What is Psoriasis?
Psoriasis is a skin condition characterised by red, itchy and scaly patches on the skin. It is not contagious. Inflammation is also common, and the patches may crack or bleed. The patches are found on:
Common causes of Psoriasis in Singapore?
Psoriasis is a chronic autoimmune disorder where the immune system triggers inflammation that causes skin cells to multiply up to 10 times faster than the average person. Normal skin cells grow and die within a month. In psoriasis, skin cells grow within 3 - 4 days. Because the turnover isn’t fast enough, the excess skin cells build up into bumpy red patches covered with white scales.
The exact cause of psoriasis isn’t known, but it does tend to run in families, although it may skip generations.
There are some factors that could trigger an outbreak of psoriasis, such as:
- Cuts or scrapes
- Surgery
- Emotional stress
- Streptococcus infections
- Medications such as blood pressure medications or antimalarial medication
What are the common symptoms of Psoriasis in Singapore?
- Red, itchy and scaly patches on the skin
- Cracking and bleeding of the scales
- Redness around scales
- Disorders of the fingernails and toenails, such as discolouration or pitting, or crumbling and detachment from the nail bed
What are the types of Psoriasis?
- Plaque Psoriasis - This is the most common type of psoriasis. It can be itchy or painful, and is sometimes misdiagnosed as eczema. The red scaly patches are often covered with white or silver scales or plaques. These plaques are usually found on the elbows, knees and scalp.
- Pustular Psoriasis - This causes red and scaly skin with tiny pustules filled with pus on the palms of hands and soles of feet. The pustules can be painful and flaky or itchy.
- Guttate Psoriasis - This causes red, scaly, small, teardrop-shaped spots on your skin.
- Inverse Psoriasis - This causes lesions in more sensitive areas like the creases and folds of your skin, such as the armpits, the groin and between your buttocks. The lesions may be painful and can crack and bleed.
- Erythrodermic Psoriasis - This is a rare form of psoriasis that is dangerous and causes fiery red skin from head to toe. There will be scaly skin all over and peeling off of large pieces. It can hurt and itch, and there might be tiny blisters called pustules filled with pus.
What are the risk factors for Psoriasis?
Anyone may develop psoriasis, but there are some factors that increase your risk of getting it, such as:
- Family History - Psoriasis runs in families. Having a parent or both parents with psoriasis increases the risk of you getting psoriasis.
- Stress - Stress can negatively impact your immune system, making you more susceptible to psoriasis.
- Smoking - Smoking tobacco increases your risk of psoriasis, and may also aggravate the disease.
What are the treatment options for Psoriasis in Singapore?
There is no cure for psoriasis, but the symptoms of inflammation and scaling can be managed. There are treatments to flow the growth of skin cells as well as remove plaques. There are 3 categories of treatments for psoriasis:
Topical Treatments
Mild to moderate psoriasis can be treated with creams and ointments applied directly onto the skin. Such topical treatments include:
- Topical corticosteroids
- Topical retinoids
- Anthralin
- Vitamin D analogues
- Salicylic acid
- Moisturisers
Systemic Medications
Those with moderate to severe psoriasis and tried other treatments that do not work for them could need oral or injected medications. Many of these may have severe side effects, so the doctors usually prescribe them for a short period only.
Systemic medications include:
- Methotrexate - This suppresses the immune system and may cause fewer side effects when the dosage is low. It may cause serious long-term side effects such as liver damage and reduced production of white and red blood cells.
- Cyclosporine - This also weakens the immune system, so you might become sick more often. Side effects of this medication are high blood pressure (hypertension) and kidney problems.
- Biologics - These alter the immune response, preventing interaction between the immune system and inflammatory pathways. They are normally injected or given through intravenous (IV) infusions.
- Retinoids - These reduce skin cell production. However, once you cease usage, the symptoms of psoriasis will most likely return. Side effects of retinoids include hair loss and lip inflammation.
Retinoids may cause birth defects so those who are pregnant or are planning to get pregnant in the next 3 years should not take retinoids.
Light therapy
Ultraviolet (UV) or natural light can help to kill overactive white blood cells that are attacking healthy skin cells and resulting in rapid cell growth. Both UVA and UVB can be effective in the treatment of mild to moderate psoriasis. Those with moderate to severe psoriasis may stand to gain from a combination of treatments.
