Psoriasis is a chronic autoimmune skin condition characterized by rapidly accumulating skin cells, leading to red, scaly plaques. It can also affect the joints, leading to psoriatic arthritis. Treatment includes topical medications, phototherapy, systemic medications, and biological agents to manage symptoms and control inflammation. The assessment of the Polygenic Risk Score for psoriasis is based on the examination of 54 gene polymorphisms.
Genetic testing for psoriasis is included along with 12 other diseases in the Genetic Screening for Immune Diseases, Polygenic Risk Score, as well as in the Genetic Screening for Sensory Organs and Skin Diseases, Polygenic Risk Score, along with 12 other diseases.
Causes and non-genetic risk factors
The new skin cells generated by the organism ascend from the deep layers of the skin to the most superficial layers where the older cells are being shed. This process, which occurs in normal conditions in a maximum of 4 weeks, in psoriasis is accelerated to 3-7 days so that the immature cells accumulate in the superficial layers of the skin, causing the associated symptoms.
The immune system seems responsible for this accelerated turnover as it directs its response against healthy skin cells, which triggers healthy skin cells to be produced faster. The exact cause of this activation of the immune system is unknown; however, in addition to the genetic contribution, several triggers or risk factors that initiate outbreaks have been described:
- Skin lesions, cuts, scratches, insect bites, sunburns
- Skin infections, respiratory infections, otitis, bronchitis, or streptococcus throat infections
- Weather, especially cold and dryness
- Excessive alcohol consumption
- Smoking and passive exposure to tobacco smoke
- Stress
- Hormonal changes, especially in women, during puberty and menopause
- Certain drugs: lithium, antimalarials (chloroquine), antihypertensives (enalapril, propranolol), antiarrhythmics (quinidine), anti-inflammatory drugs (ibuprofen, indomethacin). Also, rapid withdrawal of oral or systemic corticosteroids
- Concomitant presence of other immune disorders
Symptoms
Symptoms usually appear between 15 and 35 years of age, although it can also affect children and older people. There are several types of psoriasis: plaque psoriasis or vulgaris, the most common that mainly affects the skin; scalp psoriasis; psoriasis of the nails; psoriasis in drops, sometimes triggered after streptococcal throat infections; inverse psoriasis that affects the inguinal folds, buttocks and breasts, pustular psoriasis and erythrodermic psoriasis primarily. In addition, another entity related to psoriasis that affects the joints is known as psoriatic arthritis.
Most types of psoriasis have cycles, with flares lasting weeks or months and then subsiding or even going into remission. Signs and symptoms that can vary from person to person, but among the most common depending on the type include:
- Reddish patches of skin covered with thick, silvery scales
- Small scaly spots
- Dry, cracked skin that may bleed or itch
- Itching, burning, or irritation
- Thickened, pitted, or grooved nails
- Swollen and stiff joints
- The most commonly affected areas are the lower back, elbows, knees, legs, soles of the feet, scalp, face, and palms of the hands
Prevention
Although the causes that trigger psoriasis outbreaks are unknown, specific measures can be taken to reduce symptoms or even outbreaks:
- Keep the skin moisturized, preferably using thick creams and lotions or topicals, in case of the scalp. To help remove the scales, apply cream and cover the area with plastic or other impermeable material. Leave it on for a few hours and then remove it. Another alternative is to use humidifiers at home.
- Maintain skin hygiene to treat the development of skin infections.
- Avoid dry and cold weather as much as possible.
- Maintain a healthy weight by exercising regularly and maintaining a balanced diet rich in fruits and vegetables.
- Quit smoking and avoid areas laden with tobacco smoke.
- Avoid stress.
- Moderate alcohol consumption.
- Limiting skin exposure to sunlight.
Identifying the factors that trigger psoriasis outbreaks in each person is essential to avoid them.
