Psoriasis (Psoriasis)

What is psoriasis?

Psoriasis is a disease that is common in the community and usually lasts for a long time with attacks.
It manifests itself in various appearances. In the most common type of plaque (psoriasis vulgaris),
psoriasis, which can be separated with a sharp border, covers the raised redness of the skin and gives the disease its name
or silver-colored dandruff (flakes) are typical.

In which parts of the world does psoriasis occur? What is the frequency?

Psoriasis is a common disease all over the world. However, the disease has some geographic
may occur more frequently or less frequently. Again, the frequency varies from one population to another.
can show. In general, the incidence of the disease is due to genetic and environmental factors.
considered to be affected. Psoriasis is more common in cold northern climates than in warmer tropical regions.
occurs more frequently. In America and Europe, the disease is seen in approximately 2 out of every 100 people. This
However, the incidence is lower in African and Asian countries, and it occurs in 1 person out of every 100-200 people.
is seen.

Psoriasis is more common in which gender?

Psoriasis occurs at approximately equal rates in men and women.

At what age does psoriasis occur?

Psoriasis, which can occur at any age, most often begins between the ages of 20-30. Beginning
According to age, the disease can be examined in 2 groups. Early on when psoriasis starts before age 40
Onset is considered as late-onset psoriasis if it starts after the age of 40.
Early-onset psoriasis tends to be more severe. Again, this type of psoriasis in the family
disease is more common.

What are the causes of psoriasis? Who is it seen in?

The cause of the disease is not fully known. Immune system, genetic and environmental factors of psoriasis
It is thought to develop as a result of the interaction of factors. The immune system in the development of psoriasis
Plays an important role. T cells, one of the main elements of the immune system, enter the skin through blood vessels.
The cells called keratinocytes, which reach the epidermis layer, which is the top layer of the skin, reach faster.
leads to reproduction. While the epidermis normally renews itself in 1 month, this period is 3-5 in psoriasis.
day descends. This rapid cell proliferation results in flaking of the psoriasis skin. immune system and T
It is not known what activates the cells. Genetic factors in general who have the disease
determines its development. Many genes are thought to be responsible for the development of the disease. psoriasis
Frequent occurrence of the disease in close relatives is an important clue pointing to genetic predisposition. Various
environmental factors (throat infections caused by streptococci, some medications, scratching, bathing
physical traumas such as scaling, etc.) in which the disease begins or exacerbations develop
is considered.

What are the factors that play a role in the development of attacks of psoriasis?

The following factors play a triggering role in individuals prone to psoriasis; physical traumas;
Activities such as scratching, rubbing or picking, applications such as rubbing or scrubbing in the bathroom, psoriasis
attacks or exacerbate existing symptoms. Trauma of psoriasis
Its development in damaged skin is called the “Koebner phenomenon”. Sunlight; Moderate in most patients
Sunlight improves the symptoms of disease. Therefore, the symptoms may be alleviated in the summer months. Despite that
In some patients, excessive sunbathing or sunburn may cause attacks of the disease.
Infections; A special form of psoriasis, especially 1-2 weeks after streptococcal throat infections
guttate psoriasis may occur. Plaque type, which is the most common form of the same microbe disease
It may also play a role in attacks of psoriasis. mental stresses; In some patients, psoriasis
A history of intense mental stress can be taken at the onset or before its aggravation. One of the patients
Exclusion or treatment of this factor will help in relieving the symptoms of the disease.
is happening. Medicines; Some drugs can lead to the development or exacerbation of the disease. Oral
or intravenous cortisone, malaria drugs, lithium used in mental illnesses, blood pressure
beta blockers, drugs such as interferon, which is used in many diseases, painkillers
are some of these drugs. Cigaret; In some patients, smoking may cause the development of the disease or existing
can cause psoriasis to attack. Alcohol; Excessive alcohol consumption leads to attacks of the disease.
can open.

Is psoriasis a contagious disease?

It is not a disease caused by microbes. That’s why you don’t have to infect someone else with your disease.
is not the subject.

Is psoriasis hereditary?

