Psoriasis
is a condition which affects about 2% of the population, though
many more, who have conditions with some similarity to psoriasis
(such as seborrhoeic dermatitis, see Eczema/Dermatitis and Dandruff)
believe they have it as well. The typical lesions of psoriasis
are pink/red patches, often round, sometimes raised, which are
covered with silvery, flaking skin. These psoriatic lesions
are commonly found on the knees, elbows, trunk and scalp, but
may be found anywhere including the palms of the hands, soles
of the feet, armpits, groins, buttocks and anogenital regions.
The fingernails can be fairly severely damaged by the condition.
Sometimes large areas of the body are covered but, although
they look very irritant, there is often no itching at all. Indeed,
a large number of people who seek help for their psoriasis are
more concerned about the appearance of their lesions than any
other symptoms they may have. Many are afraid that other people
will think they are contagious, which they are not. There is
often a family history, and although psoriasis can appear at
any age, it usually comes on in early adult life. Stresses such
as infection, anxiety, minor physical trauma and childbirth
can trigger it off. The illness tends to be chronic and can
last for many years. Sometimes it gets, inexplicably, better,
enabling the person treating it at the time to claim that their
treatment was the one that did it! Exposure to sunlight often,
at least temporarily, benefits psoriasis. Some people with the
skin condition get an associated arthritis, psoriatic arthritis, this can be quite severe, painful and not easy to treat. Some, usually teenagers, develop an acute psoriatic rash of small bright red spots, following a streptococcal sore throat (guttate psoriasis). Rarely, the psoriasis can be very severe, affecting the whole body, and is, occasionally, life threatening. Some drugs such as lithium, beta-blockers and anti-malarials may be involved in the causation, or worsening, of psoriasis.
There is, at present, no cure for psoriasis. Some people with very minor lesions use little more than a skin softener, such as soft, white paraffin, or an emollient. For those with mild to moderate psoriasis, the commonest applications used by physicians contain coal tar products, dithranol or corticosteroids. A Vitamin D analogue, calcipotriol, is now also used a great deal. It is wise for the psoriasis sufferer to see a skin specialist who will often suggest quite a strict regime of treatment to be stuck to fairly religiously. In damp parts of the body, such as the armpits and the groin, where additional fungal infection may be a problem, anti fungal medication may help. In severe psoriasis, ultraviolet light combined with the plant extract, psoralen, (PUVA) may be used, as may be such powerful drugs as methotrexate (an anti-cancer drug), retinoids (see Acne) and cyclosporin. |
