30 July 2021 Author: Ana Macedo Ferreira Psoriasis is a chronic inflammatory skin disease in which the skin presents red, thick and scaly lesions. People with lighter skin types are more susceptible; In people with darker or black skin, the lesions may have a purplish, brown or dark gray hue. In about a third of people who have psoriasis, joints are also affected. The disease affects 2%-4% of the world population. It is estimated that in Portugal there are around 300 thousand people with psoriasis. Psoriasis can appear for the first time at any age, but it most commonly appears between ages 15-25 and 50-60. The disease is recurrent, with periods of aggravation and improvement after it appears for the first time. Causes There is no single cause for the appearance of psoriasis. This is a disease with a multifactorial cause to which contribute: Immunological factors; Genetic factors; Environmental influences. Symptoms and diagnosis Diagnosis of psoriasis is mainly clinical, based on signs and symptoms. Plaque psoriasis or psoriasis vulgaris is the most common form of the disease. The most characteristic clinical manifestation is the presence of prominent, thick and well-defined, reddish or darker, dry and scaly plaques on the skin. Plates can be very large; They are distributed symmetrically; They predominate on the elbows, knees and head (scalp); Scales have a silvery-white color. There may be an important itching with a great impact on quality of life. The disease can also have a very relevant psychological impact. Patients with psoriasis have a higher prevalence of comorbidities, like cardiovascular disease, inflammatory bowel disease, depression, metabolic syndrome and liver disease. The severity of the disease is determined based on: Characteristics, extent and location of injuries; Impact of the disease on daily activities and quality of life. Injuries in highly visible locations, like hands and scalp, have more impact on relationship life. Other types of psoriasis In addition to psoriasis vulgaris, there are other, less common types: Guttate psoriasis , resulting from streptococcal infection, with gout-shaped lesions throughout the body; Reverse or inverted psoriasis , where the lesions are mainly on the skin folds and are not scaly; Pustular psoriasis , in which pus-filled blisters form throughout the body; Erythrodermic psoriasis , in which the skin all over the body is red and scaly; Palmoplantar psoriasis , in which pustules form on the palms and soles; Nail psoriasis , which affects the nails and they turn different colors, appear to have holes or fall apart; Arthropathic psoriasis or psoriatic arthritis , in which there is involvement of the joints, particularly the fingers and toes and the spine, with pain and deformity. Treatment Psoriasis cannot be cured . It is a chronic and recurrent disease. After appearing for the first time, psoriasis tends to occur with periods of worsening and improvement throughout life; The period between episodes of worsening is variable, it can be years; Several factors can trigger aggravation of psoriasis, for example infections, exposure to cold, alcohol consumption, stressful situations; Exposure to sunlight can alleviate symptoms, but sunburn can make the disease to worse. Treatment of psoriasis is aimed at controlling symptoms . There are many effective treatments and combination treatments are common, including: Topical application products such as creams and ointments or lotions; Phototherapy; Systemic medicines, whether for oral or injectable administration, including biological medicines. Regular use of unscented moisturizing creams helps prevent skin dryness. The choice of the most appropriate therapeutic modality is made specifically for each patient, taking into account: The severity of the disease; The presence of comorbidities; The impact on the patient's quality of life. Meet the dermatology team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
