Plaque psoriasis is characterized by inflamed skin structure that is reddish and scaly on the skin. This disease is inherited and develops throughout the body due to lowered immunity. Actually it is not a skin disease but a disorder in the immune system. The immune system is responsible for protecting the body against diseases and infections. But in people affected with psoriases, the immune cells produce excess of protein called tumor necrosis factor which causes rapid growth of skin cells. These appear in the form of raised lesions or red patches called plaque psoriasis.
The exact cause of this disease is not known, but it is believed to be caused due to hereditary and environmental factors. Certain types of mutated genes are inherited by birth causing this skin condition as the child grows. Often, some environmental factor like bacterial infection is enough to activate the mutated gene causing lowered immunity. Hence individuals who are genetically susceptible to this disease if exposed to unfavorable environment or skin injury, it can cause plaque psoriasis.
The white blood cells contain T lymphocyte which is responsible for fighting and destroying foreign particles on the body. But in people affected with psoriasis, these T cells affect and kills the healthy skin cells causing wound and infection on the skin, leading to plaque formation. The T- cells multiply larger in number causing more harm to the skin cells. Eventually this will lead to the production of healthy skin cells which rapidly move to the upper layer of the skin forming patches. The new skin cells will not wait for the dead cells to wither; instead they are formed over the dead cells causing red scaly patches called plaque.
What factor causes increased production of T cells in certain people is not known. Some doctors believe that psoriasis get triggered by stress, strep throat infection, smoking and exposure to cold weather.
Plaque psoriasis is marked by scaly red patches or bumps on the skin. The patches are covered with silver colored scales. It lies on the uppermost layer of the skin in the form of brownish red spots which are called plaques. It would occur anywhere on the body but commonly seen on knees, elbows, and scalp and the lower back. These patches are itchy and sensitive and sometimes with burning sensation. For some people, the skin may start bleeding due to extreme dryness.
Flare-ups are increasingly seen during the time of stress or heightened emotion. Psoriasis may repeat in cycles getting better for some days and again presenting with worse symptoms. Any type of infection or skin injury may worsen the symptoms. For some people it may start as adverse effect of taking powerful drugs.
The range of symptoms may vary from one person to another. Very often plaque psoriasis may flare up for few weeks and then subside for returning with full vigor. Mild cases of this disease require no treatment but it is definitely a nuisance whereas severe cases can cause intense itching and pain sometimes disfiguring the area affected.
For people with long-term psoriasis, they are likely to develop inflammatory bowel problems, blood pressure, diabetics and even heart disease.
Your physician will easily diagnose the disease on physical examination of the affected skin. He will study its appearance and look for additional symptoms of itching and pain. Psoriasis will not only affect the skin but also the nails disfiguring them like that of fungal infection. Skin biopsy is done for getting exact picture of the disease.
Plaque psoriasis is incurable and treatment is given only for reducing the symptoms. Any small environmental factor is enough to trigger the flare-up. The method of treatment differs widely with the intensity of spread of psoriasis and the patient’s health condition. In severe cases of psoriasis, the treatment may be expensive and hazardous.
Home Remedies :
For mild form of plaque psoriasis you need not have to visit the clinic since it can be treated effectively by over the counter medications. You can use cream that contains Caldecort or Coraid for suppressing the bumps or lesions on the skin. Try using solutions that contains tar which will be effective on lesions. Tar is available in many ointments and creams and even on shampoos and hence psoriasis on scalp can be cured using medicated shampoos. Some people recommend taking sunbath for controlling the disease but you should not overdo this method causing sunburn.
Creams or ointments that contain salicylic acid or coal tar are used for treating mild forms of sunburns and psoriasis.
Any type of topical creams should be applied only after gently removing the scales or silvery patches on the skin. Otherwise, the medicine will have difficulty in penetrating through the thick layer of skin.
Medical Treatment :
The main purpose of treatment is to stop the production of T cells that induces to form several new skin cells and to remove the scaly patches from the skin. The mode of treatment can be divided basically into 3 types namely topical treatment, medications and light therapy.
Topical Treatment :
Creams that contain corticosteroids are effective in reducing inflammation and hence prescribed for controlling mild to moderate type of psoriasis. It will not only reduce swelling caused by bumps but will also suppress the immune system which attacks the healthy skin cells. Doctors would prescribe low dosage of corticosteroid for application on face and other delicate skin areas. For removing psoriasis on small areas like hands and feet, high doses are required. However using corticosteroids for long term can produce side effects like thinning of skin. Hence do not exceed the recommended dosage.
Calcipotriene cream contains vitamin D analogues for slowing down the growth of new skin cells. Usually combined form of treatment is more effective than depending on single method. Anthralin is highly recommended for reducing the production of skin cells and is also effective in removing the scaly patches. But it would cause severe stains on the skin and clothing.
Topical retinoid like Tazorac Avage is given for controlling skin damage which would reduce DNA activity of skin cells but it is sensitive to sunlight. Hence you need to apply sunscreen lotion while using this cream. Prograf and Elidel are calcineurin inhibitor are given for treating severe forms of psoriasis and is effective in reducing plaque formation.
Sunlight is considered as a natural medicine for treating psoriasis. The UV rays of the sun is effective in destroying new T cells but one should be careful while taking sunbath, failing which it would cause severe sunburn. Mild doses of UVB light is emitted on the psoriasis affected areas of the skin which would control psoriasis. You need to repeat this process of UVB therapy for 2-3 times a week for getting positive results.
Sometimes, a combination of UV therapy and coal tar therapy is given which is called Goeckerman therapy. Usually this type of treatment has to be taken as in-patient. Photo-chemotherapy is a process in which psoralen is allowed to penetrate the skin before it gets exposed to Ultra Violet rays, so that the skin becomes more responsive for the treatment. Long term method of this treatment can cause skin cancer. Laser therapy is also used for destroying the new T cells which is responsible for causing plaque.
The doctor will combine medication with light therapy for getting the best outcome.
Images, Pics, Photos and Pictures of Plaque Psoriasis :
Retinoid, corticosteroid, methotrexate are given orally or through intravenous injection for severe form of psoriasis. Retinoids may cause serious side effects like birth defects and hence women who are planning for pregnancy should avoid using retinoid.
In addition, cyclosporine is given by doctors for weakening the immune system that destroys healthy skin cells.
It is difficult to prevent plaque psoriasis but people who are prone to this disease should not expose the skin to factors like sunlight or traumatic condition which would trigger psoriasis.