All you need to know about psoriasis

According to the International Federation of Psoriasis Associations (IFPA), Psoriasis affects almost 3% of the world’s population. While the percentage may seem small, close to 125 million people across the globe live with this condition.

Often neglected as a mere skin and cosmetic condition, Psoriasis is, in fact, an autoimmune condition.

It causes raised, scaly, itchy, dry, flaky, red skin that can resemble a rash, commonly found on the elbows, knees and scalp.

However, it’s more than your typical dry skin.

On World Psoriasis Day, which fell on  October 29, medical experts urge the importance to know more about Psoriasis and the related symptoms and severity of associated diseases, especially if the condition is left untreated.

What is Psoriasis?

In Psoriasis, the body’s immune system attacks its own healthy cells and is unable to differentiate between healthy cells and foreign bodies.

Dr. B.S. Chandrashekar, Medical Director, CUTIS Academy of Cutaneous Sciences, Bengaluru, says, “Psoriasis is an auto-immune condition largely due to genetic reasons. The immune system starts attacking some parts of the skin which cause a build-up on the surface".

The attack on healthy cells hastens the formation of skin cells, which build up on the skin’s surface, resulting in dry and scaly patches.

What causes it?

Psoriasis can affect people of all age groups but is most common in the 15-35 years age group. Studies have also shown that early onset psoriasis, often known as Type I Psoriasis affects people under the age of 40 years i.e. 16-22 years of age. Also, late onset psoriasis or Type II Psoriasis affects people above the age of 40 years, between 57 and 60 years.

Dr. Monica Bambroo, HOD – Dermatology & Cosmetology, Artemis Hospital, Gurgaon said, “There is no single cause for psoriasis and it can happen to anyone regardless of age and gender. Basis several studies, some of the risk factors identified are stress, smoking, drinking alcohol, skin injury or infections and genetic predisposition. Therefore, it is imperative to consult a dermatologist immediately after the first symptoms are observed. The bottom line is not to ignore a skin rash.”

What are co-morbidities and how do they relate to psoriasis?

A co-morbidity occurs when one or more additional diseases or disorders occur with a primary disease or disorder.

Many psoriasis patients are at the risk of developing co-morbidities, one of the most known is Psoriatic Arthritis. Psoriatic arthritis (PsA) is a type of inflammatory arthritis and preceded by psoriasis. Close to 26% of psoriasis patients develop psoriatic arthritis which can be a painful, sometimes disabling condition that affects the joints, tendons and bones .

Psoriasis patients can also suffer from Cardiovascular diseases (CVD) where the blood vessels can become inflamed. This can lead to build-up of a fatty substance called plaque inside artery walls which slows or interrupts the flow of blood to the heart. This increases the risk of heart disease and heart attack. Other conditions that psoriasis patients might suffer from are diabetes and obesity.

More importantly, people with psoriasis are twice as likely to be depressed as those who don't have it.

Dr. Shehnaz Arsiwala, Dermatologist, Saifee Hospital & Prince Aly Khan Hospital and Medical Director Renewderm Centre Skin Hair Lasers and Aesthetics, Mumbai, said, “Psoriasis patients often suffer neglect and discrimination, both in their professional lives and personal relationships. The need of the hour is to raise public awareness about this disease and help people understand that it does not spread through contact. This will help build empathy for psoriasis patients, a lack of which causes them mental and emotional stress.”

Even if the psoriasis symptoms are mild, one is still prone to a higher risk of depression which can lead to take an extensive mental and emotional toll on an individual’s life. In one study, nearly 20% of people with psoriasis had some form of depression .

Dr. Maya Vedamurthy, Director, RSV Skin Clinic and Senior Consultant, Apollo Hospitals, Chennai, said, “Psoriasis can cause stress and emotional trauma in patients living with it. The average time gap between onset of symptoms and diagnosis is usually more than a year. Psoriasis is also stigmatized as being contagious and people suffering with it often start staying aloof, choosing this behaviour as a coping mechanism.”

Can Psoriasis be treated?

The severity of psoriasis varies from person to person. Some may see flare-ups at the peak of the onset of symptoms which later subside with proper diagnosis and treatment. Whereas, other people may experience flare-ups that come and go throughout their lives.

Dr. Uma Chakravadhanula, Consultant Dermatologist, Idea skin clinic at Madhapur, Hyderabad says, “Early diagnosis and effective treatment can also prevent complications associated with psoriasis like psoriatic arthritis which can cause permanent disabilities to the joints. Suitable treatment options are dependent on the stage and severity of psoriasis. The most widely used treatment for psoriasis are topical treatments, phototherapy (light therapy), systemics and biologics. Biologic drugs are considered the most effective treatment option for severe psoriasis. They are protein-based drugs that target those specific parts of the immune system, that are responsible for triggering psoriasis.”

The next time you have an itchy and flaky red rash on your skin, do not ignore it – it could be psoriasis.An early visit to your dermatologist can go a long way in effective management of the condition.