Psoriasis

Psoriasis is an inflammatory condition of the skin, nails and joints. It is not contagious. Symptoms include red, scaly patches on the skin, itchiness and flaking of the skin. The areas most commonly affected are the scalp, elbows and knees, but psoriasis can occur anywhere on the body. There is no cure, but psoriasis can usually be controlled well with treatment.

Symptoms#

Symptoms vary from person to person, and may include:

• red, scaly patches on the scalp, elbows, knees and other parts of the body
• shedding of scales of skin
• itchiness – although many people do not feel itchy at all

A severe form called erythrodermic psoriasis can require hospitalisation.

Types of psoriasis#

There are several types of psoriasis, including:

• plaque psoriasis – the most common form
• pustular psoriasis – a more severe form, which can be painful
• guttate psoriasis – found mostly in children
• napkin psoriasis – characteristically seen in infants between two and eight months of age
• flexural psoriasis – affects body folds and genital areas

Psoriasis and arthritis#

For reasons that are not fully understood, psoriasis can cause a form of arthritis known as psoriatic arthritis. Symptoms include:

• pain caused by inflammation in the joints, which stimulates nerve endings
• discomfort, throbbing or swelling in one or many joints
• tenderness in any joint

The joints most likely to be affected are the last joint in the fingers or toes, the sacrum (lower back), and the wrists, knees or ankles.

Causes and triggers#

A number of genes have been associated with different types of psoriasis, and psoriasis can run in families. Infections and certain medications – including lithium, beta blockers, non-steroidal anti-inflammatory medications and antimalarial medication – can trigger the onset of psoriasis or cause it to flare up. Skin injury and smoking can also make certain types of psoriasis worse.

Treatment#

Doctors may prescribe a range of treatments to relieve psoriasis symptoms, including:

• coal tar preparations, cortisone and other prescription creams
• medications such as methotrexate, acitretin, cyclosporin and calcipotriol
• ultraviolet light therapy
• biologic therapies

Biologic therapies have transformed the treatment of psoriasis and greatly improved understanding of how the condition works. Because these treatments are expensive, access may be restricted or subsidised only for people with severe disease when other treatment options have been exhausted.

Clinical trials#

Before a new treatment can be approved, it must undergo extensive testing. Clinical trials are used to determine the safety and effectiveness of new treatments for psoriasis, and they are run under regulations designed to keep participants as safe as possible.

People with psoriasis may consider volunteering to take part in a clinical trial. Participation can provide access to new treatments that are not otherwise available. If you are interested, talk to your doctor.

Key points#

• Symptoms include red, scaly patches on the skin, itchiness and flaking of the skin.
• The areas most commonly affected are the scalp, elbows and knees, but psoriasis can occur anywhere on the body.
• There is no cure for psoriasis, but it can usually be controlled well with treatment.
• Symptoms vary from person to person.
• Psoriasis can cause psoriatic arthritis, with pain from inflammation in the joints.

Where to get help#