Plaque psoriasis is the most common form of psoriasis , accounting for up to 90% of all cases. It is an autoimmune condition in which skin cells rapidly accumulate to form scales and dry, itchy patches that flake off .
While the underlying cause of the disease remains a mystery, there are factors that can often trigger or exacerbate an outbreak, such as obesity, stress, and smoking. Symptoms can be difficult to control, but there is an ever-expanding range of medications. It can weaken the immune response and provide significant relief.
Symptoms of plaque psoriasis
Chronic plaque psoriasis, also known as psoriasis vulgaris, usually presents as raised patches of inflamed skin covered with silvery-white scales (plaques) . Plaques are most commonly found on the elbows, knees, scalp, and back. Psoriasis can also affect the nails, causing discoloration, pitting, and even peeling of the nail from the nail bed.
The symptoms of plaque psoriasis can often be worse during an infection, when a person is under stress, or if the skin is damaged. Certain medications, such as beta- blockers and nonsteroidal anti-inflammatory drugs (NSAIDs) , can also cause symptoms. Scratching only aggravates the situation, causing bleeding and visible thickening of the affected skin .
Symptoms can come and go, often staying in remission for months or even years before flare-up for no apparent reason. In some cases, the symptoms can be cyclical or even seasonal.
Scientists do not yet fully understand the mechanisms of autoimmune diseases like psoriasis, but they believe that human genetics play a central role. About a third of people with psoriasis have a family history of the disease and evidence of chromosomal mutations in certain regions of the gene (known as PSORS1 – PSORS9).
Other causes of psoriasis , including past infections or toxic effects, have been suggested, but most are hypothetical at best.
Whatever the trigger, plaque psoriasis effectively increases the rate of skin cell production.
While normal skin cells are replaced every 28-30 days, cells affected by psoriasis are replaced every three to five days.
Because of this, new skin cells will accumulate faster than old ones can be lost. At the same time, the blood vessels under the skin will begin to enlarge in response to chronic inflammation , causing localized swelling and redness.
Plaque psoriasis is most often diagnosed by the appearance of the skin. Usually no blood tests or special diagnostic tests are required.
However, your healthcare provider will want to differentiate it from other forms of psoriasis (such as guttate psoriasis , caused by streptococcal infection or pustular psoriasis , characterized by pus-filled blisters), as well as skin conditions with similar symptoms, such as:
If a diagnosis is not made, a skin scrap or biopsy may be performed and sent to a laboratory for analysis.
Plaque psoriasis is not only uncomfortable, it can also be an unpleasant condition, sometimes undermining a person's confidence and sense of well-being. Fortunately, psoriasis treatment has advanced significantly in recent years along with a growing understanding of immunology and autoimmunity .
Plaque Psoriasis Physician Discussion Guide
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Current treatment options include:
- Topical corticosteroids that can be used continuously, but usually for no more than eight weeks (due to the risk of thinning of the skin)
- Phototherapy , which uses artificial ultraviolet light to penetrate the skin and slow the growth of skin cells.
- Non-biological drugs such as methotrexate and cyclosporine , which suppress the general immune system.
- Newer biologics such as Enbrel (etanercept), Humira (adalimumab), Remicade (infliximab), Stelara (ustekinumab), and Talz (ixikizumab) that suppress certain parts of the immune system .
- Otezla (apremilast) , approved for the treatment of psoriasis and psoriatic arthritis.
- Analogs of vitamin D3 that slow down the production of skin cells .
- Retinoids, chemical compounds associated with vitamin A that regulate skin cell production.
While plaque psoriasis can be frustrating and difficult to control, there are ways to manage the condition while you and your healthcare provider search for a sustainable solution.
The main one is stress reduction. To do this, you need to find ways to not only reduce stress in your life (for example, through yoga or meditation), but also seek professional help if you have persistent or worsening anxiety symptoms. or depression.
Diet and exercise can also help relieve inflammatory stress associated with obesity, while improving a person's mood, strength, and overall appearance .
Get the word of drug information
Plaque psoriasis often makes patients feel isolated and self-conscious. If this is you, it is important to remember that you are not alone and that literally millions of people are experiencing the same things as you.
Get started by connecting with others on Talk Psoriasis , a social media platform operated by the National Psoriasis Foundation. This is a great place to share information, ask for advice, or find support from people like you.
While there is no quick fix for plaque psoriasis, with a little support and diligence, most people will eventually control their symptoms and improve their overall quality of life.