Pso­ri­a­sis not an in­fec­tious skin prob­lem

Bray People - - LIFESTYLE - DR MICHELLE COOPER’S

PSO­RI­A­SIS is a com­mon con­di­tion where there is in­flam­ma­tion of the skin. It typ­i­cally de­vel­ops as patches (plaques) of red, scaly skin. Once you de­velop pso­ri­a­sis it tends to come and go through­out life. A flare-up can oc­cur at any time. The fre­quency of flare-ups varies. There may be times when pso­ri­a­sis clears for long spells. How­ever, in some peo­ple flare-ups oc­cur of­ten. Pso­ri­a­sis is not due to an in­fec­tion. You can­not pass it on to other peo­ple and it does not turn into can­cer.

About 1 in 50 peo­ple de­velop pso­ri­a­sis at some stage in their life. Pso­ri­a­sis is more com­mon in white peo­ple. It can de­velop at any age but it most com­monly starts be­tween the ages of 15 and 30 years.

There are dif­fer­ent types of pso­ri­a­sis. How­ever, chronic plaque pso­ri­a­sis (de­scribed be­low) is by far the most com­mon and typ­i­cal type. CHRONIC PLAQUE PSO­RI­A­SIS Be­tween 8 and 9 out of 10 peo­ple with pso­ri­a­sis have chronic plaque pso­ri­a­sis. The rash is made up of patches (plaques) on the skin. The pic­ture above shows typ­i­cal plaques of pso­ri­a­sis.

Each plaque usu­ally looks pink or red with over­ly­ing flaky, sil­very-white scales that feel rough. There is usu­ally a sharp bor­der be­tween the edge of a plaque and nor­mal skin.

The most com­mon ar­eas af­fected are over the el­bows and knees, the scalp and the lower back. Plaques may ap­pear any­where on the skin but they do not usu­ally oc­cur on the face.

The ex­tent of the rash varies be­tween dif­fer­ent peo­ple and can also vary from time to time in the same per­son. Chronic plaque pso­ri­a­sis can be itchy but it does not usu­ally cause too much dis­com­fort.

There are two vari­a­tions of chronic plaque pso­ri­a­sis:

- Scalp pso­ri­a­sis: about half of peo­ple with chronic plaque pso­ri­a­sis af­fect­ing the skin of their body will also have pso­ri­a­sis af­fect­ing their scalp. The whole scalp may be af­fected, or there may just be a few patches. If se­vere, it can lead to hair loss in some peo­ple.

- Flex­u­ral pso­ri­a­sis: this is also a type of chronic plaque pso­ri­a­sis. It oc­curs in the creases of the skin (flex­ures) such as in the armpit, groin, un­der breasts and in skin folds. AGGRAVATING FAC­TORS

In most peo­ple who have pso­ri­a­sis, there is no ap­par­ent rea­son why a flare-up de­vel­ops at any given time. How­ever, in some peo­ple, pso­ri­a­sis is more likely to flare up in cer­tain si­t­u­a­tions. These in­clude the fol­low­ing: - Stress. - In­fec­tions. Cer­tain types of in­fec­tions may cause a flare-up of pso­ri­a­sis. In par­tic­u­lar, a sore throat caused by a cer­tain type of germ (bac­terium) called Strep­to­coc­cus spp. can cause a flare-up of gut­tate pso­ri­a­sis or chronic plaque pso­ri­a­sis.

- Med­i­ca­tion. Some medicines may pos­si­bly trigger or worsen pso­ri­a­sis in some cases. Med- icines that have been sus­pected of do­ing this in­clude: beta-block­ers (pro­pra­nolol, atenolol, etc), an­ti­malar­ial med­i­ca­tion, lithium, anti-inflammatory painkillers (ibupro­fen, naproxen, di­clofenac, etc), an­giotensin-con­vert­ing en­zyme (ACE) in­hibitor medicines, and some an­tibi­otics. In some cases the pso­ri­a­sis may not flare up un­til the med­i­ca­tion has been taken for weeks or months. - Smok­ing. - Trauma. In­jury to the skin, in­clud­ing ex­ces­sive scratch­ing, may trigger a patch of pso­ri­a­sis to de­velop. The de­vel­op­ment of pso­ri­atic plaques at a site of in­jury is known as Köb­ner’s phe­nom­e­non.

- Sun­light. Most peo­ple with pso­ri­a­sis say that sun­light seems to help ease their pso­ri­a­sis. How­ever, some peo­ple no­tice the op­po­site with strong sun­light seem­ing to make their pso­ri­a­sis worse.

- Hor­monal changes. Pso­ri­a­sis in women tends to be worst dur­ing pu­berty and dur­ing the menopause.

- Al­co­hol. TREAT­MENT

There is no once-and-for-all cure for pso­ri­a­sis. Treat­ment aims to clear the rash as much as pos­si­ble. How­ever, as pso­ri­a­sis tends to flare up from time to time, you may need cour­ses of treat­ment on and off through­out your life. There are var­i­ous treat­ments op­tions. There is no ‘ best buy’ that suits ev­ery­body. The treat­ment ad­vised by your doctor may de­pend on the sever­ity, site and type of pso­ri­a­sis. It is not un­usual to try a dif­fer­ent treat­ment if the first one does not work so well. Many of the treat­ments are creams or oint­ments.

If you have se­vere pso­ri­a­sis then you may need hospital-based treat­ment. Light ther­apy (pho­tother­apy) is one type of treat­ment that can be used. If pso­ri­a­sis is se­vere and is not helped by creams or pho­tother­apy then a pow­er­ful medicine which can sup­press in­flam­ma­tion is some­times used.

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