I – Introduction:
A- Definition of psoriasis:
Psoriasis is a chronic skin disease that is characterized by red, scaly patches on the skin. Skin cells multiply at an abnormally rapid rate, causing an accumulation of dead cells on the surface of the skin. Psoriasis can affect any part of the body, but the most commonly affected areas are the elbows, knees, scalp, and back. There are different types of psoriasis, including plaque psoriasis, guttate psoriasis, and pustular psoriasis. The severity and frequency of symptoms can vary greatly from person to person, with some people experiencing mild, occasional symptoms, while others may experience severe, persistent symptoms. There is no cure for psoriasis,
B- Frequency of the disease:
C- Common symptoms:
The most common symptoms of psoriasis include red, thick, scaly patches on the skin that may itch or burn. The plaques are usually located on the elbows, knees, scalp, and lower back, but they can develop anywhere on the body. Other common symptoms include ridged or deformed nails, painful and swollen joints (joint psoriasis), and dryness and cracking in skin folds. Gutted psoriasis is characterized by small red spots on the body, while pustular psoriasis is characterized by fluid-filled pustules on affected patches of skin. Psoriasis symptoms can vary greatly in severity and frequency over time, and can worsen in response to factors such as stress, infections, and medications. People with psoriasis may also suffer from psychological symptoms such as depression and anxiety due to the appearance of their affected skin.
II- Causes of psoriasis:
A- Genetic factors:
Genetic factors play an important role in the development of psoriasis. The disease is considered to be multifactorial, which means that it is caused by a combination of genetic and environmental factors. Some studies have shown that people with psoriasis often have a family history of the disease. Researchers have identified several genes associated with psoriasis, including genes involved in immune system regulation and skin cell growth. People who have a relative with psoriasis are considered to have an increased risk of developing the disease, but it is important to note that environmental factors such as stress, infections and injuries to the skin can also play a role in the development of the disease. Recent advances in understanding the genetic factors involved in psoriasis may lead to new treatment strategies for the disease, including therapies specifically targeting the genes involved.
B- Environmental factors:
Environmental factors can also contribute to the development of psoriasis. Some of the most common environmental factors associated with worsening psoriasis symptoms include stress, infections, skin injuries, medications, and alcohol consumption. For example, stress can trigger a psoriasis flare in people who are genetically predisposed to the disease. Likewise, infections such as streptococcus can trigger an episode of guttate psoriasis. Medications such as beta-blockers, lithium, and antimalarials can also cause or worsen psoriasis symptoms. Finally, excessive alcohol consumption can lead to an exacerbation of the symptoms of the disease.
C- Emotional stress:
Emotional stress can have a significant impact on psoriasis symptoms. Many people with psoriasis report that stress can trigger or worsen their disease. Studies have shown that stress can affect the immune system, which can contribute to the inflammation associated with psoriasis. Additionally, stress can also increase levels of hormones such as cortisol, which can also have an effect on disease symptoms. Stress can also lead to behaviors such as scratching or rubbing the affected skin, which can lead to an exacerbation of symptoms. Finally, stress can also affect the quality of life of people with psoriasis by leading to anxiety and depression.
Infections can also be a trigger for psoriasis. Certain infections such as streptococcus can trigger an episode of guttate psoriasis in people who are genetically predisposed to the disease. Other infections such as HIV can also make psoriasis symptoms worse in people who already have the disease. Infections can trigger inflammation in the body, which can lead to an exacerbation of disease symptoms. It is important to treat infections early to minimize their impact on psoriasis symptoms. People with psoriasis should avoid infections by practicing good personal hygiene, avoiding contact with sick people and getting vaccinated against infections such as pneumonia and influenza. Finally, it is important to consult a doctor quickly in the event of symptoms of infection to avoid aggravation of the symptoms of psoriasis.
III- Diagnosis of psoriasis:
A- Physical examination:
Physical examination is a key part of the diagnosis of psoriasis. The doctor will begin by examining the affected skin to determine typical features of the condition, such as thick, scaly red patches, itching, and pain. The doctor may also perform a detailed examination of the whole body to detect other affected areas. In some cases, the doctor may remove a small piece of skin for a microscopic examination called a skin biopsy. This test can help confirm the diagnosis and rule out other possible causes of the skin condition.
In addition to the physical exam, the doctor may also take a medical and family history to determine if there is a history of psoriasis or other health issues that may be related to the condition. He may also ask about trigger factors such as emotional stress, infections, and exposure to certain drugs or chemicals. Finally, the doctor may perform blood tests to rule out other possible causes of the skin condition. Taken together, the complete physical exam can help the doctor make an accurate diagnosis and develop an effective treatment plan for psoriasis.
