend not to crust as much as plaque psoriasis.

Pustular psoriasis is a rare condition more common in adults, characterised by pus-filled lesions and small, white bumps, or non-infectious pus blisters. Tends to commonly affect soles and palms.

Nail psoriasis can separate from the skin underneath the nail (onycholysis), and cause yellow, crumbly nails.

Psoriatic arthritis is a condition that combines the swollen, sore joints of arthritis with psoriasis. It causes joint stiffness, swelling, and pain.

What are the causes of psoriasis?

Common factors that can increae your risk include:

A family history of psoriasis
Excess coffee and alchohol
Streptococcal Infection
Excess sunshine
Extreme cold and dry weather conditions
Skin injury such as a srape or cut
Stress
Physical Trauma

Drugs such as

Lithium
NSAIDS
Synthetic anti-malarials
Beta blockers
ACE Inhibitors
TNFa inhibitors
Withdrawal of oral corticosteroids.

Certain c-morbidities

Psoriatic arthritis
Depression
Liver Disease
Heart Disease
High Blood Pressure

What are the treatments for psoriasis?

Treatment of psoriasis will depend on the type and severity of the condition.
The main options include medications, phototherapy, and home lifestyle remedies.
Biologic therapies are one of Aurora’s signature treatments for severe psoriasis and have revolutionised the treatment of this disabling condition by targeting the specific parts of the immune system.
However, because these treatments are expensive the government will only subsidise the cost of treatment where the disease is particularly severe or all other options have been exhausted. Check with your dermatologist or GP.

Other effective treatments for psoriasis include:

Anti-itch agents and hydrocortisone cream (mild psoriasis)
Topical corticosteroids, cortisone creams/ointments/shampoo
Vitamin D analogue Daivobet creams/ointments /foam
Dithranol
Coal Tar
Topical Retinoids
Tacrolimus, Pimecrolimus
Phototherapy, narrow-band UVB Phototherapy with ultraviolet light can reduce irritation and
slow immune activity, although some patients such as those with lupus are not suitable. Click here to learn more about Phototherapy.
Biologic treatment
Methotrexate
Psoriasis injections
Ciclosporin
Acitretin
Apremilast

Natural/home remedies do not cure psoriasis, but can alleviate symptoms.
These include frequently moisturising the skin, eating a healthy diet with lots of Omega 3s, stress reduction, and avoiding hot and frequent showers.