Psoriasis is not an inherited disease. However, there is a genetic predisposition for the disease.
This means that the incidence of psoriasis in individuals with close blood ties is higher than that of other people in the community.
more than individuals. Studies have shown that 1 in 3 patients with psoriasis
shows that psoriasis is present in family members with close blood ties. As a result,
susceptibility to psoriasis can be passed on from parents to children. However, this child will have psoriasis.
Does not mean.

What are the symptoms of psoriasis?

Psoriasis Vulgaris (Plaque Type Psoriasis)

It is the most common clinical form of psoriasis. Plaque psoriasis in 8 or 9 out of 10 psoriasis patients
disease is seen. Oval or round, separated from solid leather by a sharp border, silver on
Pink, red symptoms with flakes are seen. Placement in almost every area of ​​the skin
The most common localization areas are the knees, elbows, scalp, and lower back.
Symptoms may be minor at first; these may coalesce or grow towards the periphery to become large and diverse.
They cause blistering symptoms on the skin. Psoriasis is sometimes located in the usual localities.
on the contrary, such as armpit, groin, under the chest, between the hips, back of the knee, inner surface of the elbow and neck.
may be located in the fold (fold) areas of the body. This form of the disease is Inverse Psoriasis.
(psoriasis inversa) 3 is called. Redness is more prominent in inverse psoriasis, whereas scaling is evident.
is uncertain. Palmoplantar when the typical symptoms of psoriasis are located on the palms and soles
It is defined as psoriasis. In this clinic, skin thickening and scaling are prominent. these last two
The particular picture may be more resistant to treatments. In the scalp location (scalp psoriasis);
usually without pruritus, with a red background, sharply demarcated from firm-appearing skin, overlying
Symptoms covered with scales larger than thick and simple dandruff are seen. Usually leads to hair loss

does not open.

Guttate Psoriasis (Psoriasis Guttata)

Mostly on the upper half of the body, on the parts of the arms and legs close to the body, raindrops
sized (less than 1 cm), round or oval, pink, red in color, raised on the skin
signs of flaking are seen. It is frequently seen in children and adolescents. Especially
It may develop 1-2 weeks after streptococcal pharyngitis (throat infection) or a viral infection.
It can also appear as an acute exacerbation of pre-existing plaque-type psoriasis. Symptoms
It usually regresses in a few weeks, sometimes within 3 months.

Erythrodermic Psoriasis

Psoriasis covers more than 80% of the entire body. During the active stages of the disease
psoriasis becomes generalized under the influence of triggering factors (medication, excessive sunlight, trauma, infection, etc.),
It can cover all skin, including the face and nails. Psoriasis has all the symptoms; However, the redness
prominent feature. This severe form of psoriasis is seen in 1-2 out of every 100 psoriasis patients. This
Patients usually need close follow-up and treatment in hospital conditions.

Pustular Psoriasis

In this clinical form, pus-filled pimples are found. Symptoms may develop over the typical plaques of psoriasis.
It can also occur directly on intact-looking skin, such as 2-3 with red halos around it
Pimples with pus with a diameter of mm are typical. This picture has 2 different clinical appearances; Palmoplantar pustular
psoriasis; Symptoms are localized on the palms of the hands and soles of the feet. It is considered to be closely related to smoking.
is done. Diffuse pustular psoriasis; It is common in the body, especially in the fold areas.
indicates placement. General disease symptoms such as fever, malaise, joint pain in diffuse pustular psoriasis
can also be seen. Hospitalization and follow-up may be required. Psoriasis of the Joints
(Arthropathic Psoriasis) An inflammatory disease involving joint surfaces, joint ligaments, tendons, and joint membrane.
is the table. It occurs in about 2 out of every 10 psoriasis patients. It is often seen in the 40s.
Complaints may be limited to a single joint (knee joint, hip joint, etc.). In the majority of patients,
Similar to rheumatoid arthritis, more than 5 joints are affected, especially the hand joints. pain in joints,
redness and swelling are observed. Psoriasis skin anywhere on the body in most patients
has symptoms. Nail involvement is common in the joint involvement of psoriasis. Still
current information, joint involvement is more common in patients with psoriasis in the scalp and inter-hip region.
indicates that it is seen.

