Psoriasis is an inflammatory skin disease characterised
by an increased rate of skin cell turnover, resulting in thick scales appearing
on the skin. The affected skin becomes dry and unsightly. Itching is often experienced
in our hot and humid climate.
As part of our skin, nails also show changes like “pitting”
of their surface in up to 50% of people with psoriasis. Joint pain and swelling
are seen in 5-40% of those with more extensive psoriasis.
Psoriatic plaques on the back
do you know if you have Psoriasis?
Psoriasis usually presents with red scaly patches on
the scalp, body and limbs. The scaly patches on the scalp are usually thicker
and more extensive than ordinary dandruff. Common body sites affected include
the elbows, knees and back.
Why does Psoriasis happen?
Studies show that patients with psoriasis have a
genetic predisposition to develop the disease, which is triggered off by
environmental factors such as infection, or certain medications. As a result, there
is an imbalance in the immune system which leads to the appearance of
Psoriatic arthritis and nail psoriasis
makes Psoriasis worse?
Physical and emotional stress are well known to aggravate
psoriasis. Throat infections or flu may also aggravate the disease as well.
Some drugs e.g. steroids and certain anti-hypertensives may provoke the
appearance of psoriasis.
the natural history of Psoriasis?
Psoriasis usually starts in the 20s but has been described
at birth and in old age. Like diabetes and other chronic diseases, psoriasis
has a delayed onset and seldom remit permanently. However, unlike other chronic
illnesses, it rarely shortens life expectancy.
treatment modalities are available for Psoriasis?
1. Topical Creams/Ointments/Scalp
Most people with psoriasis have mild disease and get
considerable relief with topical applications. These include topical steroids,
coal tar and nonsteroidal vitamin D3 derivatives e.g. calcipotriol and calcitriol.
For the face, hairline and groin areas, mild steroid or calcitriol creams can
Psoriasis responds to ultraviolet (UV) light treatment.
Ultraviolet light, either UVB or UVA have been found to be effective in
clearing psoriasis if used in gradually increasing doses over a period of
several months. UVA is usually given with psoralens to enhance the effect of
Narrowband UVB Phototherapy Cabin
3. Oral Drugs
Your dermatologist may prescribe oral medications when
psoriasis does not respond to topicals and phototherapy. Examples of such drugs
include methotrexate, cyclosporin, acitretin and hydroxyurea. Unfortunately, these
drugs can sometimes cause severe side effects. Patients who are taking such drugs
will require regular blood tests to detect side effects e.g. liver damage, bone
marrow damage, etc.
These are drugs which help to control extensive disease
when other treatments have failed. Biologics have to be administered via
injection just under the skin or into a vein. They work by balancing the immune
system in the skin. As these are powerful drugs, side effects can occur and patients
need regular blood test monitoring.
we can handle Psoriasis?
• Do use treatments regularly as directed.
• Do keep skin well moisturised as this will help reduce
itching and scaling.
• Do have healthy lifestyle habits, eat in
moderation, exercise regularly and manage your stress levels.
• Do regular health screening as obesity, diabetes, high
blood pressure and cholesterol problems are more common in psoriasis.
• Do remember that the sun may help psoriasis but be
careful not to get sunburnt.
• Do monitor for any joint pain or swelling as a
proportion of patients also have psoriasis involving the joints (psoriatic
· Don’t scratch the plaques as this may damage the skin
and actually worsen psoriasis.
give up treatments too soon as it may take a few weeks for some of them to
allow yourself to have too many thoughts of self-pity or sadness. Don’t
distance yourself from your loved ones. Learn to accept it as part and parcel
Is Psoriasis contagious?
I pass Psoriasis to my children?
Not necessarily so. Psoriasis is a hereditary disorder
but only about 10% of people with psoriasis have a family member affected by
psoriasis. The causation of psoriasis is a multi-factorial and inherited genes
do not always express disease without the appropriate environmental triggers.
Is Psoriasis a rare skin disease?
No, psoriasis is not an uncommon skin disease. It is
estimated that 1-2% of the population have psoriasis.
Are there any foods to avoid, or
supplements to help my Psoriasis?
No, but it is wise to consume a nutritious, well balanced
diet containing more green vegetables and less meats. Excessive alcohol
consumption is best avoided because of its association with malnutrition and
Is there a quick cure for
No, but your doctor should be able to help you control
your psoriasis. Oral or injected steroid treatment is best avoided because
although it helps to clear psoriasis fast, it may result in a quick and severe rebound
of psoriasis. But remember, psoriasis can be controlled with appropriate treatment.
is psoriasis related to metabolic disorders?
In psoriasis, there is chronic inflammation of the
skin and an imbalance in the skin’s immune system. This can also contribute to
heart disease, development of hypertension and diabetes.
1. Consult your doctor for advice on screening for metabolic
- Check body mass index/waist circumference.
- Blood pressure measurement.
- Blood tests for cholesterol and glucose levels (Fasting
of 8 hours is required for cholesterol and glucose tests).
2. Stop smoking.
- Smoking cessation counselling is available in NSC.
Please ask your doctor or pharmacist for more information.
3. Avoid alcohol abuse.
4. Maintain a healthy weight, diet and exercise regularly.
5. Ensure metabolic disorders are well-controlled.
DEDICATED TO EXCELLENCE IN DERMATOLOGY
By National Skin Centre (Singapore)
Copyright (C) 1995 - National Skin Centre (Singapore)