Psoriasis | |
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Back and arms of a person with severe psoriasis | |
Pronunciation | |
Specialty | Dermatology (primarily); immunology, rheumatology and other specialties (e.g., cardiology and vascular medicine, nephrology, hepatology/gastroenterology, endocrinology, haematology) (indirectly/by association) |
Symptoms | Red (purple on darker skin), itchy, scaly patches of skin[3] |
Complications | Psoriatic arthritis[4] |
Usual onset | Adulthood[5] |
Duration | Long-term[4] |
Causes | Genetic disease triggered by environmental factors[3] |
Diagnostic method | Based on symptoms[4] |
Treatment | Steroid creams, vitamin D3 cream, ultraviolet light, immunosuppressive drugs such as methotrexate and biologics[5] |
Frequency | 79.7 million[6] / 2–4%[7] |
Psoriasis is a long-lasting, noncontagious autoimmune disease characterized by patches of abnormal skin.[4][5] These areas are red, pink, or purple, dry, itchy, and scaly.[8][3] Psoriasis varies in severity from small localized patches to complete body coverage.[3] Injury to the skin can trigger psoriatic skin changes at that spot, which is known as the Koebner phenomenon.[9]
The five main types of psoriasis are plaque, guttate, inverse, pustular, and erythrodermic.[5] Plaque psoriasis, also known as psoriasis vulgaris, makes up about 90% of cases.[4] It typically presents as red patches with white scales on top.[4] Areas of the body most commonly affected are the back of the forearms, shins, navel area, and scalp.[4] Guttate psoriasis has drop-shaped lesions.[5] Pustular psoriasis presents as small, noninfectious, pus-filled blisters.[10] Inverse psoriasis forms red patches in skin folds.[5] Erythrodermic psoriasis occurs when the rash becomes very widespread, and can develop from any of the other types.[4] Fingernails and toenails are affected in most people with psoriasis at some point in time.[4] This may include pits in the nails or changes in nail color.[4]
Psoriasis is generally thought to be a genetic disease that is triggered by environmental factors.[3] If one twin has psoriasis, the other twin is three times more likely to be affected if the twins are identical than if they are nonidentical.[4] This suggests that genetic factors predispose to psoriasis.[4] Symptoms often worsen during winter and with certain medications, such as beta blockers or NSAIDs.[4] Infections and psychological stress can also play a role.[3][5] The underlying mechanism involves the immune system reacting to skin cells.[4] Diagnosis is typically based on the signs and symptoms.[4]
There is no known cure for psoriasis, but various treatments can help control the symptoms.[4] These treatments include steroid creams, vitamin D3 cream, ultraviolet light, immunosuppressive drugs, such as methotrexate, and biologic therapies targeting specific immunologic pathways.[5] About 75% of skin involvement improves with creams alone.[4] The disease affects 2–4% of the population.[7] Men and women are affected with equal frequency.[5] The disease may begin at any age, but typically starts in adulthood.[5] Psoriasis is associated with an increased risk of psoriatic arthritis, lymphomas, cardiovascular disease, Crohn's disease, and depression.[4] Psoriatic arthritis affects up to 30% of individuals with psoriasis.[10]
The word "psoriasis" is from Greek ψωρίασις, meaning "itching condition" or "being itchy"[11] from psora, "itch", and -iasis, "action, condition".
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