Getting a rash is usually a common thing many people experience at least once in their lifetime. But not all rashes are harmless and will go away on their own. According to Dr Sherene Kalloo because of certain genetic factors and certain triggers some people's seemingly harmless rash can actually be psoriasis.
She said, "Psoriasis is a chronic non-contagious autoimmune disease which affects 2-3 per cent of the world population. This disease affects skin cells causing them to grow rapidly; building up excess layers which do not shed easily. People who suffer with psoriasis have an increase risk for stroke, arthritis, high blood pressure, high cholesterol and depression. You can also experience Crohns disease; an inflammatory bowel disease that can be quite painful and debilitating. There are different types of psoriasis and according to type and where it is located and the extent of the rash will determine treatment."
According to Dr Kalloo, Plaque psoriasis is the most common psoriasis that usually present in the form of a silvery, scaly rash. It is usually localised to one spot; be it the knees, back of the elbows, scalp and lower back. In 50 per cent of cases the nails are usually affected by the appearance of little holes also referred to as pits. Often times these symptoms can also be detected by a manicurist, she said.
"Guttaee, Pustular, Inverse and Erythrodermic are other forms of psoriasis. People with Guttae psoriasis usually have large areas of skin with small teardrop-like lesions that has tendency to stick mainly to the torso area. With Pustular psoriasis certain areas of the body have yellow pustular lesions that are unsightly but not infectious. While many people often associate psoriasis with a silver scaly rash this is absent with Inverse psoriasis. People who have this condition often notice a red rash appearing in the folds of the skin," she said.
"Unlike the other types of psoriasis, Erythrodermic psoriasis is a potentially life-threatening disease. Affecting the entire body including the body's ability to regulate its own temperature, it can also lead to heart failure," Dr Kalloo said.
"Psoriasis is one of the oldest and most common diseases which date as far back as ancient Egypt. Back then those who suffered with the disease used all sorts of remedies. From arsenic to cat urine their attempts to find a cure for the disease only resulted in ways to ease some of the symptoms but not completely eradicate them," she said.
"I must stress that psoriasis is not contagious. It is not an infection. It may look terrible but you can't get it from another person. People with psoriasis usually have poor self image and often have psycho-sexual concerns and a fear of public rejection," she added.
"In normal skin it takes between 26-28 days for the cells from the basal layer to reach the surface to be cast off. In a person with psoriasis, it happens in three or four days and does not cast off easily. This in turn causes thicken white silver scales. In a dark skin individual it looks greyish white. Beneath the scales lies a very vascular skin that can bleed easily when scratched. This is one way in which psoriasis can be diagnosed," she said.
"Another way is to take a biopsy of the skin. Doctors usually look for Rete pegs. If they are present then the person has psoriasis," she added.
"What causes the disease is still unclear however a family history of the disease and certain triggers in some patients are said to bring on the disease," she said.
According to Dr Kalloo these triggers would vary from individual to individual and they are as follows:
-Stress - Dramatic life changes can bring on the disease
-Skin injury - A bite, burn, vaccine, tattoos, acupuncture or any form of skin trauma- even surgery
-Infection - After a strep infection
-Medication - Once you are on anti-hypertensive medication like Atenolol, Inderal, Enalapril and you get a rash you should suspect it maybe psoriasis. Pain tablets like Indocid can also trigger it. People on Lithium to treat bi-polar disorders are also at risk for developing the disease.
-Changes in the weather - Cold weather and even working in an air-condition environment can trigger psoriasis
-Smoking and alcohol use can also aggravate the condition.
Women who become pregnant see improvement in their condition however after the delivery their psoriasis tends to worsen, she said.
"If you have one parent that has psoriasis, there is a 10 per cent chance that your child would get the disorder. If you have two parents with psoriasis, there is 50 per cent chance your child would get the disorder. There is unfortunately no cure for psoriasis, only ways of managing it," Dr Kalloo said.
"Treatment of psoriasis depends on the type of psoriasis and the severity of it. If it affects less than three per cent of the body, you have a mild case. If it affects between 3-10 per cent of the body you have a moderate case and greater than 10 per cent it is severe," she said.
"Most cases are treated with moisturising and emollient creams however if the psoriasis is on the scalp, patients would use various moisturising shampoos. Most patients are told not to use hot water when bathing since it can aggravate their condition. With more severe cases, steroid creams and moisturising creams are also used to peel the layers of skin and reduce the cell turnover. Light therapy also helps. Spending some time in the sunlight or going under special ultra-violet lamps used by some physicians can also assist with treatment," she said.
According to Dr Kalloo it is important to note it is important to have a balanced diet. Some studies show that cod liver oil as well a vegetarian diet may help some individuals. Get adequate sleep, drink plenty of water, deal with stress and learn your trigger factors can better help you treat the disease.
"Recently a new biological treatment has come on the market which is more specific targeting the immune response like Humira which comes in the form of injections however there are some restrictions. Psoriasis can easily be mistaken for other diseases so it is important to seek advice from your physician before starting any treatment," Dr Kalloo said.