Psoriasis is a common skin problem of unknown cause. In Psoriasis, the person gets red and scaly patches at certain places like the knees, elbows, back, scalp, palms and soles. But it is interesting to note that patches of Psoriasis can never occur on the face.

What exactly goes wrong in Psoriasis is that the epidermal cells multiply about 4 times more rapidly within patches of Psoriasis as compared to the normal skin. Unfortunately the factors that trigger off this hyper–proliferation are yet unknown. Today the current concept is that this defect could be due to an exaggerated immunological response and inflammation against some common organisms like bacteria and viruses. Psoriasis is neither hereditary nor contagious.

Types of psoriasis
Exfoliate psoriasis
It is a type where there are widespread lesions involving more than 80% of the body surface. This is associated with fever and weakness and can leave the patient ill for months together.

Pustule psoriasis
It is the most dangerous type, where the whole skin is filled with pustules which come together to form lakes of pus. The patient has high grade fever and is bedridden. Rarely this can be fatal too.

Psoriatic arthropathy
Rarely the joints can become painful and stiff due to Psoriasis. This problem usually occurs in patients of long standing disease.

Treatment of psoriasis
The treatment is tailor–made for each patient. Localized forms can be treated with creams and ointments. Commonly used creams are steroid creams, diathronal creams, coal tar ointment, liquid paraffin and even plain Vaseline ointment. However, in generalized varieties, systemic treatment is chosen. Drugs like Methotrexte, Azathioprine, Hydroxyurea are anti-metabolites, which are commonly used. However, these drugs are quite toxic and cannot be taken without specialist’s supervision. PUVA therapy using psoralins and UVA rays is also one modality of treatment which is commonly used.

Even the most recent and the costliest drugs do not guarantee a complete cure. All drugs can induce a remission but psoriasis may flare up under unknown influences. Relapse of psoriasis is known to occur in winters and under psychologically stressful conditions.

Recent drugs for psoriasis
Retinoids and Calcipotriol are the most recent introductions in treatment. However the costs of these drugs are exorbitant in India.

Psoriasis [pronounced sore–EYE–ah–sis] is a noncontagious, lifelong skin disease. The most common form, Plaque [plak] Psoriasis, appears as raised, red patches or lesions covered with a silvery white buildup of dead skin cells, called scale.

This is non–infectious disease of skin, characterized by well–marked red lesions which are dry with silvery white scaling becoming obvious only after scraping.

Condition is characterized by exacerbations (flare–ups) & remissions (temporary disappearance). It can be associated with nail changes like thickening, thimble pitting, involvement of finger joints & occasionally severe systemic effect like fever & chills.

Commonest site involved is elbows, knees & lower back. Other sites which are prone to be affected are – scalp marked scaling with lumpiness, nails, all over the body, palms, soles.

Contributed by Dr. R. S. Sonawane