Psoriasis is a chronic autoimmune disorder that causes an accelerated buildup of skin cells, leading to symptoms such as scaly, dry, and itchy skin. This results in the formation of scales on the skin’s surface, which can range in color from whitish-silver to purplish or dark brown, depending on skin tone. The affected areas often become inflamed and red, and may crack and bleed.
Unlike the typical skin cell life cycle of one month, psoriasis causes skin cells to grow and rise to the surface in just a few days, preventing them from shedding naturally. This rapid overproduction leads to the accumulation of skin cells.
While there is no definitive cure, lifestyle modifications and medications can alleviate symptoms. Tracking and identifying potential triggers can also help manage the condition.
A 2021 study reported that approximately 7.5 million American adults over the age of 20 suffer from psoriasis, with a prevalence rate of 3%. Prevalence rates vary among racial and ethnic groups, with 3.6% of white individuals, 3.1% of non-Hispanic individuals, 2.5% of Asian individuals, 1.9% of Hispanic individuals, and 1.5% of Black individuals affected by the condition.
Psoriasis growth area
Psoriasis commonly manifests in areas around the joints, particularly the elbows and knees. Yet, it’s not restricted to these regions and can appear anywhere on the body, encompassing the hands, feet, neck, scalp, and even the face. There are less frequent forms of psoriasis that can affect the nails, mouth, and the areas surrounding the genitals. Notably, psoriasis is often linked with a range of other health issues such as type 2 diabetes, inflammatory bowel disease, heart disease, psoriatic arthritis, as well as mental health challenges like anxiety and depression.
Various types of psoriasis
Plaque psoriasis, the most prevalent form of the skin condition, affects an estimated 80-90% of individuals with psoriasis, according to the American Academy of Dermatology (AAD). It is characterized by red, inflamed patches on lighter skin tones and can appear as purple, grayish, or dark brown on skin of color, making it more challenging to diagnose. These patches are typically covered in whitish-silver scales or plaques and are often found on the elbows, knees, and scalp.
Guttate psoriasis often presents in childhood and is characterized by small, pink or violet spots that commonly appear on the torso, arms, and legs. Unlike plaque psoriasis, these spots are not usually thick or raised.
Pustular psoriasis, more frequently seen in adults, leads to white, pus-filled blisters and broad areas of inflamed skin, appearing in red or violet hues depending on skin tone. It is generally localized to smaller areas like the hands or feet but can also be widespread.
Inverse psoriasis manifests as bright, red, shiny and inflamed skin, developing in areas such as underarms, groin, or around genital skinfolds.
Erythrodermic psoriasis is an extremely rare and severe form, as stated by the National Psoriasis Foundation. It can cover large sections of the body, resembling a sunburn and may cause large scales to slough off. This type can also be accompanied by fever or illness and is considered life-threatening, necessitating immediate medical attention.
Symptoms of psoriasis
Symptoms of psoriasis vary widely among individuals and are determined by the specific type of psoriasis one has. The affected areas can range from small patches, such as a scattering of scales on the scalp or elbow, to extensive areas covering most of the body.
For those with plaque psoriasis, the predominant symptoms include:
- Elevated, reddened skin patches that appear crimson on lighter skin and can take on a brown or purplish hue on darker skin.
- Overlying plaques which are whitish-silver on red patches and similar grayish scales on purple and brown areas.
- Skin that is prone to dryness, potentially leading to cracks and bleeding.
- Discomfort and inflammation surrounding the affected areas.
- Itchiness or a burning sensation around the inflamed skin.
- Nails that are thickened and dimpled.
- Joints that are achy and exhibit signs of swelling.
It’s important to note not all individuals will encounter every one of these symptoms, and symptoms can be quite different for those with less prevalent forms of psoriasis. The course of psoriasis often involves fluctuating “cycles.” One might experience intense symptoms for several days or weeks; these symptoms may then subside, becoming almost imperceptible.
After some time, or when provoked by triggers associated with psoriasis, the condition may undergo a new flare-up. There are instances where psoriasis symptoms may vanish altogether.
During periods with no active symptoms, one is considered to be in “remission”—a temporary absence of symptoms, although psoriasis can recur. It is essential to understand that psoriasis is not infectious; it is impossible to transmit the skin condition through physical contact. Therefore, touching a psoriatic lesion on another individual will not cause you to contract psoriasis.
Factors that trigger psoriasis flare-ups
Psoriasis stems from an immune system malfunction predominantly involving T cells, a type of white blood cell. In a healthy system, white blood cells target and neutralize foreign invaders like bacteria to fend off infections. However, in the case of psoriasis, those T cells mistakenly assault the skin cells themselves.
This erroneous immune response prompts an accelerated turnover of skin cells. New cells are produced and ascend to the skin’s surface at an atypically rapid pace, leading to an accumulation of cells that form the thick, scaly patches emblematic of psoriasis. Such patches are typically unmistakable due to their raised, silvery appearance on the skin, alongside marked redness and inflammation.
When it comes to genetics, there’s evidence to suggest a hereditary predisposition to psoriasis. Individuals with a family history of the condition are more predisposed to it, as highlighted in research from 2019. Specifically, those with close relatives—like parents or siblings—who are affected by psoriasis show a higher risk of experiencing the disease themselves.
Identifying and Diagnosing Psoriasis: A Comprehensive Guide
Physical Examination
Most doctors are able to diagnose conditions through a basic physical examination, and psoriasis is no exception. Its symptoms are generally obvious and distinguishable from those of other conditions with similar manifestations.
During the exam, make sure to show your doctor all areas of concern and inform them of any family history of psoriasis.
Biopsy
If your symptoms are ambiguous or if your doctor needs to confirm their diagnosis, they may perform a skin biopsy. This procedure involves taking a small sample of your skin.
The biopsy can be conducted in the doctor’s office during your visit and is typically done with a local anesthetic to minimize discomfort.
The skin sample will then be sent to a laboratory for analysis and examined under a microscope. This examination can confirm the type of psoriasis you have, as well as rule out other potential conditions or infections.
Once the results are in, your doctor may schedule a follow-up appointment to discuss the findings and explore treatment options with you.