Psoriasis is a chronic inflammatory, hyperproliferative skin disease. It is characterised by well-defined, erythematous scaly plaques, particularly affecting extensor surfaces and scalp, and usually follows a relapsing and remitting course.
Exacerbating factors in psoriasis
Trauma
- Psoriatic lesions can appear at sites of skin trauma, such as scratches or surgical wounds (Köbner isomorphic phenomenon)
Infection
- β-haemolytic streptococcal throat infections often precede guttate psoriasis
- Severe psoriasis may be the initial presentation of HIV infection
Sunlight
- A minority of patients experience exacerbation of psoriasis after sun exposure, mainly due to Köbnerisation at sites of sunburn or polymorphic light eruption
Drugs
- Antimalarials, β-adrenoceptor antagonists
Psychological factors
- Anxiety and stress may exacerbate psoriasis in predisposed individuals
TYPE OF PSORIASIS
Plaque psoriasis
This is the most common presentation and usually represents more stable disease. The typical lesion is a raised, well-demarcated erythematous plaque of variable size . In untreated disease, silver/white scale is evident and more obvious on scraping the surface. The most common sites are the extensor surfaces, notably elbows and knees, and the lower back.
Guttate psoriasis
This is most common in children and adolescents and is often the initial presentation. It may present shortly after a streptococcal throat infection and rapidly evolves. Individual lesions are droplet-shaped, small (usually less than 1 cm in diameter), erythematous, scaly and numerous.
Pustular psoriasis
Pustular psoriasis may be generalised or localised. Generalised pustular psoriasis is uncommon, unstable and life-threatening.
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