Psoriasis
Psoriasis is an inflammatory skin disease. It is typically characterized by the appearance
of thick, scaly patches of skin (peeling off as white flakes).
The patches appear in many different places on the body, most commonly on the elbows, knees, and scalp. They leave areas of red skin.
This chronic disease progresses in cycles, with periods of remission. It is not contagious and can be well controlled with treatment.
Psoriasis can be very unpleasant or even painful when it appears on the palms of the hands, soles of the feet, or in skin folds. The severity of the disease varies greatly from one individual to another.
Depending on the location and extent of the plaques, psoriasis can be embarrassing and disruptive to social life. Indeed, the way others view skin diseases is often painful.
Types of psoriasis:
There are several types of psoriasis. The most common form is plaque psoriasis , also called psoriasis vulgaris (because it accounts for more than 80% of cases).
It is characterized by red, well-circumscribed, thick plaques covered with whitish scales, which are located mainly on the scalp, elbows, knees and lower back although plaques can also be found on other parts of the body.
• Guttate psoriasis:
Less than 10% of cases. This form is common in children and adolescents after angina. It appears suddenly in the form of numerous small patches a few millimeters in diameter, mainly on the trunk. This form of psoriasis can sometimes progress to psoriasis vulgaris.
• Pustular psoriasis:
It is characterized by the appearance of tiny pustules on red patches. These pustules do not contain microbes: they are linked to the intensity of the inflammation.
We distinguish:
- The localized form, which affects only the palms of the hands and/or the soles of the feet (palmo
-plantar pustulosis). - The form that affects the fingertips, with pustules that are constantly renewed (acrodermatitis continua of Hallopeau).
• Erythrodermic psoriasis: generalized form
It can affect the entire skin surface in the form of pustules scattered in red and inflamed areas (Zumbusch pustular psoriasis). Always accompanied by fever and chills. This very rare generalized psoriasis is serious and requires rapid treatment.
Causes and triggers:
Many factors play a complex role in the development of psoriasis. Today, it is believed that it is an autoimmune disease that develops in people who have a suitable predisposition and are under the influence of certain so-called favorable factors.
• An autoimmune disease:
Specific immune cells present in the skin are activated in patients with psoriasis and play an important role both in the proliferation of superficial epidermal cells and in the initiation and maintenance of inflammatory phenomena.
• A genetic predisposition:
Although psoriasis is a genetic disease, it is not systematically passed down from generation to generation. At most, we inherit genes that predispose us to psoriasis.
• Favoring or aggravating factors:
Scratching, skin trauma, certain ENT infections, stress, taking certain medications, being overweight, excessive alcohol or tobacco consumption, and the seasons can be factors that trigger or aggravate psoriasis flare-ups.
Possible complications:
Depending on the individual, the disease progresses in fairly unpredictable and very different stages. Symptoms generally last 3 to 4 months. It then disappears (in remission) over months or years and most often reappears.
People with moderate or severe psoriasis can have a huge impact on their appearance and, as a result, experience stress, anxiety, loneliness, low self-esteem, and even depression.
People with psoriasis appear to be more likely to suffer from cardiovascular disease, metabolic syndrome, and obesity, but we still don't know why.
Symptoms:
Discover the different symptoms of psoriasis with this fact sheet.
The complete and detailed list of symptoms of this disease is available below.
• Plaque psoriasis (or common psoriasis):
Distinct round or oval red patches covered with thick, white, scaly crusts. They are commonly found on the elbows, knees, scalp, and buttocks. These patches can cause discomfort, pain, and sometimes intense itching.
• Nail psoriasis:
Various abnormalities of the fingernails and toenails: small “depressions” that look like thimble holes, peeling, crumbling, discoloration, thickening, ridges.
• Scalp psoriasis:
Red patches with silvery scales on the scalp and forehead.
• Palmoplantar psoriasis:
Dry patches on the palms of the hands and soles of the feet, often painful and cracked.
• Inverse (or inverted) psoriasis:
Red patches that appear in the folds (armpits, groin, near the genitals and gluteal folds) without scales and can be painful when exposed to friction.
• Pustular psoriasis:
Plaques covered with small white pustules, especially on the hands and soles of the feet (palmoplantar pustulosis
). This form can also affect the fingertips.
• Erythrodermic psoriasis:
Almost all of the skin is red and inflamed with no obvious spots. Fever and chills are usually present. This is a severe form that requires emergency treatment.
• Guttate psoriasis:
This is a rare form that mainly affects children and adolescents and occurs after a streptococcal infection (most often tonsillitis or pharyngitis).
The plaques are small (less than 1 cm), teardrop-shaped and are usually present on the trunk, arms and legs.
Note: You cannot transmit the plaques to other people or spread them elsewhere on your body. They are not contagious.
This is a rare form that mainly affects children and adolescents and occurs after a streptococcal infection (most often tonsillitis or pharyngitis).
Preventive measures:
There is no known way to prevent psoriasis. However, with the measures described in this leaflet, the frequency and severity of relapses can be reduced.
To reduce the frequency and intensity of flare-ups: There is no known way to prevent psoriasis. However, it is possible to reduce the frequency and intensity of flare-ups. In addition to closely monitoring prescribed treatments, you can observe what triggers the development of symptoms.
This process requires time and patience.
Here are some general tips:
- It is recommended to wear an effective sunscreen (at least SPF 15) if you are going to be exposed to the sun for a long time.
- Smoking ban. Several studies have clearly shown that the severity of psoriasis is linked to the number of cigarettes smoked.
- Some patients have seen significant improvement in their condition after losing a little weight.
- People may seek psychotherapy to help them become aware of the events and psychological conditions that underlie some psoriasis flare-ups.
Anecdotally, it was observed that the severity of patient symptoms observed over 20 weeks was positively related to life events and emotional distress.
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