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** Warning to our readers** Some of the images in this post are graphic and we advice you to use caution when reading.

 

To be honest, psoriasis is a challenge to the physicians for there is no permanent cure for psoriasis; also it gives major heart-breaks to those who suffer from this disease. As the writer, John Updike so poignantly said about being a person with psoriasis, “I am silvery, scaly. Puddles of flakes form wherever I rest my flesh. Lusty, though we are loathsome to love. Keen-sighted, though we hate to look upon ourselves. The name of the disease, spiritually speaking, is Humiliation.”

Throughout the years, a lot of new medications has been introduced to alleviate the symptoms and nightmares of the patients. To date, there is approximately 2-3% of the population who are still suffering from psoriasis. Generally, it is a metabolic disorder that causes the epidermis, which normally replaces itself in the course of several days, to speed up the process and to produce excess skin cells. This disease involves skin lesions which are either localised or generalised, and these lesions are the reason behind the haunting stigmata of the society.

 

What do they look like, the skin lesions?


The commonest type of psoriasis is known as psoriasis vulgaris, which consists of small, solid, raised lesions (papules) and elevated, flat lesions (plaque). Sometimes the lesions are reddish or salmon-pink in colour with well-defined margins. The hallmark of this disease would be the flaky silvery-white scales which are loosely attached to the skin surface.

psoriasis

Image From Fitzpatrick’s dermatology



These are the common sites of the lesions:

  1. pressure points

  2. scalp

  3. back

  4. elbows

  5. knees


psoriasis

Image From Fitzpatrick’s dermatology


Other types of psoriasis include:


Guttate psoriasis


Eruption of small (0.5–1.5 cm in diameter) papules over the upper trunk and upper extremities.

psoriasis

Image From Fitzpatrick’s dermatology


Inverse Psoriasis


Lesions localize in major skin folds, such as the armpits, neck, umbilicus, lower boundary of breasts, and groin region.

 

Pustular psoriasis


It causes pus-filled bumps (pustules) surrounded by red skin. (Lakes of pus)

psoriasis

Image From Fitzpatrick’s dermatology



 

Erythrodermic psoriasis


This affects all body sites, including the face, hands, feet, nails, trunk, and extremities.

psoriasis

Image From Fitzpatrick’s dermatology



psoriasis

Image From Fitzpatrick’s dermatology


From skin lesions to the nails and to the joints


 

Psoriasis does not stop at the skin involvement, it also makes people complain about their painful joints and ugly nails. Discolouration and pitting of the nail plate, oil spot staining, separation of the nail and the nail plate, thickening of the nail plate and excessive proliferation of the nail bed are the characteristic signs of psoriasis. Check out the pictures below:



 



 


Who is at risk?


“Doctor, both of my parents do not have psoriasis, why do I have it?”

Truth is, anyone is at risk of having psoriasis, even though the risk is relatively low. Some studies show that if both of your parents have psoriasis, you have 41% of chance to have the same disease too. However, people are more concern with other triggering factors that could possibly increase the risk of getting psoriasis, which are:

 

  1. Physical trauma

  2. Infections

  3. Stress

  4. Drugs

  5. Alcohol


 

Your doctor will proceed to skin biopsy to further confirm the diagnosis. Other investigations are like blood test and x-rays. To treat psoriasis, topical agents will be given to be applied on the affected skin region and oral medications to suppress the immune system.

 

Besides, you may have heard of photo therapy given for babies who were yellowish-looking when they were born. In fact, photo therapy (narrow band UV B photo therapy) is given to those having psoriasis too. It helps to reduce the scales and plaques formation on the skin and also to control the symptoms. “Only the sun, that living god, had real power over psoriasis; a few weeks of summer erased the spots from all of my responsive young skin that could be exposed.” – John Updike.

 

Being at war with your own skin is as devastating as losing your partner. It keeps you thinking why, it makes you angry about you and everything around you, it makes you so depressed. But people with the disease have to be reminded that having psoriasis doesn’t mean it is the end of the world. Seek the correct treatment from your trusted dermatologist and accept who you are.

 

Nobody’s perfect anyway.

 

References:

New York Times

WebMD

 


Angie Loh

by Angie Loh

A medical student with nothing but passion and a pen. Poems and novels never fail to make me feel alive. I'm inspired to make the world a better place and fill it with a little bit more love. But first, where's my coffee? View all articles by Angie Loh.




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