B- Laboratory tests:
Lab tests can be used to help diagnose psoriasis and rule out other possible causes of the skin condition. The most commonly used tests include:
1- Blood test: The blood test can help detect systemic abnormalities such as anemia and immune disorders that may be related to psoriasis.
2- Skin biopsy: Skin biopsy is a microscopic test that can help confirm the diagnosis of psoriasis. For this test, a small portion of affected skin is removed for further examination under a microscope.
4- HIV testing: HIV can make psoriasis symptoms worse, so it is important to determine if a person with psoriasis is infected with this virus.
5- Liver and kidney function tests: Medicines used to treat psoriasis can have side effects on the liver and kidneys, so it is important to check the function of these organs before starting treatment.
In general, laboratory tests can provide valuable information about the overall health of a person with psoriasis and can help the doctor develop an effective treatment plan. It is important to follow the doctor’s instructions to prepare for these tests and to discuss the results with the doctor to understand their meaning and impact on the treatment plan.
C- Evaluation by a dermatologist:
Evaluation by a dermatologist is a crucial aspect of the diagnosis and treatment of psoriasis. The dermatologist will perform a careful visual inspection of the affected skin, taking into account the characteristics and severity of the symptoms. The doctor may also request information about the person’s medical history, including family history of psoriasis or other skin conditions.
The dermatologist may also perform a thorough physical examination to rule out other potential causes of the skin condition. This may include lab tests and skin images for more detailed analysis.
Finally, the dermatologist can discuss available treatment options with the person, depending on the severity of their symptoms and their overall health. The doctor can also give advice on skin care to manage psoriasis symptoms at home.
Evaluation by a dermatologist is an important process for people with psoriasis because it can help establish an accurate diagnosis and put in place an effective treatment plan to relieve symptoms and improve quality of life. It’s important to see a dermatologist if you suspect you have psoriasis or have any questions about your skin condition.
IV- Treatment of psoriasis:
A- Topical treatment:
Topical treatment is a common type of treatment for psoriasis, which involves applying medication to the affected skin. Topical medications can include creams, ointments, lotions, and gels, which can help relieve psoriasis symptoms.
Common topical medications used to treat psoriasis include corticosteroids, cell growth regulators, calcipotriol, and vitamin D. Some of these medications can be used alone or in combination with other forms of treatment for increased effectiveness.
Topical treatment can be administered directly to the affected skin, usually several times a day. The effects of topical medications can vary from person to person, depending on the severity of symptoms and the body’s response to these medications.
It is important to consult a dermatologist before beginning any topical treatment to determine the most appropriate medication and treatment plan for you. Topical medications can cause potential side effects, such as skin irritation, burning, and itching, so it’s important to follow your doctor’s instructions to minimize these side effects.
B- Systemic treatment:
Systemic therapy is a type of treatment for psoriasis that involves taking medication by mouth or intravenously. It is generally recommended for people with severe psoriasis or who have not responded to other forms of treatment.
Systemic medications commonly used to treat psoriasis include methotrexate, cyclosporine, acitretin, and ustekizumab. These can help reduce the accelerated production of skin cells, which is the main cause of psoriasis symptoms.
Systemic treatment may be given over an extended period, depending on the severity of symptoms and the body’s response to these drugs. Potential side effects can include effects on the liver, blood system, and immune system, so it’s important to follow your doctor’s instructions and get tested regularly to monitor for these side effects.
As with any other treatment for psoriasis, it is important to consult a dermatologist before beginning systemic therapy. The doctor can help you determine the most appropriate medication and treatment plan for you, based on the severity of your psoriasis and your medical history.
C- Photodynamic therapy:
Photodynamic therapy (PDT) is a form of treatment for psoriasis that uses a combination of light and photosensitizing drugs. The doctor first applies medication to the affected skin, which works by binding to the abnormal cells. Then, a specific light source is used to activate the drug, which causes a chemical reaction that destroys the abnormal cells.
PDT may be an effective treatment option for people with moderate to severe psoriasis, especially those who have previously tried topical and systemic treatments without success. Therapy may be given over an extended period, depending on the severity of symptoms and the body’s response to this treatment.
Potential side effects of PDT can include temporary skin irritation, redness, and pain, but these effects are usually mild and temporary. It is important to discuss the risks and benefits of photodynamic therapy with a dermatologist, who can help you determine if this treatment option is the most appropriate for you.
In general, photodynamic therapy is considered a safe and effective treatment for psoriasis, and can help significantly improve the quality of life for people with this skin condition.
D- Alternative therapies:
Alternative therapies for psoriasis can include approaches such as acupuncture, aromatherapy, meditation, and exercise. Although these therapies are not considered standard treatments for psoriasis, they can help relieve symptoms and improve quality of life for people with this skin condition.
Acupuncture, for example, can help reduce the inflammation and pain associated with psoriasis. Aromatherapy uses essential oils to soothe the skin and stimulate the senses, while meditation can help reduce emotional stress that can exacerbate psoriasis symptoms.
