October 29 is World Psoriasis Day – a non-infectious, immunologically mediated inflammatory disease manifested, among others, by: skin problems. We talk to dermatologist, prof. about the myths related to this ailment, as well as its less obvious symptoms. Dr. hab. n. med. Łukasz Matusiak.
Psoriasis affects up to two percent of the population in Europe and the United States. In Poland, the percentage of people suffering from it is slightly higher and amounts to three percent. Chronic and recurrent ailment is manifested primarily by skin inflammation, manifested by the formation of the so-called plates, which are covered with layers of silvery scales.
Is psoriasis an infectious disease? Causes of the disease
Psoriasis is not contagious. It cannot be transmitted by such behaviors as shaking hands, swimming in the same pool, staying in the same room as a sick person, or using the same towel. This disease is not a consequence of poor hygiene.
– People are afraid of diseases that appear on the skin because they are not familiar with their specificity. Some people believe that all of them may be contagious. This is not the case – emphasizes dermatologist Prof. in an interview with TVN24.pl. Ph.D. Łukasz Matusiak from the Department and Clinic of Dermatology, Venereology and Allergology of the Medical University of Wrocław. – Psoriasis is definitely not an infectious disease. It has primarily a genetic basis.
What can accelerate the manifestation of the disease?
According to the expert, the factors that may accelerate the manifestation of the disease in people who are already genetically predisposed to it are: infections, especially streptococcal infections of the throat, some medications (e.g. lithium salts, beta-blockers, antimalarials) and stress factors. – Some sources say that the disease may also be exacerbated by non-steroidal anti-inflammatory drugs, which are so eagerly and widely used – adds Prof. Ph.D. Łukasz Matusiak. – Sometimes I also jokingly say that psoriasis “blooms” when it is “nurtured” with a lot of cigarettes, alcohol, stress and lack of sleep. We should therefore avoid these factors.
Psoriasis – typical symptoms of the disease
What are the symptoms of psoriasis? The expert explains that “the disease consists in the fact that the inflammatory infiltrate in the dermis is accompanied by a maturation process of the epidermis shortened to 3-4 days, which usually lasts 26-28 days in healthy skin.” – The result of these processes is the occurrence of the previously mentioned characteristic changes on the skin: psoriatic plaques, located symmetrically in typical places, the so-called predilection – explains Professor Matusiak.
As the expert notes, the name psoriasis covers many subtypes of the disease, which differ in their clinical manifestations. In the most common form of this disease, i.e. plaque psoriasis, convex lesions of various shapes appear on the patient’s body, covered with silvery scales, located mainly on the elbows, knees, in the sacral-lumbar area and on the scalp. However, there are also other, less common types of psoriasis. How do they manifest themselves?
Less typical symptoms of psoriasis
There is a group of patients in whom – as the expert explains – the lesions “are located in completely different places than in most patients, such as around the skin folds, under the armpits, breasts, in the groin or in the intergluteal cleft – this is inverse psoriasis.” Among the rarer forms of the disease, dermatologists also distinguish erythroderma psoriasis. – In this case, the entire skin or the vast majority of it becomes inflamed, not selected fragments – adds Prof. Ph.D. Łukasz Matusiak.
– When talking about less common forms of psoriasis, we should also mention pustular psoriasis, which is an often severe skin disease. In this case, in addition to psoriatic plaques, pustular changes may appear on the patient’s body – explains the expert. He adds that this form “may be generalized, i.e. it may cover almost the entire body surface or most of it, or limited to the patients’ hands.”
– It is also necessary to mention the variants of the disease, such as old-time psoriasis or tartan psoriasis, which can be described as variants of psoriasis that have been neglected and not treated by the patient. Then the psoriasis lesions are very intense, thick, and sometimes even oozing – emphasizes the doctor.
Psoriatic arthritis – how to recognize PsA
As a less obvious form of psoriasis, the doctor also indicates psoriatic arthritis (PsA), during which, in addition to skin problems, there is also inflammation of the joints, manifesting themselves in pain and swelling. According to the expert, it affects about 1/3 of psoriasis patients. – Depending on the patient, both large joints (such as ankles, shoulders, knees) and small joints (especially hand joints) or spine joints may be affected.
Professor Matusiak points out that joint symptoms usually develop in patients 6-8 years after the first skin lesions appear. – In the case of approximately 20 percent of patients with PsA, the situation may be the opposite: first, inflammatory changes in the joints appear, often of unclear origin to the doctors diagnosing them, and only later do psoriatic plaques appear, allowing an accurate diagnosis to be made. And in about 10 percent of patients, skin symptoms and joint problems begin to occur simultaneously.
The expert also points out that “patients with psoriasis, and especially psoriatic arthritis, very often struggle with nail changes.” – This deformation can manifest itself in several ways. Some of the problems are related to the nail matrix and some to the nail bed. The most common deformations are: onycholysis, i.e. the separation of the nail plate from its bed, thimbleness, i.e. the formation of small cavities in the nail plate, making its surface resemble a thimble, and a symptom called “oil drops”, when under the nail, on nail bed, psoriatic papules are formed, which, when pressed by the nail plate lying over them, take on a color similar to that of a drop of engine oil. Sometimes, complete destruction of nails may occur.
“Psoriasis is a disease of the entire body”
– Let us also remember that psoriasis is not only an inflammation that affects the skin, but a disease of the entire body – sums up Prof. Ph.D. Łukasz Matusiak in an interview with TVN24.pl. – Patients, especially those with severe disease, also experience a reduced life expectancy, even by several years. They are more likely to suffer from cardiovascular diseases and have liver and kidney problems. They also experience heart attacks and strokes more often.
October 29 is World Psoriasis Day.
Main photo source: ARTFULLY PHOTOGRAPHER/Shutterstock