WHAT IS PSORIASIS?

Psoriasis is an inflammatory skin condition that causes thickening, redness and scaling. It can affect the whole of the skin including the scalp and nails. Occasional it can be associated with arthritis. It tends to be intermittent in nature and is characterized by remission and ‘flare ups’. The causes of psoriasis remain unknown but it can run in families and be precipitated by illnesses, stresses or even some medications. Although there is no cure, the condition can be well controlled with medication.

WHAT CAUSES PSORIASIS?

Psoriasis tends to be intermittent in nature and is characterised by remission and ‘flare ups’. Psoriasis appears when the body replaces skin cells more quickly than usual, so the cells that appear on the surface of the skin are not fully mature. This is likely due to a problem with the immune system, but the exact causes of psoriasis remain unknown. Psoriasis can run in families and be brought on by illnesses, stresses or even some medications. Although there is no cure, the condition can be well controlled with medication.

If Psoriasis is affecting your life, then the Harley Street Dermatology Clinic is here to help. Our consultant dermatologists can offer you expert treatment with a very good chance of dramatically improving your Psoriasis.

WHAT DOES PSORIASIS LOOK LIKE?

There are several clinical patterns of psoriasis (see pictures):

Chronic Plaque– The commonest variant, it tends to occur on the extensor aspects of the elbows and knees and in the scalp. Skin changes include pink or red inflamed, thickened plaques with copious white scale (see image).
Sebopsoriasis – similar to scalp psoriasis but can occur on the face, chest, armpits and groin
Flexural – raw, red areas in the groin, armpits or under the breasts
Guttate – multiple small spots of psoriasis that erupt on the trunk following a sore throat or illness (see image).
Erythrodermic – extensive disease covering more than 90% of the body surface area.
Palmoplantar pustular – pus-filled inflamed spots and the palms and soles
Pustular – the most severe form of psoriasis, skin lesions are red, tender and filled with pus spots

Psoriasis can vary in severity from no more than a minor irritation to being a major problem – in extreme cases, sometimes requiring hospitalisation. Even a small bit of psoriasis in a delicate area such as the face or genitals can cause immense distress. Occasionally it can be itchy or cause painful splitting or fissuring of the skin. As well as the skin being affected, the nails can become abnormally brittle with flaking and pitting. 5% of patients might develop arthritis associated with psoriasis.

HOW CAN PSORIASIS BE TREATED?

The treatment of psoriasis can be divided into three basic strategies depending on severity, namely creams, phototherapy (ultraviolet/sunlight) or systemic medication (oral or injectable drugs).

Creams include emollients, soap substitutes, vitamin D, tar, steroids.

Phototherapy involves precise doses of ultraviolet light being delivered by a medical UV-machine. Phototherapy involves precise doses of ultraviolet light being delivered by a medical UVA/UVB machine. 

Systemic medications include tablets such as acitretin, methotrexate and ciclosporin or injectables such as etanercept, adalimumab or ustekinemab. These powerful drugs are reserved for severe or life-limiting psoriasis. (For more information on psoriasis, please see the British Association of Dermatologists website treatment for moderate or severe psoriasis advice leaflet).

Remember, although psoriasis is incurable, it can be well controlled with medication. There is no need to let psoriasis rule your life.