The skin consists of layers of cells, with the top layer constantly flaking off and peeling and new cells taking their place. For reasons not completely known, there could be excessive production of cells so that the top layer grows extremely thick and scaly. In severe cases, it can grow up to 10 times the normal rate, producing extremely thick and scaly layers. The reason in most cases is an overactive immune system, causing what is known as an autoimmune disorder.

Psoriasis is one of the most common autoimmune skin conditions, and there are various types, the common one being plaque psoriasis. In some cases, the joints are exclusively involved, producing a condition known as psoriatic arthritis. This causes pain and swelling in the joints along with thickening of the skin at the joints.

Symptoms of psoriasis are easy to detect and include:

• Red, inflamed skin with plaques of dead skin which can be itchy and painful. There are scales of dead skin at the top, producing a fish-like appearance of the skin. The person will have a chronic tendency to itch, and the condition gets its name from this urge to itch (psora in Latin means itch).
• The abnormal patches of skin tend to grow and spread and merge, thereby increasing in size
• In severe cases, these scales can crack and bleed, and even get infected
• There is a constant, burning sensation around the patches
• Nails of the fingers and toes can be affected, which can cause pitting, disfiguration, and separation of nails from their nail beds.
• When the scalp is affected, there could be scaling of the scalp area, along with severe flaking, which can be very embarrassing.
• Joint pain and stiffness if the joints are involved
• Commonly affected areas are the torso, back, face, neck, and hands

In addition to plaque psoriasis mentioned above, there are other types of psoriasis, such as:

• Pustular psoriasis :

  In these patients, there are pustules formed which contain liquid that can break open and ooze.

• Guttate psoriasis :

  In children or young adults, after a bout of infection with Strep or injury, there could be small red spots which appear similar to psoriasis. These disappear with a round of steroids and do not persist as in adults.

• Erythrodermic psoriasis :

  This happens post sunburn or a skin infection, where there are red patches which occur on the skin. These patches contain scales that shed away, leaving the underlying reddened skin exposed. This needs to be immediately treated to avoid severe flare-ups and complications.

People with psoriasis know that it is not an easy condition to live with. While on one hand there is the skin itself to manage, there is also the necessity to identify the triggers which can exacerbate the condition and prevent these symptoms. There is also the need to dress so that the patches are not easily visible. For, whatever is done, there is no escape from the red, itchy patches.

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