PSORIASIS

The Facts

What is Psoriasis?

    Psoriasis is an inflammatory skin disease characterized by an increased rate of skin cell turnover resulting in thick scales appearing on the skin. The affected skin becomes dry and unsightly. Itching is often experienced in our hot and humid climate. 

    As part of our skin, nails also show changes like "pitting" of their surface in up to half of people with psoriasis. Joint pains and swelling are associated in 5% to as much as 40% in more extensive psoriasis.

How do you know if you have Psoriasis?

    Psoriasis usually presents with red scaly patches on the scalp, body and limbs. The scaly patches on the scalp are usually thicker and more extensive than ordinary dandruff. Common sites of the body affected are the elbows, the knees and the back.

Why does Psoriasis happen?

    The cause of psoriasis is unknown. Studies point to a genetic predisposition, although complex interaction with environmental factors are necessary to trigger off the appearance of psoriasis.  Once psoriasis starts, there will be periods of remission alternating with periods of active psoriasis.

What makes Psoriasis worse?

    Physical and emotional stress are well known to aggravate psoriasis. Throat infections or the flu may trigger off aggravation of the disease. Some drugs, eg. steroid hormones and certain antihypertensives may provoke the appearance of psoriasis.

What's the natural history of Psoriasis?

    Psoriasis usually starts in the 20's but has been described at birth and in old age. Like diabetes and other chronic diseases, psoriasis has a delayed onset and seldom remits permanently. However, unlike other chronic illnesses, it rarely shortens life expectancy.

What treatments are available for Psoriasis?

    Topical Creams I Ointments I Lotions I Shampoos & Scalp Solutions:
    Most people with psoriasis have mild disease and get considerable relief with moisturizing creams/ointments. These include coal tar, anthralins, steroids and vitamin D3 derivatives (eg alcipotriol) ointment/cream. For the face, hairline and groin areas, mild steroid creams are usually used. 

    1. For psoriasis on the scalp.
    Tar shampoos and steroidal lotions/gels are commonly used to control it. Others include coal tar ointment & vitamin D3 derivatives (eg calcipotriol) scalp solution. 

    2. Photo therapy
    Psoriasis responds to ultraviolet (UV) light treatment. Ultraviolet light, either UVB or UVA have been found to be effective in clearing psoriasis if used in gradually increasing doses over a period of one to several months. UVA is usually given with tablets called psoralens to enhance the effect of phototherapy     (PUVA).

    Oral Drugs
    Your dermatologist may prescribe oral medications when psoriasis does not respond to topicals and phototherapy. Examples of such drugs are methotrexate, cyclosporin, acitretin and sulphasalazine. Unfortunately, these drugs cause side-effects. Patients who are taking such drugs will require regular blood tests to detect side-effects eg. liver damage, bone marrow damage, etc.

How we can handle Psoriasis

Do's

  • Do use treatments regularly as directed.
  • Do keep skin moist as this will help reduce itching and scaling.
  • Do protect the skin against scratches and cuts as this may cause the psoriasis to flare up at the site of injury.
  • Do remember that the sun may help the psoriasis but be careful not to burn.

Don'ts

  • Don't scratch the plaques as this may damage the skin and actually worsen psoriasis.
  • Don't give up treatments too soon as it may take a few weeks for some of them to work.
  • Don't indulge in self-pity and avoid people. Psoriasis is not evil. Learn to accept it as a part and parcel of life.

Fiction

Is Psoriasis contagious?

    No.

Will I pass my Psoriasis on to my children?

    Not necessarily. Psoriasis is a hereditary disorder but only about 10% of people with psoriasis have a family member affected by psoriasis. The cause of psoriasis is multifactorial and inherited genes do not always express disease without the appropriate environmental triggers.

Is Psoriasis a rare skin disease?

    No, psoriasis is not an uncommon skin disease. It is estimated that 1 - 2% of the population in Singapore have psoriasis.

Are there any foods to avoid, or supplements to help my Psoriasis?

    No. But it is wise to consume a nutritious, balanced diet containing more green vegetables and less meats. Alcohol abuse is best avoided because of its associated malnutrition and liver disease.

Is there a quick cure for Psoriasis?

    No, but your doctor should be able to help you control your psoriasis. Oral steroid treatment is best avoided because although it helps to clear psoriasis fast, it invariably results in a quick and severe rebound of psoriasis. But remember, psoriasis can be controlled with appropriate treatment.

 
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