Psoriasis is a common chronic inflammatory dermatological disorder. Mild to severe itching is a common symptom. Silvery Scales with plaques are found in this skin disease. Genetic factors also play a great role in the pathogenesis of Psoriasis. It sometimes goes into remission and sometimes flares up.
While the fundamental cause of psoriasis arises from the immune mechanism of your body, some causes can create symptoms worse or trigger flare-ups. These causes for psoriasis include:
Symptoms of Psoriasis varies from person to person. It may be asymptomatic or mild-severe itching may be seen well-demarcated red plaques with silvery scales are common findings. The most common sites are Scalp, Elbow, Knee, Palms, and Soles. Nail pitting and onycholysis are found.
Dermatologists diagnose it through clinical examination and case history. Skin biopsy is needed where the diagnosis is uncertain.
Highly potent topical corticosteroid ointments are used when <10% of body surface area affected. Calcitriol (vitamin D analog) 0.003% is also used along with topical steroids but must be used at a different time. Other topical treatments include 6% Salicylic acid, P and S solution or emollient cream. 0.1% Tacrolimus ointment and 1% Pimecrolimus cream are also found useful for Psoriasis treatment.
Almost 30% of Psoriasis patients suffer from specific non-erosive arthritis known as psoriatic arthritis. It is a type of polyarthritis involving unilateral or bilateral joints. Joints are painful and swollen, stiff, often resemble Rheumatoid Arthritis. Sausage shaped fingers and toes are characteristic of psoriatic arthritis. Abnormal immunomodulation causes inflammation in joints, but no joint erosion. It may cause low back pain due to Sacroiliitis. Psoriatic Arthritis is a type of Seronegative spondyloarthropathies commonly involved joints are hand, feet, knees, ankles and spine. Psoriatic arthritis patients may develop tendonitis (inflammation of tendon) or enthesitis (inflammation of entheses)
Treatments of Psoriatic arthritis include NSAIDs, DMARDs, and exercise. NSAIDs give symptomatic relief from joint pain. Exercise must be done regularly to prevent joint deformity. DMARDS (Disease Modifying Anti Rheumatoid Drugs) are very effective in this disease as they prevent joint destruction as well as joint deformity. Sulfasalazine, Hydroxychloroquine, Methotrexate are commonly used in DMARDS.