Nail Changes in Psoriasis

In psoriasis, about half of the patients are affected by the hands, and in 1 out of every 3 patients, the toenails are affected.
As mentioned above, it is more common in patients with joint involvement. Bulk on nail surface
Pinhead-sized pits are typical for the disease. Separation of the nail from its bed (onycholysis),
yellowish discoloration (oil stain appearance) under the nail plate, loss of nail and free nail
Thickening of the skin under the part of the skin is another nail changes that can be seen in psoriasis.

What is the course of psoriasis?

Psoriasis usually has a long-term course with unpredictable attacks and periods of remission.
is following. In about 1 out of every 3-4 patients, the disease may disappear completely. psoriasis
the guttate form tends to last shorter. The symptoms and severity of the disease can vary from person to person or even the same.
It can change in person over time. In general, the severity of the disease over time (advanced age)
shows a decrease.

Does pregnancy (hormonal factors) affect the course of the disease?

Psoriasis patients can become pregnant. The effect of pregnancy on the disease is highly variable. However, the same
The effect of recurrent pregnancies on the disease in the individual is similar. disease in general
tends to improve over time. Psoriasis usually regresses with attacks after birth.
returns. Sudden pustular psoriasis attack in a very small proportion of patients during pregnancy
can develop. It is absolutely necessary to determine whether the drugs used during pregnancy and breastfeeding are safe.
doctor should be consulted.

Does psoriasis cause other organ diseases?

Some of the psoriasis patients also have additional diseases. Even psoriasis is just below
may contribute to the development of additional diseases given; cardiovascular diseases; in recent years
Studies have shown that some patients with severe psoriasis predispose to cardiovascular disease.
indicates that these factors are common. In these patients, high blood lipids, high blood pressure and
diabetes is more common. Obesity (obesity); Obesity in psoriasis patients
is seen more frequently. Inflammatory bowel diseases; Inflamed bowel called Crohn’s disease
disease is more common in psoriasis patients.

How is psoriasis diagnosed?

Diagnosis is usually made by clinical findings. Taking a small piece of the skin retained in diagnostic difficulty
The diagnosis can be confirmed by histopathological examination (skin biopsy).

How is psoriasis treated?

There is no definitive treatment for psoriasis today. However, in recent years, the
With the increase in our knowledge, the use of new and more effective treatment options, the disease is getting worse.
can be treated effectively. Psoriasis can be controlled with appropriate treatment and
long periods of well-being can be achieved. In the treatment of the disease, the parties (physician, patient and patient)
It is an inseparable part of the treatment to be in cooperation (with relatives) and to strive in harmony.
The effect of many triggering factors mentioned above on the disease should be considered. You
Psoriasis patients should avoid any application that may exacerbate the disease (scratching, rubbing in the bathroom, scrubbing, etc.).
you should definitely avoid. 5 Less side effects in the most common limited psoriasis
Local treatment methods are preferred primarily because of its ease of application and ease of application. Local
the most commonly used drugs in the treatment; keratolytics (drugs that remove dandruff from the skin surface),
corticosteroids, anthralin, calcipotriol (synthetic vitamin D), calcineurin inhibitors and phototherapy (UVB).
Depending on the age of the patient, compliance with the treatment, the extent and duration of the disease, these treatment methods can be used.
one or a combination (the combination of different treatments) is chosen. widespread, resistant to local treatments
Methotrexate, cyclosporine-A and retinoids are the main systemic treatments used in patients with involvement.
is coming. Apart from these treatments, a widely used and highly effective application is PUVA therapy.
PUVA, ultraviolet A (UVA) 2 hours after oral Psoralen
radiation is applied in certain doses. In recent years, biological agents (infliximab, adalimumab,
etanercept etc.) is used in cases unresponsive to the above treatments. Many treatments today

option is available. Sometimes multiple drugs are used together to relieve symptoms.
may be required. Your doctor will decide on your treatment by taking into account many parameters related to you and your disease.
regulates. The prevalence of the disease, the location of the symptoms, which are decisive in the choice of drug and the duration of treatment,
are parameters such as the severity of nail involvement and joint involvement. The treatment method and application to be chosen
The way, the duration of the treatment, the dosage of the drugs are regulated by the physician. In the treatment and follow-up of the disease
As much as it is necessary for physicians to work in knowledge, experience and cooperation, we recommend you, psoriasis patients.
Compliance with treatment is just as important.

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