Psoriasis

Psoriasis can be very severe

Serious skin conditions affect around seven million of people in the UK alone.

They can cause significant emotional distress as well as physical discomfort.

What is it?

It is a common skin problem that occurs when the skin cells replace themselves too quickly - every few days compared to the normal 21-28 day cycle.

This leads to the characteristic scaly appearance seen in psoriasis.

There are several different types of psoriasis, classified according to the appearance of the lesions or where they are on the body.

These include:

• Plaque psoriasis - larger lesions, typically on the elbows, knees, scalp and lower back
• Guttate psoriasis - small, round lesions, generally widespread
• Pustular psoriasis - pustules accompany the redness and scaling seen in other types of psoriasis
• Plantopalmar psoriasis - affecting the palms of the hands and soles of the feet

Who gets it?

Psoriasis tends to run in families but it can affect anyone.

About 1.5 million people in the UK have psoriasis.

Most often it first appears in early life (during adolescence or as a young adult) but children and older adults can develop it too.

No one knows what causes psoriasis but certain genes have been linked to it.

Other factors also appear to act as triggers, such as certain drugs, throat infection and physical or emotional stress.

What are the symptoms?

Psoriasis feels uncomfortable and may itch. The patches look red and are covered with silvery scales.

If the lesions are in the skin creases and folds they may not have these scales, however.

What is the outlook?

Most people with psoriasis will have only small patches that get better on their own or with little treatment.

For a minority, the psoriasis will be severe and may need intensive treatment.

In about 10% of people the joints will be involved as well.

This is called psoriatic arthritis and generally affects the fingers, toes and lower back.

Psoriasis tends to wax and wane. It is not uncommon to have long spells of years without a flare up.

How can it be treated?

Moisturisers or emollients help to soften the scaly skin and may reduce the itch.

Steroid creams and soaps and shampoos that contain coal tar may help to reduce the inflammation and scaling.

Vitamin D ointments may also be useful. They are thought to work by altering the rate of skin cell turnover.

Two other medicinal creams, Dithranol and Tazarotene, can also be applied to the plaques.

However, they should not be applied to healthy skin because they are irritants.

Some people are helped by ultra violet light therapy.

The main problem for many people with psoriasis is its unsightly appearance.

Some people may become anxious, withdrawn and depressed because of this.