Psoriasis is a chronic inflammatory disorder of the skin characterised by an increased rate of skin cell turnover. The affected skin is usually red, dry and scaly. Itching and irritation can be experienced in our climate. However, it is not an allergy or a skin infection.
Both genders are affected equally. In some patients, the disease manifest at a younger age (20s) especially if there is history of psoriasis in the family. In other patients, the disease manifest later in life (50-60s), and is usually associated with metabolic syndrome. The cause of psoriasis is partly genetic and partly environmental. Some drugs and sudden stopping of systemic steroid, may provoke the appearance of psoriasis.
Like eczema, psoriasis can affect various parts of our body, but in a different distribution. The nails also show changes like ˇ§pittingˇ¨, thickening, change of colors and shape. There is no particular sequence as to when or where they will appear. One thing of note is that injury to the skin can cause new psoriatic lesions. In rarer cases, psoriasis can occur all over the body causing diffuse redness or painful pustules in body parts. If these situations occur, contact your dermatologist immediately for assessment and treatment. Sometimes, your dermatologist needs to manage the psoriatic emergency (especially with fever) in hospital.
Sometimes, psoriasis is not just localized to the skin. It can affect joints and tendon insertion points, the spine and the eyes. Some patients feel depressed or anxious. Your dermatologist will do a detailed assessment factoring in all these conditions and manage accordingly with appropriate specialists.
Is Psoriasis contagious?
No. It is definitely not contagious. We encourage a healthy lifestyle and regular exercise including swimming.
What Treatments Are Available For Psoriasis?
Your dermatologist will first need to confirm the diagnosis of psoriasis and evaluate the severity and other comorbidities as we mentioned before in a comprehensive manner. Clinical examination is usually enough, but there have been cases where skin biopsies are performed to exclude other similar-looking conditions or during psoriatic emergencies.
So far, there are effective and safe treatments that help us bring psoriasis into good control and prevent complications. It is important to discuss openly with your dermatologist for individualized treatment plans
1. Topical Creams / Scalp Solutions
  Most people with psoriasis have mild disease and get considerable relief with moisturizing creams and ointments. These include a combination of topical steroids, non-steroidal treatment and keratolytics.
2. Phototherapy
  Psoriasis responds to ultraviolet (UV) light treatment. Regular treatments 2 to 3 times a week for a few months is required for phototherapy to be effective. Targeted phototherapy can help alleviate lesions on sensitive areas and as an add-on for resistant lesions.
3. Oral Drugs
  Your dermatologist may prescribe oral medications to effectively control psoriasis where necessary. These drugs have potential side effects. Patients who are taking such drugs will require regular blood tests to monitor for any side effects. However, we need to choose carefully for oral drugs for women planning for pregnancy. We do not advocate the long term use of systemic steroid in psoriasis because we have seen more side effects than benefits in such cases.
4. Biologics
  Biological therapy helps to control extensive or stubborn disease. They are administered as regular injections. They work by neutralizing the part of the immune system that specifically causes psoriasis (the TNF-alpha pathway, the Interleukin pathways). These drugs are very effective and have been used in the rheumatological and gastrointestinal fields. Careful screening for infection and other conditions before treatment, and close monitoring during treatment is vital.