Psoriasis: Causes, Symptoms and Treatment Options
Psoriasis is a chronic inflammatory skin condition causing scaly, red plaques on the skin. It is not contagious and affects approximately 2-3% of the global population.
Wissenswertes über "Psoriasis"
Psoriasis is a chronic inflammatory skin condition causing scaly, red plaques on the skin. It is not contagious and affects approximately 2-3% of the global population.
What is Psoriasis?
Psoriasis is a chronic, immune-mediated inflammatory skin disease that follows a relapsing-remitting course. It affects approximately 2–3% of the global population and can appear at any age. The condition is not contagious and results from an overactive immune response that accelerates the skin cell renewal cycle, leading to a buildup of cells on the surface of the skin.
Causes
Psoriasis is caused by a combination of genetic predisposition and immune system dysregulation. Overactivated T-cells trigger an inflammatory cascade that speeds up skin cell production from the normal 28-day cycle to just 3–5 days. Known triggers that can initiate or worsen flare-ups include:
- Family history of psoriasis (genetic susceptibility)
- Psychological stress
- Infections, particularly streptococcal throat infections
- Certain medications (e.g., beta-blockers, lithium, antimalarials)
- Alcohol consumption and smoking
- Skin injury or trauma (Koebner phenomenon)
- Hormonal changes
Symptoms
The hallmark of psoriasis is the appearance of well-defined, raised red patches (plaques) covered with silvery-white scales. These plaques most commonly occur on:
- Elbows and knees
- Scalp
- Lower back and buttocks
- Nails (nail pitting, thickening, or separation)
- Palms and soles of the feet
- Genital area
Affected individuals frequently experience itching, burning, and skin tightness. In more severe cases, psoriatic arthritis can develop, causing joint pain, swelling, and stiffness.
Types of Psoriasis
There are several clinical forms of psoriasis:
- Plaque psoriasis (psoriasis vulgaris): The most common form, accounting for about 80–90% of cases
- Guttate psoriasis: Small, drop-shaped lesions, often triggered by infections
- Inverse psoriasis: Affects skin folds such as the armpits and groin
- Pustular psoriasis: Characterized by non-infectious pus-filled blisters
- Erythrodermic psoriasis: A severe form covering large areas of the body
Diagnosis
Psoriasis is primarily diagnosed through a clinical examination by a dermatologist. The characteristic appearance of the skin is usually sufficient for diagnosis. In uncertain cases, a skin biopsy may be performed to confirm the diagnosis. Disease severity is commonly assessed using the PASI score (Psoriasis Area and Severity Index).
Treatment
While there is currently no cure for psoriasis, it can be effectively managed. Treatment depends on the severity and extent of the disease:
Topical Therapy
- Corticosteroids (anti-inflammatory creams and ointments)
- Vitamin D analogues (e.g., calcipotriol)
- Dithranol (anthralin)
- Topical retinoids (tazarotene)
- Moisturizers and emollients as base therapy
Phototherapy
- Narrowband UVB therapy
- PUVA therapy (psoralen combined with UVA light)
Systemic Therapy
- Methotrexate (MTX)
- Ciclosporin
- Acitretin (oral retinoid)
- Biologics: Targeted antibody therapies (e.g., TNF-alpha inhibitors, IL-17 inhibitors, IL-23 inhibitors)
- Janus kinase (JAK) inhibitors
Living with Psoriasis
Psoriasis can significantly impact a person's quality of life, both physically and psychologically. The visible nature of the condition can lead to social stigma, anxiety, and depression. Support groups, psychological counseling, and lifestyle adjustments — including stress management, a balanced diet, and avoiding alcohol and tobacco — can positively influence the disease course.
References
- World Health Organization (WHO) – Global report on psoriasis. Geneva: WHO Press, 2016.
- Griffiths CEM, Armstrong AW, Gudjonsson JE, Barker JNWN. Psoriasis. The Lancet, 2021; 397(10281):1301–1315. doi:10.1016/S0140-6736(20)32549-6
- National Institute for Health and Care Excellence (NICE) – Psoriasis: assessment and management. NICE guideline NG95, 2017. Available at: www.nice.org.uk
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Verwandte Suchbegriffe: Psoriasis + Psoriasis vulgaris + Psorasis + Plaque psoriasis