Psoriasis

What is Psoriasis?

Psoriasis is a medical condition that occurs when skin cells grow too quickly. It is a non-contagious chronic inflammatory skin disease that causes redness and irritation. Majority of the people with psoriasis have thick, silvery flakes of scale on raised pinkish red skin with well-defined margins. Itching is often reported in our hot and humid climate.


What causes Psoriasis?

Psoriasis is a condition that may affect people of any age but more commonly is seen in those between 15 and 35. In many cases, psoriasis goes away and then flares up again repeatedly over time.

Psoriasis also appears to be an inherited disorder. Some people report a positive family history of psoriasis.


What are the symptoms of psoriasis?

Persons with psoriasis have irritated patches of skin. The redness is often seen in elbows, knees and trunk but can appear anywhere on the body. There may be flaky patches on the scalp as well.

  • Raised, red patches of scaly skin

  • Dry, red skin (that may also bleed at the same time)

  • Skin that can be itchy or sore

  • Nail changes - including nail thickening and yellow brown spots on nail surfaces

  • Pus-filled blisters on the red patches of skin in severe cases


What can trigger an attack of psoriasis?

  • Bacteria or viral infections (including upper respiratory tract infection)

  • HIV infection or AIDS

  • Certain medications e.g. medication for high blood pressure

  • Injury to the skin, including cuts, and burns

  • Stress

  • Smoking

  • Alcoholism


How can psoriasis be treated?

There is no cure for psoriasis. The goals of treatment are to control your symptoms, prevent secondary infections and ultimately improve quality of life.

Regular use of a moisturiser is important in reducing itch and scaling. Mild psoriasis is usually treated with topical creams, ointments or scalp solutions. These include coal tar, dithranol, salicylic acid, corticosteroids, or vitamin D-type drugs (calcipotriol or calcitriol).

More severe psoriasis may require phototherapy with ultraviolet light which requires 2 - 3 treatments a week.

Severe psoriasis not responding to the above may need oral medication such as methotrexate, acitretin, cyclosporin and hydroxyurea. Unfortunately, oral medications can cause side effects such as bone marrow damage, liver damage and kidney damage, thus require regular blood tests to detect these side effects. Injections of biologic agents are an exciting new treatment with less troublesome side effects, but are much more expensive than conventional treatment.


Prevention

There is no known prevention. Keeping skin clean and moist and avoiding your specific psoriasis triggers may reduce the number of flare-up.

Doctors recommend daily baths or showers for persons with psoriasis. Avoid scrubbing too hard as this can irritate the skin and trigger an attack.


Possible complications:

  • Pain

  • Severe itching

  • Secondary infection

  • Side effects from medicines used to treat psoriasis


Prognosis

Psoriasis is a life-long condition that can be controlled with treatment. It may go away for a long time and then return. Without appropriate treatment, it can affect your general well-being and quality of life.

Psoriasis can cause both social and emotional stress at work, school or home. You may wish to get in touch with other affected people through support groups such as the Psoriasis Association of Singapore.


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