Psoriasis

  • Definition

Psoriasis is a Greek word meaning being itchy.

It is a non-infectious chronic condition that presents mainly in the skin but may also affect the joints and nails.

Affects 2% of most populations, currently 125 million people affected worldwide.

Affects both sexes equally

Usually in two peaks late teens/young adulthood and after the age of forty but can develop at any age.

  • Causes of Psoriasis

The cause of psoriasis is still not known, however it develops as a result of an interplay between 3 factors:

  1. Genetics – it has been found that psoriasis occurs mainly in families and particular combinations of genes have been found in individuals with psoriasis.
  2. The immune system – the immune system in patients with psoriasis attacks healthy skin cells causing the skin to regenerate itself every few days rather than every month.
  3. Environmental factors – certain factors have been found to trigger and worsen psoriasis.

 

 

  • Triggers of Psoriasis

For many patients, their symptoms begin or are worsened by specific events or factors. These include:

  1. Injury to the skin – psoriasis has been found to develop in and around areas of injury e.g. cut, insect bite, needle prick
  2. Sunlight – most patients find that their condition improves when exposed to sunlight, however for some it worsens.
  3. Infection – throat infections caused by a certain bacteria trigger a specific type of psoriasis in children and young adults (guttate psoriasis)
  4. Drugs – some antimalarials, some painkillers, some drugs used to treat high blood pressure and heart failure, some antidepressants.
  5. Smoking is associated with development of psoriasis especially palms and soles of feet
  6. Drinking excessive alcohol
  7. Psychological stress – though psoriasis is a distressing condition, stress itself triggers and worsens it
  8. Hormonal changes especially in women during puberty and menopause
  9. Other conditions affecting the immunity such as HIV

 

  • What does Psoriasis Look Like?

 

  • The classical presentation – well defined, scaly , raised patches on the skin.
  • Affects mainly – elbows, lower back, knees, shins and scalp and is often symmetrical.
  • Can affect other areas of the body and appear different from the “classical” picture

 

  • Types of Psoriasis

 

Psoriasis Vulgaris

  • Is the commonest type, 90% of patients present with this type.
  • Is the classical well defined, silvery scale, raised patch.

 

Guttate Psoriasis

  • Guttate means ‘drop’
  • Well defined, small scaly, raised patches
  • Found mainly in children and young adults.
  • Triggered by streptococcal throat infection

 

Inverse Psoriasis

  • Inverse – opposite.
  • Occurs in armpits, neck, groin area, under breasts, abdominal folds
  • Appears red or dark with little scaling

 

Scalp Psoriasis

  • Very scaly scalp, can be very distressing

Pustular Psoriasis

  • Pus filled rash, associated with feeling unwell, fever and poor appetite
  • Is an emergency

 

Erythrodermic Psoriasis

  • The whole body is red or very dark and shiny with fine scaling
  • Is an emergency.

 

Joint Psoriasis

  • Swollen, stiff, painful joints of fingers and toes
  • Very distressing as movement and function is limited.

 

Nail Psoriasis

  • Separation of the nail from the nail bed, pitting of the surface of the nail and discolouration of the nail.

 

  • How is a diagnosis made?

 

The appearance of the lesion + biopsy (taking a piece of affected skin and examining under microscope).

 

  • Associated Conditions

 

  • Hypertension
  • Diabetes
  • High Cholesterol
  • Obesity

Your doctor will often do laboratory investigations and other assessments for these conditions during checkups and follow ups.

 

  • Management of Psoriasis

 

  1. Identify triggers and avoid them, if possible
  2. Adequate moisturisation
  3. Medical interventions – depend on severity ( area affected, quality of life)
  • Topical therapies applied directly to the affected areas
  • Phototherapy – use ultraviolet radiation
  • Oral Medication
  • Psoriasis is not curable but can be managed and controlled.

 

  • Patient Support Groups

The Psoriasis Association of Kenya is a patient support group comprised of people from all over Kenya living with psoriasis and medical practitioners.

 

The association’s mission is to educate, empower and improve the quality of life of people living with psoriasis through education, advocacy and research.

 

Website: www.psoriasiskenya.org

Email: info@psoriasiskenya.org