Psoriasis can present itself in different clinical forms, the most frequent being plaque psoriasis. Its exact causes are unknown. At present we have different therapies that must be selected according to the severity of the patient, and that allow in most cases, the control of the disease.
Psoriasis: what it is
Psoriasis, according to dermatology experts, is a chronic inflammatory disease that occurs in outbreaks and can affect the skin and joints (psoriatic arthropathy).
Its onset is conditioned by genetic and environmental factors, with an immunological background responsible for the inflammatory manifestations of the disease.
Psoriasis: how it occurs
The most common form of presentation of psoriasis at the cutaneous level is plaque psoriasis, characterized by raised erythematous areas with a typical silvery scale on the surface.
The distribution is usually bilateral and symmetrical, affecting locations such as the scalp, forearms, knees, lumbosacral region…
Other types of psoriasis
- Erythrodermic psoriasis: lesions affect more than 80% of the body surface.
- guttate psoriasis: small plaques in the form of generalized droplets
- Inverted psoriasis: in which body folds such as the armpits and groin are affected.
- Pustular psoriasis: characterized by the appearance of small sterile pustules that evolve into desquamation. This form may affect palms and soles (palmoplantar pustulosis) or be generalized (very rare).
Nail involvement in psoriasis occurs in up to 50% of patients (psoriatic onychopathy).
Psoriasis may or may not be pruritic, but what is a fact is the decrease in the quality of life of patients with psoriasis.
Consequences of Psoriasis
A higher incidence of comorbidities such as metabolic syndrome (dyslipidemia, diabetes, hypertension and obesity) and Chron’s disease has been found in patients with psoriasis compared to the general population.
In erythrodermic psoriasis, the large body surface area affected may alter the skin barrier functions and require hospitalization of the patient.
Treatment of psoriasis
As general measures all patients with psoriasis should maintain proper hygiene and apply emollients daily.
For mild cases (the most frequent) topical therapies with corticosteroids and vitamin D derivatives, specially designed for this disease, are available. Phototherapy in different modalities has proven to be effective for psoriasis.
In more severe cases, systemic therapies such as methotrexate, cyclosporine and acitretin are available, as well as the well-established biologic therapies, which allow long-term control of the disease in selected cases. However, there is currently no definitive cure for psoriasis.