Psoriasis: The Facts – Information on Psoriasis

Psoriasis is a chronic autoimmune skin condition that affects up to 2% of the population. It commonly affects the skin on the scalp, elbows, knees, hands, feet, trunk, and nails. Psoriasis comes in several forms, each presenting with unique symptoms and challenges. Here’s an overview of the main types, along with treatment options and resources to help manage this condition.

Types of Psoriasis

1. Plaque Psoriasis
   The most common form, plaque psoriasis appears as red, symmetrical plaques with silvery or whitish scales, often found on the elbows, knees, scalp, hands, and feet. These patches can be itchy, painful, and may even bleed.

2. Guttate Psoriasis
   More common in children, guttate psoriasis often follows an upper respiratory infection. It appears as small, red, teardrop-shaped papules or plaques. These lesions sometimes disappear on their own after a few weeks.

3. Flexural Psoriasis
   Affecting the folds of the skin (armpits, under the breasts, groin, and buttocks), flexural psoriasis presents as red, shiny plaques without scales, which can be painful and prone to cracking due to movement and sweat.

4. Pustular Psoriasis
   Rare and marked by white or yellow pustules on red skin, pustular psoriasis can affect any part of the body and is often associated with fever or infection.

5. Psoriatic Arthritis
   Psoriatic arthritis involves joint pain, swelling, and inflammation, often accompanied by psoriasis skin symptoms. It can lead to swelling of fingers and nail changes. Psoriasis usually appears first, though in some cases, arthritis symptoms may come first or occur simultaneously.

The Impact of Psoriasis on Health and Wellbeing

Psoriasis is more than a skin condition—it can affect both mental and physical health. Severe psoriasis can impact daily functioning, especially if it affects areas like the hands, limiting mobility and causing pain. The mental toll of psoriasis can be substantial, sometimes leading to depression, anxiety, and social discrimination due to visible symptoms.

Treatment Options for Psoriasis

Psoriasis treatments vary based on the type and severity of the condition. It’s essential to work closely with a GP or dermatologist to find the right treatment, especially if you experience side effects or your current treatment isn’t effective.

Main treatment categories include:

1. Phototherapy
   Phototherapy uses artificial UV light, delivered under controlled conditions in a dermatology department. It is not the same as sunbeds and is carefully monitored for safety.

2. Topical Treatments
   Creams, ointments, gels, and foams are applied to the skin to reduce inflammation and scaling. These treatments may include corticosteroids, vitamin D analogues, coal tar, emollients, salicylic acid, and calcineurin inhibitors.

3. Systemic Treatments
   These are oral or injectable medications like methotrexate, prescribed for more severe cases that don’t respond to topical treatments alone.

4. Biological Treatments
   These medications target specific immune pathways involved in psoriasis. Examples include alefacept, etanercept, infliximab, adalimumab, and ustekinumab. Biological treatments are typically prescribed for moderate to severe psoriasis and psoriatic arthritis.

Each treatment plan should be developed by a healthcare provider, as factors like liver and kidney function, other medications, pregnancy, and medical history will influence suitability.

Additional Resources

For more information and support, visit the Irish Skin Foundation at irishskin.ie, which offers an ‘Ask-A-Nurse’ helpline for personalized guidance (appointment required).

Psoriasis is a complex condition, but with the right treatment and support, you can manage symptoms effectively and maintain a good quality of life. If you’re struggling with psoriasis, speak to your GP or dermatologist for further assistance.