Psoriasis is a common inflammatory skin condition that affects about 1% (1 in 100) of the population. It results from rapid multiplication of skin cells leading to thickening of the skin and scaling. It is estimated that there are about 80 million people with psoriasis throughout the world. In Singapore, it is estimated that at least 40,000 persons are affected with psoriasis.
Psoriasis appears as red patches of skin covered with loose silvery scales that flake off constantly. It can occur on any part of the body although the knees, elbows, back and scalp are common sites of involvement.
Commonly, it begins as persistent dandruff in the scalp before spreading elsewhere. These may often be accompanying irritation or itch but the severity of this may vary considerably from person to person. Sometimes if the patches are thick and dry they crack and become sore.
Chronic plaque psoriasis is the most common form of psoriasis. This commonly affects the scalp, knees and elbows and umbilicus, although any part of the body can be affected. Guttate psoriasis presents as small plaques of psoriasis scattered on the trunk and limbs. This form of psoriasis is often aggravated by streptococcal throat infections. Other forms of psoriasis include pustular psoriasis, palmoplantoar, inverse or flexural psoriasis.
In addition to the skin, psoriasis can sometimes also affect the nails and joints. Psoriatic arthritis or painful swelling of the joints commonly affects the small joints of fingers, the knees and ankles. In some persons, the arthritis may develop before the appearance of skin changes or vice versa. Anti-inflammatory drugs, rest and physiotherapy are used in the treatment of psoriatic arthritis. Early and effective treatment of arthritis can prevent deformity of the joints.
Psoriasis affects men and women in equal numbers and may appear for the first time at any age. It does however start more frequently between the ages of 15 and 45 particularly during puberty and menopause. Psoriasis may appear in children.
Psoriasis affects all major races and is found throughout the world. Persons of all socio-economic classes and educational levels may be affected. There is a family history in a quarter to a third of persons with psoriasis.
Psoriasis is neither infectious nor contagious. It cannot be passed on to other persons. It is not caused by poor standards of hygiene. Please see What Causes Psoriasis?
Psoriasis is known to be a waxing and waning disease. There may be considerable variations in a severity from person to person and in any one person from time to time. The extent of skin involvement varies from a few patches in the majority of cases, to widespread and serious eruption. A type of psoriasis, erythrodermic psoriasis is generalised, affecting the entire skin and requires intensive medical and nursing care.
Psoriasis has a tendency to persist and recur. It can be an economic and social burden. Widespread ignorance of the public and misconceptions about the disease result in social avoidance and embarrassment in people with psoriasis. This may lead to social withdrawal and feelings of isolation, depression and defensive shyness. Sometimes the psychological suffering can be more severe than the physical suffering.
Sometimes, psoriasis patients may lose the condition naturally for long periods of time and completely on occasions. Careful planning and good compliance with treatment may leave the patient with minimal or no skin lesions for several years after completion of treatment.
Long term treatment is usually necessary and multiple visits to the clinic may be required. Psoriasis by nature responds slowly to treatment. Severe psoriasis may require hospitalisation. Please see Treating Psoriasis.
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