Psoriasis

Psoriasis is a common, chronic inflammatory condition, caused by dysfunction of the immune system, which results in skin cells reproducing at a faster rate than normal.1,2,3 As a result, raised patches form on the surface of the skin, which can appear red or purple and be flaky, itchy and scaly.2

Psoriasis affects approximately 125 million people worldwide and is a life-long condition, for which there is no cure.2,3,4

Nearly half of psoriasis patients have a moderate to severe form of the disease.5

Women and men of all ages and ethnicities can be affected by psoriasis.6 There are many types of psoriasis, though plaque psoriasis is the most prevalent, comprising approximately 90 percent of all psoriasis cases.5

Several other serious health conditions are associated with psoriasis, including diabetes, obesity, cardiovascular disease, depression, stroke and psoriatic arthritis – a chronic disease that causes inflammation, swelling and pain in the joints.1,7

 

Find out more about psoriasis

Impact

Because of its visible and physically debilitating impact, psoriasis often takes an emotional toll on those who have it.8 The specific location in which symptoms appear on the body has been shown to have a direct link to the impact of psoriasis on patients’ quality of life, as visible psoriasis in noticeable areas, such as the scalp, nails and hands can be highly stigmatizing.9,10,11

People with psoriasis have experienced feelings of stigmatization, shame, embarrassment, anger or worry because of their condition.12, 13

People living with psoriasis also frequently report sleeping problems, difficulties at work, issues interacting with family members, disrupted leisure activities and sexual difficulties.14,15 They also report that the significant impact the disease has on their quality of life is not well understood by physicians.16

Symptoms

Symptoms of psoriasis can vary from person to person6. People with psoriasis may have symptoms of flaking, scaling, itching and scratching, a rash, skin pain, bleeding, redness, skin drying and cracking, and physical discomfort.6

Psoriasis can flare up anywhere on the body and can be severe or mild.2 Symptoms occur most often on the lower back, knees, elbows, legs, soles of the feet, scalp, face and palms but can also affect the hands, nails, skin folds and genital area.3,17

Types

Plaque psoriasis - has the highest prevalence and causes dry, raised, red skin lesions (plaques) covered with silvery scales.3,5 The plaques may be itchy or painful and can occur anywhere on the body, including the scalp, knees, elbows and lower back.3

Nail psoriasis – Can cause fingernails and toenails to become pitted, discoloured or to grow abnormally.3 Psoriatic nails may become loose and separate from the nail bed (onycholysis), which in severe cases may cause the nail to crumble.3

Guttate psoriasis – Primarily affects young adults and children and is regularly triggered by a bacterial infection.3

Inverse psoriasis – Mainly affects the skin in the folds of the groin, breasts and buttocks, and may be triggered by fungal infections.3

Pustular psoriasis – Can occur in widespread patches or in smaller areas on the palms or soles, causing pus-filled lesions.3

Erythrodermic psoriasis – The least common type of psoriasis, can cover the entire body with a red, peeling rash that can itch or burn intensely.3

Causes and risk factors

While it isn’t entirely clear exactly what causes the immune system to malfunction in people with psoriasis, researchers have discovered genes that are linked to the development of the condition, and it is believed that environmental factors also play a role.18 There are a number of key factors which contribute to the onset and exacerbation of psoriasis, including:19

Genetics

Studies have shown a positive family history in approximately 35 percent of people with psoriasis.19

Medications
Numerous medications can trigger psoriasis, including lithium, nonsteroidal anti-inflammatory drugs, antimalarials, beta-blockers and angiotensin-converting enzyme inhibitors.19

Infection
Streptococcus, HIV, fungi and other bacterial and viral infections have been found to trigger or exacerbate psoriasis.19

Lifestyle
Obesity, smoking and stress are factors which are thought to increase the risk of psoriasis.3,19

References
  1. British Skin Foundation. What is Psoriasis. https://knowyourskin.britishskinfoundation.org.uk/condition/psoriasis/. Last accessed on September 2024.
  2. Global Psoriasis Atlas. Resources. https://www.globalpsoriasisatlas.org/resources/resources. Last accessed on September 2024.
  3. Mayo Clinic. Psoriasis: Symptoms & Causes. https://www.mayoclinic.org/diseases-conditions/psoriasis/symptoms-causes/syc-20355840. Last accessed on September 2024.
  4. Griffiths C, van der Walt J, Ashcroft D, et al. The global state of psoriasis disease epidemiology: a workshop report. Br J Dermatol. 2017;177(1):e4–7.
  5. Møller A, Erntoft S, Vinding G, et al. A systematic literature review to compare quality of life in psoriasis with other chronic diseases using EQ-5D-derived utility values. Patient Relat Outcome Meas. 2015;6:167-77.
  6. World Health Organization. Global Report on Psoriasis 2016. https://apps.who.int/iris/bitstream/handle/10665/204417/9789241565189eng.pdf.psoriasis?sequence=1. Last accessed on September 2024.
  7. National Psoriasis Foundation. Related Conditions of Psoriasis. https://www.psoriasis.org/related-conditions/. Last accessed on September 2024.
  8. Reddy M, Chaturvedi S. Psychosocial issues in dermatology. EMJ Dermatol. 2017;5(1):83-89.
  9. Augustin M, Sommer R, Kirsten N, et al. Topology of psoriasis in routine care: results from high-resolution analysis of 2009 patients. Br J Dermatol. 2019;181(2):358-65.
  10. Alpsoy E, Polat M, FettahlıoGlu-Karaman B, et al. Internalized stigma in psoriasis: a multicenter study. J Dermatol. 2017;44(8):885-91.
  11. Sampogna F, Linder D, Piaserico S, et al. Quality of life assessment of patients with scalp dermatitis using the Italian version of the Scalpdex. Acta Derm Venereol. 2014;94(4):411-14.
  12. Hrehorów E, Salomon J, Matusiak L, et al. Patients with psoriasis feel stigmatized. Acta Derm Venereol. 2012;92:67-72.
  13. Sampogna F, Tabolli S, Abeni D, et al. Living with psoriasis: prevalence of shame, anger, worry, and problems in daily activities and social life. Acta Derm Venereol. 2012;92(3):299-303.
  14. Moon HS, Mizara A, McBride SR. Psoriasis and psycho-dermatology. Dermatol Ther (Heidelb). 2013;3(2):117-30.
  15. Gupta MA, Simpson FC, Gupta AK. Psoriasis and sleep disorders: A systematic review. Sleep Med Rev. 2016;29:63-75.
  16. Krueger G, Koo J, Lebwohl M, et al. The Impact of Psoriasis on Quality of Life: Results of a 1998 National Psoriasis Foundation Patient-Membership Survey. Arch Dermatol. 2001;137(3):280-4.
  17. National Psoriasis Foundation. Locations and Types. https://www.psoriasis.org/locations-and-types/. Last accessed on September 2024.
  18. NHS UK. Psoriasis Causes. https://www.nhs.uk/conditions/psoriasis/causes. Last accessed on September 2024.
  19. Lee EB, Wu KK, Lee MP, et al. Psoriasis Risk Factors and Triggers. Cutis. 2018;102(5S):18-20.