Did you know that the skin is the largest organ in the body? Many of us underestimate the size and wonder of this incredible organ, perhaps until something goes wrong.
One of the most common skin conditions we see in general practice is Psoriasis. It affects approximately 2% of the population and is usually recognizable by thickened plaques of red skin with silvery scales on top. The elbows, knees, lower back and scalp are most commonly affected and it can be itchy and uncomfortable.
It’s not entirely clear what causes Psoriasis, but it is thought to be linked to the body’s own immune system overreacting, which in turn causes the skin cells to replicate much faster than they normally would. There is a strong genetic link, so it often runs in families, with smoking and obesity also being linked to the condition. Some patients find that their Psoriasis will flare up where they have had trauma or injury to the skin – so called Koebner’s phenomenon.
In addition to skin plaques, there are often symptoms in the nails which can develop pits or ridges. About 10% of Psoriasis patients can develop an inflammatory arthritis, called Psoriatic Arthropathy, which can be debilitating and needs specialist input from a rheumatologist.
Guttate Psoriasis is a form of Psoriasis that we often see in younger patients after they have had a sore throat or viral illness. It causes smaller, raindrop-like spots all over the body and usually settles down by itself in a few weeks.
Usually, however, Psoriasis is a chronic condition, which is lifelong and can flare up from time to time. While there is currently no cure, numerous treatments can help manage the symptoms and improve quality of life.
Happily, the summer months tend to be better for Psoriasis patients if we are lucky enough to get some sunny weather, although many patients tell me they feel uncomfortable about exposing their skin as they often face stigma, with people erroneously believing that they may be contagious.
The Psoriasis Association has a great website and works hard to dispel this stigma and offer valuable information for patients and their families: www.psoriasis-association.org.uk If you (or someone close to you) have Psoriasis, don’t suffer in silence – check out the website and see your pharmacist or GP to discuss treatment.
Top Tips
1) Moisturise – using emollient creams can help reduce the discomfort from cracking and scaling and can also allow your other creams, such as Vitamin D or steroid creams, to penetrate the skin more easily.
2) Medication triggers – Some people find other medications they are prescribed can cause their Psoriasis to flare up. These can include: betablockers, eg bisoprolol; ACE inhibitors (commonly used for blood pressure, eg ramipril); or anti-inflammatories like ibuprofen or naproxen. If you think this may be the case for you, speak to your doctor to discuss alternatives.
3) Look after your heart – There is some evidence that Psoriasis is linked to higher rates of cardiovascular disease, so if you haven’t already, make sure you get your blood pressure and cholesterol checked.
4) Joints – If you notice stiffness or swelling in your joints and also have Psoriasis, let your doctor know as this may need further treatment.
3) Enjoy the sunshine – Exposure to sunlight can significantly improve the condition, but make sure it is for no longer than 20 minutes at a time and avoid burning.