AI Summary Overview
What is Psoriasis?
Psoriasis is a long-term autoimmune condition that occurs when your immune system becomes overactive and makes skin cells multiply faster than normal. The cells do not naturally shed, but build up on the skin, causing patches that are red, discoloured, flaky and itchy. The patches are most often found on the scalp, elbows and knees but can develop on other parts of the body, too.
It should be noted that psoriasis is not transmissible from one person to another through contact. The condition can vary in severity from person to person. Some may see mild, localised patches, and others may suffer from more widespread symptoms that affect their daily lives.
What are the Types of Psoriasis?
There are 5 main types of psoriasis, and it is possible for a person to have more than one type at the same time or experience different types over the course of their lifetime.
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Plaque Psoriasis
Plaque psoriasis is the most common type of the disease, affecting 80% of patients. The patients get inflamed patches of skin that are itchy and painful, typically covered with scales. Depending on a person's skin tone, these patches may look red with silvery-white scales or appear more purple in colour.
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Inverse Psoriasis
Inverse psoriasis affects about one in four people living with psoriasis. Unlike other types, it does not produce scales. The patients see smooth, deep-red or darkened patches of inflamed skin. It is usually seen in areas prone to friction and sweating, often triggered by fungal infections.
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Guttate Psoriasis
Guttate psoriasis is most commonly seen in children and young adults and affects roughly 8% of people with psoriasis. It is often triggered by a bacterial infection, most frequently strep throat. The patches appear on arms, legs, and torso, but can develop on other parts of the body as well.
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Pustular Psoriasis
This type of Psoriasis affects only about 3% of patients. It causes painful pustules surrounded by inflamed or discoloured skin. It may be limited to specific areas such as the hands and feet, or, in some cases, it can spread across a larger portion of the body.
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Erythrodermic Psoriasis
This is the rarest form of Psoriasis, occurring in approximately 2% of patients, but it is also the most severe. It can cause intense redness, discolouration, and shedding of the skin in large sheets. Because of how serious this type can be, it is important to seek medical attention immediately if an erythrodermic flare occurs.
How Common is Psoriasis in India?
Psoriasis is more widespread than many people realise. According to data, an estimated 2.9 million people in India are affected by psoriasis. In fact, India is one of the countries with the highest number of people living with the condition. It was observed that the disease was less prevalent in children, mostly affecting adults.
What are the Symptoms of Psoriasis?
The symptoms of psoriasis can vary depending on the type a person has. Here is a quick look at the key symptoms associated with each type:
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Symptoms of Plaque Psoriasis
- Swelling in the affected joints
- Raised, inflamed patches of skin that are itchy and painful, most commonly on the scalp, elbows, knees, lower back, and around the belly button.
- Dry, scaly skin on the patches.
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Laboratory Tests
- Smooth, inflamed patches of skin without scales, affecting the skin folds of the underarms, under the breasts, in the groin, and on the buttocks.
- Severe itching and pain.
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Symptoms of Guttate Psoriasis
- Small, round, drop-shaped spots, typically appearing on the arms, legs, and torso
- Spots that are red or discoloured due to inflammation.
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Symptoms of Pustular Psoriasis
- White, pus-filled bumps called pustules, commonly on the hands and feet, though they can spread across a larger area of the body.
- Inflamed or reddened skin surrounding the pustules.
- Pain and tenderness in the affected areas.
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Symptoms of Erythrodermic Psoriasis
- Intense redness or discolouration on most of the body.
- Shedding of skin in large sheets.
- Severe itching and pain.
- Changes in heart rate and body temperature.
- Dehydration and nail changes.
What Causes Psoriasis?
The exact cause of psoriasis is not fully understood. Research indicates that a combination of genetic, immune system, and environmental factors can cause it. In people with psoriasis, the immune system mistakenly attacks healthy skin cells, triggering an overproduction of new ones.
Here are some factors that can trigger psoriasis:
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Scratches, sunburns, bug bites, and even vaccinations.
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Infections that affect the immune system, such as ear infections, bronchitis, tonsillitis, or respiratory infections, can bring on or worsen symptoms.
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Lower temperatures and reduced humidity can dry out the skin and trigger flare-ups.
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Certain foods and allergens may act as triggers in some individuals.
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Alcohol consumption has been linked to triggering or worsening psoriasis in some people.
Risk Factors of Psoriasis
Psoriasis can develop in anyone, regardless of age or background. However, certain factors can increase the likelihood of developing the condition:
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Genetics: Having one parent with psoriasis increases the risk of developing it, and having both parents with the condition increases that risk even further.
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Smoking: Smoking tobacco not only raises the risk of developing psoriasis but can also make the condition more severe in those who already have it.
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Viral and Bacterial Infections: Recurring infections like influenza, bronchitis, sinus infections, and strep throat can increase the risk of guttate psoriasis.
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Obesity: If you are overweight, the risk of psoriasis onset increases. Existing symptoms can also worsen due to weight gain.
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Medications: Certain medicines, like antimalarial drugs, beta-blockers, and lithium, can cause psoriasis flare-ups or make existing symptoms worse.
What are the Complications of Psoriasis?
The inflammation caused by psoriasis can affect other organs and tissues as well. When you have psoriasis, you have a higher risk of developing other conditions mentioned below.
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Psoriatic Arthritis: A condition that causes pain, stiffness, and swelling in and around the joints, affecting one in three people with psoriasis.
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Eye Conditions: Psoriasis has been linked to certain eye problems, including conjunctivitis, blepharitis, and uveitis.