Regular exercise may also be beneficial for people with psoriasis. Exercise can help improve blood circulation, boost the immune system and reduce stress. It is important to consult a doctor before starting a new exercise routine to ensure that it will not cause further damage to the skin.
In general, alternative therapies can be a helpful option for people with psoriasis looking to improve their overall well-being and supplement their standard treatment. However, it is important to discuss these approaches with a doctor to ensure that they will not interfere with standard treatment or overall health.
V- Prevention of psoriasis:
A- Stress management:
Managing stress can be an important part of managing psoriasis for many people. Emotional stress can indeed exacerbate the symptoms of psoriasis, which can make the disease more difficult to control. It is therefore important to find ways to manage stress to help reduce the symptoms of psoriasis.
There are several strategies for dealing with stress, such as meditation, deep breathing, exercising regularly, and participating in enjoyable activities. Meditation can help reduce anxiety and improve mood, while deep breathing can help reduce stress and improve mental health.
Regular exercise can also be beneficial for managing stress. Exercise can improve blood circulation, strengthen the immune system and reduce stress. It is important to consult a doctor before starting a new exercise routine to ensure that it will not cause further damage to the skin.
Finally, participating in enjoyable activities can help manage stress and improve mood. This can include activities such as reading, gardening, nature outings and creative hobbies. Finding activities that bring you a sense of calm and satisfaction can help manage stress and improve your quality of life.
In general, stress management can be an important part of managing psoriasis for many people. Finding ways to manage stress that suit your lifestyle and personality is important to help reduce psoriasis symptoms.
B- Healthy food :
Diet can play an important role in the management of psoriasis. A healthy, balanced diet can help improve the symptoms of the disease. It is important to include fruits, vegetables, whole grains and lean proteins in your diet. Avoid foods high in fats and added sugars, which can exacerbate psoriasis symptoms. Diets such as the Mediterranean diet, which includes plenty of fruits, vegetables, nuts, and olive oil, may be beneficial for people with psoriasis. It is also important to drink enough water to maintain adequate hydration. It is always best to consult a medical professional for advice on proper diet for your individual needs.
C- Avoid triggers:
It is important for people with psoriasis to identify and avoid triggers that can exacerbate their disease. Triggers can vary from person to person, but some of the most common include emotional stress, infections, skin injuries, medications, and weather conditions. By avoiding these triggers, it is possible to reduce psoriasis flare-ups and control symptoms. It can be helpful to keep a diary to identify potential triggers and work with a medical professional to find ways to manage them. Some people may benefit from stress management techniques such as meditation, yoga, or deep breathing to help deal with emotional triggers.
D- Regular follow-up with a dermatologist:
Regular follow-up with a dermatologist is crucial for people with psoriasis. Dermatologists can monitor disease progression and adjust treatment accordingly. Additionally, dermatologists can help manage potential complications such as skin infections and associated skin problems. They can also offer skin care advice to help prevent new lesions and improve the appearance of the skin. It’s important to remember that psoriasis is a chronic condition and flare-ups can occur at any time, so it’s important to follow up regularly with a dermatologist to ensure treatment is working and to make adjustments if needed. .
A- Summary of key information:
Psoriasis is a chronic skin disease that is characterized by red, scaly lesions on the skin. The frequency of the disease varies widely, but it affects about 2-3% of the world’s population. Common symptoms include itching, pain, and burning of the skin. Genetic, environmental, and emotional factors can all contribute to the development of the disease. The diagnosis is usually made by a dermatologist after a physical examination and laboratory tests. Treatment for psoriasis can include topical treatments, systemic treatments, photodynamic therapy, and alternative therapies. Managing stress, eating healthy, and avoiding triggers can help control symptoms. Finally,
B- Importance of psoriasis management:
Proper management of psoriasis is important to improving the quality of life for people with this chronic skin disease. If psoriasis is not treated properly, it can get worse and cause severe pain, itching and burning, which can lead to additional emotional stress. Psoriasis management typically involves drug therapy to control symptoms, along with lifestyle modifications to avoid triggers and manage stress. Also, regular follow-up with a dermatologist is important to assess the effectiveness of the treatment and to adjust the treatment plan accordingly. People with psoriasis can also find support from online support groups and family and friends.
C- Tips for people with psoriasis:
It is important for people with psoriasis to proactively manage their condition to minimize symptoms and improve their quality of life. It is advisable to follow a healthy diet, limit triggers such as stress and infections, and maintain good skin hygiene. It is also important to see a dermatologist regularly for regular follow-up and to discuss the most appropriate treatment options. Topical, systemic, and photodynamic treatments can help manage symptoms, but it’s also important to consider alternative therapies such as stress management and regular exercise for a holistic approach to managing psoriasis.