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Psoriasis is a chronic (long-term), non-contagious, inflammatory skin disorder. It usually appears as small or large salmon-pink coloured plaques or lesions, with large silvery scales attached that flake off. It is common on the elbows, knees, trunk, scalp, ears and nails but can occur anywhere on the body.
Psoriasis can start at any age but is most common between 15 and 40 years of age. Its course is unpredictable but is often chronic (long-term) with exacerbations and remissions.
Prevalence and Types
There are several types and presentations of psoriasis, they can all become chronic and all share similar skin characteristics. Not all types are listed here.
Plaque Psoriasis is usually chronic and can range from mild to extensive. It commonly affects the elbows, knees and lower back, but can occur anywhere on the body. Plaque psoriasis can be triggered by skin injury, trauma to the skin or sunburn (Koebner phenomenon). It can also be triggered by infection, stress, toxicity, pharmaceutical drugs or drug withdrawal.
Guttate Psoriasis usually appears on the back or trunk following a streptococcal infection. It presents as small, widespread plaques and often resolves itself after a few months. However, it can become chronic if other triggers are present such as a weakened immune system, chronic stress or an inflammatory diet.
Inverse, or Flexural Psoriasis affects the skin folds such as under the breasts, in the armpits, under the buttocks, near the genitals or in the abdominal folds. It appears as smooth, well-defined patches and is linked to candida overgrowth (fungal infection).
Pustular Psoriasis can be a complication of chronic psoriasis or it can occur spontaneously. It appears as large red plaques with pustules that can join together to form one large pustule. It is linked to infections, sunburn, withdrawal of steroid drugs, the use of some medications, aggravating topical agents, calcium deficiency and jaundice.
Scalp Psoriasis is often the first or only site of psoriasis, and can present as itchy, flaky scalp, small or large plaques. Sebopsoraisis is an overlap of seborrheic dermatitis and often affects the scalp, face, ears and chest. It is linked to malassezia overgrowth (fungal infection).
Nail psoriasis is more common in people with plaque psoriasis and may present with ‘thimble pitting’, ridging, thickening of the nails, ragged nails, discoloration, and oncholysis (separation of the nail from the nail bed). At Auckland Skin Clinic we use products to break down the excess keratin, promote healing of the nail bed and eventually healthy regrowth of the nails.
Psoriatic Arthritis occurs in about 5-20% people with psoriasis. It can affect the toe and finger joints, especially in those with nail psoriasis. In some people it can affect a single large joint, and in others the spine and sacroiliac joints. At Auckland Skin Clinic we use specific herbal medicines to help reduce inflammation in the joints.
Causes or triggers
There are two key abnormalities in psoriatic plaques: over-production of keratinocytes (skin cells that produces keratin); and an abnormal inflammatory reaction that affects the immune function of the skin barrier.
The precise cause of psoriasis is unknown, but there is often a genetic predisposition and an obvious environmental trigger. Common triggers include immune system dysfunction, emotional stress, Koebner phenomenon caused by physical trauma to the skin (sunburn, wounds, environmental irritants), smoking, some pharmaceutical drugs (steroids, lithium, anti-malarials, beta-blockers, blood pressure medications), fungal infections, and infections caused by Streptococci or Staphylococci bacteria.
Psoriasis is our specialty at Auckland Skin Clinic. The products we use to treat psoriasis were formulated by Professor Tirant of ‘The Psoriasis and Eczema Clinic’ in Australia. He is an Integrative Dermatologist who has spent more than 30 years researching and formulating products for his patients. He had a 90% success rate with treating psoriasis in his clinic using the same products and protocols used at Auckland Skin Clinic.
Regardless of the type or the age of onset psoriasis can contribute to negative self-image and self-esteem and can be very difficult to manage on a day to day basis.
Psoriasis is a multi-factorial disease thus our approach to treating psoriasis is holistic at its essence. Safe, topical agents and body washes are used to help support healthy skin, while nutrient deficiencies, underlying infections, dietary, environmental and lifestyle triggers are identified and addressed.
At Auckland Skin Clinic, we’re aware that having a chronic skin disorder can be very frustrating, embarrassing and depressing. We are also aware that it often requires some major effort on your part to change your habits and adopt a healthy lifestyle. We do our best to ensure your emotional well-being is supported throughout this process.