All about Psoriasis
Psoriasis is a chronic skin disease that causes red, scaly plaques anywhere on the body. It can decrease the quality of life, but there are effective treatments to control it.
How is psoriasis diagnosed?
Psoriasis is a disease that usually is diagnosed by examining the affected skin. The difficulty in psoriasis is to distinguish it from other skin diseases. Usually the physician will be able to recognize psoriasis by examining your skin closely, but sometimes a small piece of skin (biopsy) may be needed in order to examine it in greater detail under a microscope. Unfortunately, not all general practitioners are familiar with the various forms of psoriasis, and oftentimes a dermatologist is needed to confirm the diagnosis.
To support the diagnosis of psoriasis, the doctor will ask you questions about your family history, that is, if other people in your family have psoriasis.
It is also very important for you to tell the doctor in case that you suffer back pain or pain in other joints and stiffness.
How is evaluated the psoriasis’ severity?
The doctor will examine the skin throughout the entire body for two purposes. First, to make sure that the spots are in fact psoriasis and second, to determine their intensity (grade of redness, flaking, etc.) and extension (the percentage of affected skin). Intensity and extension are two of the factors that the doctor uses to determine the severity of psoriasis. These are usually combined in indexes and scales. Some of the indexes most used by dermatologists are PASI (psoriasis area and severity index) and BSA (body surface area).
Equally important is to find out the psychological toll that psoriasis takes on your quality of life; and how it impacts your physical and psychological well-being and your social relationships. As this is something only the patient knows, the doctor will conduct a series of questions and ask you to fill in a quality of life questionnaire.
Based on these factors, Psoriasis can be classified from mild, moderate to severe. Your doctor needs to ascertain the type and grade of your psoriasis to determine what the best medical treatment for your condition is, and to evaluate how psoriasis responds to such treatment over time.
References
- European Academy of Dermatology and Venereology (EADV). Psoriasis, a closer look [Internet]. 2019. Available at: https://eadv.org/cms-admin/showfile/9635-EADV%20PSORIASIS-1-A%20closer%20look.pdf
- National Institute for Health and Care Excellence (NICE). Psoriasis: assessment and management. Clinical guideline [CG153] [Internet]. 2012 [Updated 2017]. Available at: https://www.nice.org.uk/guidance/cg153/resources/psoriasis-assessment-and-management-pdf-35109629621701
Frequently asked questions about psoriasis
Psoriasis affects more than 60 million people worldwide.
It affects men and women equally and occurs more commonly in adults than in children. Psoriasis can occur at any age. While some studies indicated the average age of onset for psoriasis was 33 years of age, and 75% of cases occurred before 46 years of age (93), others suggested that the onset of psoriasis was bimodal with two peaks of the disease – the first between 16 and 22 and the second between 57 and 60 years of age.
Psoriasis has a hereditary component. That is, if you have psoriasis, your child is more likely to have it than other people. However, there are other factors that also play a role. The most important risk factors for psoriasis are obesity, smoking, alcohol use, infections, stress and some drugs.
No, psoriasis is not contagious, neither by contact nor by any other transmission mode.
Psoriasis cannot be cured. At present, there is no treatment that cures psoriasis. However, there are many medications that control the symptoms and allow you to lead a normal life.
Most people have mild psoriasis that is controlled with certain measures (such as hydrating the skin daily) and topical medications.
However, in some people, the disease affects a larger skin area or the joints or has a significant impact on the sufferer’s well-being and quality of life. In these cases, psoriasis may require other medications, either in tablets or in an injected form. Adequate and effective treatments are available for each person and for each type of psoriasis.
Psoriasis is a visible disease and because of that it can affect your quality of life. However, it does not impact all the people in the same way. It depends on many factors, such as the extension and intensity of the disease, the social environment and the personality of the sufferer. Anxiety and depression are frequent. To improve your quality of life, it is important for you to follow the treatment prescribed by your doctor, to maximize remission times and reduce the risk of other psoriasis-related diseases.
It is not known. It is impossible to predict how psoriasis will evolve in a specific person, or how long the flare-ups and remissions will last.
The doctor will adjust treatment based on disease course.
To date, diet has not been shown to be a risk factor to develop psoriasis. Therefore, there is no known food that causes psoriasis. Moreover, there is no scientific evidence to support a "diet for psoriasis".
However, it should not be forgotten that obesity is in fact a risk factor for psoriasis. Hence, following a hypocaloric or low-calorie diet to lose weight is beneficial for overweight people. In addition, psoriasis can be associated with cardiovascular diseases, and, therefore, a healthy, balanced and beneficial diet for the heart, such as a Mediterranean diet, is highly recommended.
Furthermore, if you have psoriasis and celiac disease, eliminating gluten from your diet can improve psoriasis, according to the National Psoriasis Foundation, which, on the other hand, does not recommend this type of diet in people without gluten intolerance.