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“A chronic, of unknown cause, caused by too rapid multiplication of skin cells.”
This rapid growth of cells causes the well-known lesions of psoriasis: red plaques, covered by scales, which appear on the elbows, knees, area and scalp.
This pathology can affect both women and men, and at any age, from babies to the elderly, although 75% of patients are over 40 years of age.
Among the causes of psoriasis, the AEDV points out several such as genetic inheritance, immunological factors, environmental factors and even psychological factors, such as .
types of psoriasis
The clinical manifestations of this disease and how they are experienced are different depending on the patient. That is why dermatologists differentiate several categories of this pathology:
- plaque psoriasis. It is the most common form of psoriasis (80% of cases). In these patients, the lesions usually appear on the elbows, knees, lower back, and scalp. These are “red plaques in relief covered with pearly scales, which shed regularly,” the AEDV specialists explain. In some cases patients with plaque psoriasis experience itching.
- Psoriasis on the scalp. This type is also very common and can present mildly (very fine and light scales) or more severely. In these cases, the lesions can extend beyond the scalp, towards the ears or neck.
- guttate or guttate psoriasis This type is less common and especially affects children and adolescents. “Small red scaly dots appear, which look like drops of water splashed across the body,” the dermatologists explain. It is usually caused by a strep throat infection and usually goes away without treatment.
- pustular psoriasis. This form of psoriasis is rare (less than 5% of cases). It is characterized by the appearance of pustules in the plaques.
- Inverted or fold psoriasis. It is also not frequent and usually appears in the armpits, groin or under the chest.
- Erythrodermic psoriasis. It is very rare but more serious because the scales cover almost the entire body.
As we have already said, psoriasis is a chronic disease, that is, it cannot be cured. But there is a wide range of drugs and therapies to alleviate and improve the lesions it produces on the skin.
These treatments, which may consist of highly moisturizing products, corticosteroids, derivatives of , anti-inflammatory or phototherapy. It will be the specialist in dermatology who will determine which of them is most convenient for each patient.
Psoriasis: It’s not just a skin issue
Psoriasis is a pathology that goes far beyond its best-known symptom: the appearance of plaques on the skin. And it is that patients who suffer from it are exposed to other comorbidities related to their joints, their mental health or their cardiometabolic health.
Therefore, the Dr. Pablo De la Cuevahead of the Dermatology Service underlines that:
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“The comprehensive approach to psoriasis requires going beyond skin involvement, in addition to improving and making skin lesions disappear, which is what patients most want. It is also necessary to look at other psychiatric-type pathologies (such as anxiety or ), non-alcoholic fatty liver, increased cardiovascular risk or metabolic syndrome”.
One of the most frequent comorbidities in patients with psoriasis is psoriatic arthritis. As indicated by the Dr. Lourdes Rodríguez Fernández-Freirehead of the Psoriasis Unit of the Dermatology Service at , “33% of patients with psoriasis present or will present psoriatic arthropathy in their lifetime and in 80% of cases, the skin condition precedes the joint condition, hence the importance of early diagnosis from Dermatology”.
Other affectations that occur in patients with psoriasis are cardiometabolic. In the words of Dr. Rodríguez Fernández-Freire:
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“The association between psoriasis and cardiovascular risk has been demonstrated, as well as with arteriosclerosis and thrombosis”.
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“Some studies have observed a prevalence of coronary disease of 59% in patients with psoriasis compared to 28% in people of the same age, sex and similar risk factors.”
There are also other pathologies that register more cases among psoriasis patients: “It is estimated that the prevalence of metabolic syndrome varies between 15 and 20% of the general population and in the case of patients with psoriasis the prevalence can reach 39%. ”, explains the expert.
Psoriasis and mental health
Last but not least the Dr. Rosa Molinaa specialist in the Psychiatry service of the Hospital Clínico San Carlos points out that “psoriasis affects quality of life and also leaves a ‘mental imprint’”.
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“Physical symptoms such as irritation or itching can lead to insomnia; injuries can generate feelings of shame, frustration, anger, hopelessness, depression, stigmatization or anticipation of rejection and this repercussion is extrapolated to other areas such as sexuality”, he explains.
Worse not only that, the psychiatrist stresses that “in the case of dermatological lesions there may be a tendency to magnify the physical changes, to pay excessive attention to the lesions or to develop avoidance behaviors to hide them.”
Thus, he specifies that the main challenges go through “improving psychoeducation and knowing the emotional impact of psoriasis, which can be extrapolated to other diseases.”
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However, he has remarked that “it is necessary to normalize certain symptoms, since not all patients require a psychiatrist or psychologist, but to understand that feelings of anger, fear, frustration or anxiety are part of an adaptive process.”
For all these reasons, specialists insist on the importance of early diagnosis, to control the disease and all these associated comorbidities.
“The sooner we diagnose psoriasis, the sooner we can treat and clarify the skin lesions, which are the ones that worsen the quality of life of patients, because they cause itching, stinging or pain, to which is added the flaking of the skin,” he explains. Paul of the Cave.
“Also in the case of severe forms of psoriasis, which require a comprehensive approach to screen for these comorbidities as soon as possible,” he adds.