Psoriasis

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 Psoriasis

Most common triggers for psoriasis and different clinical types.

Psoriasis is a inflammatory and proliferative condition of the skin. There are various

triggers that cause changes in the immune system resulting to manifestation of psoriasis .The

most common triggers include; illness such as skin infection , stress, certain medications such

as antimalarial and lithium, injury to the skin, weather changes, smoking, heavy alcohol

consumption and rapid withdrawal of systemic or oral corticosteroids. There are various

types of psoriasis and the clinical type determine the type of treatment that can be most

effective for the manifesting symptoms (Rendon & Schäkel, 2019). Psoriasis can be classified

as pustular and none pustular. The most common no pustular psoriasis include; psoriasis

vulgaris, erythrodermic psoriasis, inverse psoriasis, guttate psoriasis, psoriasis arthritis and

palmoplantar psoriasis. The pustular psoriasis include; impetigo hypertiformis, generalized

pustular psoriasis and localized pustular psoriasis.

Treatment and non-pharmacological options.

Topical therapies such as corticosteroid, vitamin D analog, retinoids and coal tear are

used in treating mild and moderate cases of psoriasis. They play a role in retaining the

hydration of the skin and improving the barrier function. Cola tear reduces the itching,

scaling and inflammation of the skin. Systemic medications are most effective in extensive

cases such as psoriasis arthritis and also when there is nail involvement. The mot common

systemic medications include; retinoids, methotrexate, fumarates and cyclosporine (Nair &

Badri, 2020). It is vital to monitors renal and liver functions and blood when administering

the systemic medications. Biological agents such as infliximab and interleukin interrupt with
the immune process of psoriasis. The biological agents should not be administered to patients

with hepatitis and tuberculosis because it increases the risk of infections.

The most appropriate medications for relapse are corticosteroids. The play a role in

reducing inflammation and suppressing the immune system and therefore slowing the build-

up and growth of cells resulting to relieve of psoriasis symptoms. Retinoid such as acitretin

can also be administered to reduce skin cell production in cases where K.B is not pregnant or

breastfeeding. Acitretin is also contraindicated in patients who are unwilling to cease blood

donation, excessive alcohol consumption, deVere renal and hepatic dysfunction and also

hypersensitivity to the drug (Stiff et al., 2018).

The most effective non-pharmacological therapy ultraviolet radiation or light therapy.

Phototherapy can also be an effective treatment especially for pregnant and lactating mothers

in addition to children and older adults because it has no any side effects (Nair & Badri,

2020). Psoralen plus ultraviolet A (PUVA) plays a role in improving the skin and therefore

improving psoriasis. Phototherapy respond best for guttate psoriasis.

Manifestation of psoriasis

The clinical presentations of psoriasis vary depending on the clinical type more than

90% of the psoriasis cases correspond to the plague type psoriasis. The various clinical

symptoms include; erythematous, sharply demarcated and pruritic scales (Rendon & Schäkel,

2019). The most common manifestations include; rashes that are covered with scales or

appear as red patches in areas of the skin, and painful and dry or itchy skin that can easily

crack and bleed. The rashes can be of different colors and can vary from brown, pink, silver,

gray or even black. The rashes can appear in any part of the body including the trunk, scalp,

and extensor surface of the limbs.

 References

Nair, P. A., & Badri, T. (2020). Psoriasis. PubMed; StatPearls Publishing.

https://www.ncbi.nlm.nih.gov/books/NBK448194/

Rendon, A., & Schäkel, K. (2019). Psoriasis Pathogenesis and Treatment. International

Journal of Molecular Sciences, 20(6), 1475. https://doi.org/10.3390/ijms20061475

Stiff, K. M., Glines, K. R., Porter, C. L., Cline, A., & Feldman, S. R. (2018). Current

pharmacological treatment guidelines for psoriasis and psoriatic arthritis. Expert

Review of Clinical Pharmacology, 11(12), 1209–1218.

https://doi.org/10.1080/17512433.2018.1548277