Not all subtypes of psoriasis have the scaley dry patches, instead may present as small round red spots (guttate psoriasis); red skin with pimple like bumps (pustular psoriasis); deep red, smooth and very itchy skin (inverse psoriasis); or intense redness with large areas of shedding skin (erythrodermic psoriasis).
Joints can also be affected, causing pain, stiffness and swelling on any joint in the body, from the spine to the fingertips (psoriatic arthritis).
Psoriasis was originally considered a disease of the skin, however it is now recognised as one of the most common disorders driven by the immune system with disturbances in both the innate and adaptive immune responses. Affecting approximately 2% of the world’s population, and now considered a systemic (“whole body”) disease, psoriasis is also associated with other disorders such as arthritis, diabetes, hypertension, and cardiovascular diseases.
The exact cause or driving factor of psoriasis still remains unclear, however the formation of the scaley patches is due to an abnormal production of inflammatory mediators from complex interactions between skin cells and the immune system. Environmental factors can include stress, infection, physical trauma, and medications. There is also rising evidence that changes in the microbiome of both the gut and the skin play a role. Studies show the microbes of both the skin and gut in patients with psoriasis were significantly different from those of normal, healthy levels – although more research is needed to confidently identify changes.
The skin within a psoriasis lesion is on overdrive. The skin cell turnover from first to second epidermal layer (stratum basale to spinosum) is approximately 13 days in normal skin, however, in psoriasis this turnover process happens in just 48 hours. This creates a buildup of skin cells that have not had a chance to complete their full lifecycle and are therefore not only overcrowded but also not functioning properly.
Treatment options and how we can help
While there is no cure for psoriasis, it can be kept under control with treatments that aim to slow down and normalise the cell turnover and reduce the amount of cell build up. This will make living with the condition much more comfortable and results in clearer skin with reduced symptoms such as itching and pain.
Some lifestyle changes may also have additional benefits.
A range of treatments options are available including Light therapy with the support of topical products containing Vitamin A, Salicylic acid, Lactic acid or urea.
If you’d like to discuss your concerns with us, please book a skin consultation so that we can determine a suitable and tailored treatment plan just for you.
Griffiths, C., Barker, J. (2007) Pathogenesis and clinical features of psoriasis. The Lancet. 370(9583) 263-271. https://doi.org/10.1016/S0140-6736(07)61128-3
Parisi, R., Iskandar, I., Kontopantelis, E., Augustin, M., Griffiths, C., Ashcroft, D. (2020) National, regional, and worldwide epidemiology of psoriasis: systematic analysis and modeling study. BMJ 369:m1590. http://dx.doi.org/10.1136/bmj.m1590
Rendon, A., Schakel, K. (2019) Psoriasis pathogenesis and treatment. International Journal of Molecular Sciences. 20(6) 1475. https://doi.org/10.3390/ijms20061475
Chen, L., Li, J., Zhu, W., Kuang, Y., Liu, T., Zhang, W., Chen, X., Peng, C. (2020) Skin and gut microbiome in psoriasis: Gaining insight into the pathophysiology of it and finding novel therapeutic strategies. Frontiers in Microbiology. 11. https://doi.org/10.3389/fmicb.2020.589726