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Obesity: People with psoriasis have a higher risk of developing obesity.
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Type 2 Diabetes: The chronic inflammation associated with psoriasis can increase the risk of developing type 2 diabetes.
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High Blood Pressure: Psoriasis is associated with a greater likelihood of high blood pressure.
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Cardiovascular Disease: The condition can raise the risk of heart-related problems.
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Other Autoimmune Diseases: People with psoriasis may be more susceptible to other autoimmune conditions such as coeliac disease, multiple sclerosis, and Crohn's disease.
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Mental Health Conditions: Living with a visible, chronic condition can be emotionally challenging. People with psoriasis are at a higher risk of experiencing low self-esteem and depression.
When Should I See My Healthcare Provider?
If you notice any symptoms that may indicate psoriasis, such as raised, scaly patches on the skin, persistent itching, or unusual skin discolouration, it is advisable to consult a healthcare provider promptly.
If you are already diagnosed with the condition, visit a dermatologist if:
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The skin patches become severe or spread to larger areas of the body
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The condition causes significant discomfort or pain.
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You feel distressed about the appearance of your skin or feel under-confident.
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Symptoms do not improve even after regular treatment.
How is Psoriasis Diagnosed?
There is no single test to diagnose psoriasis. A dermatologist needs to examine your skin condition and diagnose it. Here is what the process generally involves.
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Physical Examination
The dermatologist will begin by examining your skin, nails, and scalp for visible signs of psoriasis. They will look for characteristic features such as thick, raised plaques or fine scaling and take note of where on the body these appear, as certain areas are more commonly affected than others.
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Medical History and Questions
Alongside the physical examination, the dermatologist will ask a series of questions to better understand your situation. These may include whether you have symptoms such as itchy skin, nail changes like thickening or yellowing, joint pain or stiffness, a family history of psoriasis, or any recent life changes such as an illness or a period of increased stress.
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Skin Biopsy
Sometimes, a dermatologist can recommend a skin biopsy for a better diagnosis. In this test, a small piece of skin is removed and analysed under a microscope to confirm the diagnosis.
Psoriasis During Pregnancy
Psoriasis does not affect your chances of getting pregnant. However, managing the condition during pregnancy can be complex. Here are some things you need to take care of during pregnancy:
Some of the most commonly recommended treatment approaches include:
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Comorbidities: Psoriasis is associated with several conditions that can occur alongside it, some of which may worsen during pregnancy. These include high blood pressure, metabolic syndrome, type 2 diabetes, obesity, cardiovascular disease, depression, inflammatory bowel disease, and eye inflammation (uveitis). Since some of these conditions are also more common in pregnancy, treatment requires extra care and close medical supervision.
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Pregnancy-safe Medications: It is important to speak with your doctor about your medications before trying to conceive, as some psoriasis treatments are not safe to use before or during pregnancy or while breastfeeding. Your doctor will be able to suggest suitable alternatives.
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Specialised Treatment: In larger hospitals, specialised clinics for patients with psoriasis during pregnancy are often available, and your clinician can refer you if needed.
What is the Prognosis of Psoriasis?
Psoriasis is a lifelong condition, and its symptoms may come and go throughout a person's life.
Like many chronic diseases, its impact extends beyond physical health. It can affect emotional well-being, personal relationships, and the ability to manage stress. In some cases, it may even influence everyday choices such as skincare routines and clothing preferences.
Living with psoriasis can be challenging, but it is entirely possible to lead a fulfilling life with the right approach. Managing stress, prioritising mental health, eating a balanced diet, and staying physically active can all make a meaningful difference in how the condition affects day-to-day life.
Does Health Insurance Cover Psoriasis?
Psoriasis is generally covered under most health insurance plans in India. However, the terms of coverage can vary depending on when you were diagnosed and the specific insurer you are with.
If you already have psoriasis at the time of purchasing a policy, it will be treated as a pre-existing condition and will typically be covered after a waiting period, which generally ranges from 2 to 3 years. Some insurers also offer an optional add-on cover that allows you to reduce this waiting period by paying an additional premium.
If your psoriasis was diagnosed after purchasing your policy, it will be covered after the initial waiting period of 30 days from the commencement of the policy. It is always advisable to read your policy documents carefully and check directly with your insurer to understand the exact coverage and conditions that apply to you.
How Much Health Insurance is Needed for Psoriasis Treatment?
Since psoriasis is a long-term condition, it often requires ongoing treatment and regular medical attention. The yearly cost of managing the condition, including doctor visits, medicines, and treatments, can range from ₹50,000 to ₹1.5 lakh, depending on your location, the healthcare provider you consult, and the type of treatment recommended. A health insurance cover of around ₹5 to 10 lakh is generally considered adequate to manage these expenses comfortably.
FAQs
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Q1. What is the main cause of psoriasis?
Ans: Psoriasis is an immune system disease. This happens when the immune system attacks healthy cells in the skin, causing them to multiply much more rapidly than normal. -
Q2. Is there a cure for psoriasis?
Ans: At this time, there is no cure for psoriasis. But it can be controlled with the right treatment plan, which may include topical medication, light therapy, oral medicines and lifestyle changes. -
Q3. How can one minimise psoriasis?
Ans: If you have psoriasis, staying moisturised, avoiding known triggers such as stress and cold weather, following your prescribed treatment plan and making healthy lifestyle choices such as maintaining a healthy weight and staying active can all help to minimise flare-ups.
