Psoriasis

Treatment at Auro Skin Clinic

The treatment options available for Psoriasis Treatment at Auro Skin Clinic are:

General examination with detailed history and lifestyle and other comorbid conditions is first done for all Psoriasis patients.
Generally a medical line of treatment is prescribed. Sometimes blood tests and then medication accordingly is given according to the Psoriasis severity.
Biopsy is rarely required but if needed can be added to diagnosis.
For localized Psoriasis Auro skin clinic provides Excimer light treatment.
For nail Psoriasis intralesional injections can be given.
Rheumatology reference is guided when joint involvement is present.

What is Psoriasis?

The exact cause of Psoriasis is not known. It is a complex interplay between genetics and immunology.
Genetic susceptibility and environmental factors are responsible for disease.
Normally the outer layer of skin is continuously replaced and it takes place in four weeks. There is increased turnover of skin cells in Psoriasis so that the skin cells are formed and shed in 5 days.

Is Psoriasis hereditary? Is Psoriasis transmissible to family members or contacts?

Psoriasis is a multifactorial disease.
It can be inherited, but the mechanisms are complex.
It is not necessary that children of affected parents will develop Psoriasis but there is a higher chance of developing Psoriasis compared to children of non-affected parents. If one parent is affected, then the chance of developing Psoriasis in the child is approximately 15% and chances are increased to 40 % if both parents are affected.
Psoriasis is not an infectious disease and cannot be transmitted by contact.

What factors can aggravate Psoriasis?

Many factors are known to aggravate Psoriasis.
Infections - sore throat and HIV infection can trigger Psoriasis.
Certain medications such as antihypertensive drugs (beta-blockers), antimalarials (chloroquine), pain killers, medications for psychiatric illnesses (lithium) and withdrawal of systemic corticosteroids can aggravate Psoriasis.
Physical trauma and mental stress can trigger Psoriasis.
Cold climates and winters commonly aggravate Psoriasis in most cases, but some patients may have summer aggravation.
Alcohol intake and smoking can aggravate the disease.
Obesity and decreased physical activity are well known aggravating factors for Psoriasis as well as other coexisting diseases with Psoriasis.

How does Psoriasis manifest? Which areas of the body are affected by Psoriasis?

Psoriasis presents as well demarcated, elevated, scaly, reddish, itchy skin lesions mainly on outer aspects of upper & lower limbs, palms & soles and scalp.
If Psoriasis affects the hands and feet, painful fissures (cracks) can develop and these can affect use of the hands and walking. Severe Psoriasis on the body can also develop cracks which are painful and can bleed.
Trauma prone areas of the bodies are commonly affected.
Psoriasis may involve any site of the skin. Patients may have a single lesion or involvement of the whole body. Occasionally, patients may develop tiny pus filled lesions.
Nails are commonly involved in the form of small pits or abnormalities or total destruction of nail plates.
Few patients may have joint involvement in the form of pain, stiffness and swelling, particularly in the morning. Joints of hands are commonly involved.

What should one do if he/she gets Psoriasis?

If one gets Psoriasis, he/she must consult a dermatologist.
Don't self-medicate or take treatments from untrained physicians.
Improper or wrong treatments may make Psoriasis unstable.

Are there any tests to confirm Psoriasis?

A dermatologist can easily confirm the diagnosis based on the appearance of skin lesions. No laboratory tests are usually needed for diagnosis.
A skin biopsy or a small sample of the skin tissue may be needed to confirm the diagnosis in doubtful cases.
Blood tests may be recommended to check out for co-existing diseases or when systemic medications are indicated.

Which diseases can be associated with Psoriasis?

Psoriasis, particularly moderate to severe Psoriasis, is associated with an increased risk of anxiety, depression and harmful use of alcohol.
Moderate to severe Psoriasis increases the risk of heart disease and stroke and treatment of Psoriasis may reduce this risk.
Psoriasis can also be associated with diabetes, obesity, venous,thromboembolism inflammatory bowel disease, high cholesterol and high blood pressure.

How can Psoriasis be treated?

Psoriasis can be treated by topical medicines, phototherapy and/or systemic drugs depending upon the severity of the disease.
Most people need to try different treatments or combinations of treatments before they figure out what works best.
Regular use of moisturizers and managing the aggravating factors play an important role.
Topical moisturizers, steroids, keratolytic agents, vitamin D analogues and immunomodulators are the chief treatment options in limited diseases. Tar based and keratolytic based shampoos are helpful in scalp involvement.
Phototherapy with PUVA, narrow band UVB or targeted therapies with excimer light are effective options. A course of treatment usually takes about 8-10 weeks and will require treatment sessions two to three times a week. This usually means attending a phototherapy unit in a hospital.
Systemic drugs such as methotrexate, acitretin, cyclosporin, apremilast are recommended in severe cases and extensive disease.
Biological agents such as etanercept, infliximab, adalimumab, ustekinumab and secukinumab can be used in cases that are unresponsive or difficult to treat.
All medications should be taken under the supervision of a dermatologist and proper follow up with maintenance treatment is mandatory.

Can Psoriasis be cured? Can Psoriasis recur?

No. Psoriasis is treatable but not curable.
Yes, Psoriasis can recur.

Can a person with Psoriasis marry?

Yes. Psoriasis affected people can marry and have children.
Psoriasis is not a contagious disease.

What are the lifestyle modifications to be adopted by patients with Psoriasis?

Weight reduction to ideal body weight.
Physical exercise
Limited alcohol intake.
Quit smoking
Biofeedback and cognitive behavior therapy for reduction of stress level

Disclaimer

The above clinical content is published by The Indian Association of Dermatologists, Venereologists and Leprologists (IADVL) for circulation amongst patients for their education purposes.

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