Psoriasis is a common skin condition affecting up to 3% of the population of the United Kingdom and Ireland.
Psoriasis is an immune condition, which causes symptoms on the skin and sometimes the joints. When a person has psoriasis, their skin replacement process speeds up, taking just a few days to replace skin cells that usually take 21-28 days. This abundance of skin cells builds up to form raised ‘plaques’ on the skin, which can also be flaky, scaly, red on caucasian skin, darker patches on darker skin tones, and itchy. Psoriasis can occur on any area of the body, including the scalp, hands, feet and genitals, although different types tend to occur on different areas.
Who gets psoriasis?
The current thinking is that psoriasis affects between 2% and 3% of the UK population- up to 1.8 million people- although this is an estimate. It affects males and females equally. Psoriasis can occur at any age, although there seem to be two ‘peaks’; from the late teens to early thirties, and between the ages of around 50 and 60.
Some people with psoriasis may also get psoriatic arthritis- a type of arthritis associated with the skin condition. However, just having psoriasis doesn't mean you will get psoriatic arthritis, and not everybody who goes on to develop psoriatic arthritis necessarily has psoriasis of the skin, either.
Why does it happen?
Recent research has found that the psoriasis-causing changes in the skin begin in the immune system when certain immune cells (T cells) are triggered and become overactive. The T cells act as if they were fighting an infection or healing a wound, which leads to them producing inflammatory chemicals, again leading to the rapid growth of skin cells causing psoriatic plaques to form. You may therefore hear psoriasis being described as an “auto-immune disease” or “immune-mediated condition”. It is not yet clear what initially triggers the immune system to act in this way.
Some people will have a family history of the condition, but others may not. A flare-up of psoriasis can be triggered by a number of factors, such as stress or anxiety, injury to skin, hormonal changes, or certain infections or medications.
Can psoriasis be treated?
Yes, there is a wide variety of treatments for psoriasis, and many people find that their psoriasis can be managed successfully. However, finding the right treatment or combination of treatments can be a process of trial and error.
Is psoriasis catching?
Not at all. It can’t be passed from one person to another, nor can it be ‘spread’ across the body by touching an area of psoriatic skin to an area of non-psoriatic skin.
How will psoriasis affect me?
Psoriasis is a complicated condition that is very unique to each individual. Everyone has different ways in which they cope with their psoriasis, and the amount of skin affected by psoriasis can differ markedly from person to person. For example, someone with a relatively small amount of skin affected by psoriasis may find it difficult to come to terms with, whereas another with more affected skin may cope with it much more easily. It is important, therefore, that both the physical signs of psoriasis (how much of your skin is affected by it) and the psychological aspects of psoriasis (how you cope with the condition) are assessed together, and regularly, so that the most appropriate treatment can be prescribed.
Your healthcare professional will asses the extent of your psoriasis and ask you how your psoriasis affects you. If you have been prescribed or recommended psoriasis treatments, it is always very helpful to bring your treatments to your appointment. If you are referred to hospital, you may be assessed by the dermatology specialist who will measure your physical signs and symptoms of psoriasis using a Psoriasis Area Severity Index (PASI). This tool not only assesses how much psoriasis you have, but also the thickness of the plaques, level of scaling and the redness of those plaques. A score between 0 and 72 is calculated, with anything over 10 being classed as severe psoriasis.
How well you are coping with your psoriasis, and the impact it may be having on your daily life can be measured using the Dermatology Life Quality Index (DLQI). This is a questionnaire that you, the patient completes. A score between 0 and 30 is calculated, with anything over 10 being classed as having a severe impact on your quality of life. It is hoped that as the psoriasis is treated, both the PASI and DLQI scores would get lower.
If you are finding it difficult to cope with your psoriasis, please visit your GP, or get in touch with the Psoriasis Association for information and advice.
If you'd like to speak with others who have psoriasis, and share personal experiences and advice, feel free to register for our Connect Forum.
What should I do if I think I have psoriasis?
The most important thing to do is to make an appointment to see your GP to get the diagnosis confirmed. Many dermatological conditions can mimic each other, so it's important to make sure the diagnosis is correct. They can then begin to treat your skin, or refer you to a Dermatologist to confirm diagnosis and start treatment. You can also use the links on the left to learn more about psoriasis, or get in touch with the Psoriasis Association if you have any questions.
For further information about psoriasis, or for a list of resources used in the production of this resource, please contact the Psoriasis Association.
September 2013 (Review: Mar 2014)