Psoriasis

What is psoriasis?

Psoriasis is an immune-mediated condition characterised by an accelerated turnover of skin cells.  This rapid growth leads to thick, scaly patches that cause discomfort and affect your skin’s appearance. Commonly affected areas include the scalp, elbows, or knees.

The impact of psoriasis goes beyond physical symptoms. Due to its visibility, it can pose significant social and emotional challenges. For example, psoriasis can restrict your clothing choices and even restrict activities such as swimming. However, this does not have to be the case now, where treatment options are readily available, and we at Lumine Dermatology & Laser Clinic are here to help.

When someone has psoriasis, flare-ups often last weeks or months, followed by periods of remission or reduced symptoms. Several factors trigger psoriasis, and understanding these triggers can help relieve symptoms.

Besides the symptoms described below, those with psoriasis may also experience joint pain (psoriatic arthritis), itching, pain if the plaques crack and bleed, and nail problems. They may also experience the Koebner Phenomenon, where new psoriasis lesions form at sites of skin injuries.

Moreover, individuals with psoriasis are at an increased risk of developing metabolic syndrome, making regular health screenings vital for maintaining overall well-being.

There are five major types of psoriasis, which present different symptoms and have different characteristics.

Types of psoriasis

Type of psoriasis	Appearance and symptoms of psoriasis
Plaque psoriasis	The most common form of psoriasis, plaque psoriasis, is characterised by raised and red plaques with silvery scales.
Guttate psoriasis	Guttate psoriasis is characterised by small, dot-like lesions. It is more common in children and teenagers and may develop rapidly after a streptococcal (strep throat) infection.
Inverse psoriasis	Inverse psoriasis is characterised by smooth and red patches in the skin folds, such as the groin or armpits.
Pustular psoriasis	Pustular psoriasis is a rare form of psoriasis and is characterised by pus-filled blisters surrounded by red skin.
Erythrodermic psoriasis	Erythrodermic psoriasis causes widespread redness and scaling, often covering a large surface area (> 90%) of the body.

What causes psoriasis?

The root cause of psoriasis remains a topic of ongoing research, but it is known that the immune system behaves abnormally in those affected. This misdirected immune response accelerates the growth cycle of skin cells, leading to the rapid buildup that forms the characteristic inflamed, scaly patches.

Key factors influencing psoriasis:

• Genetic factors: having family members with psoriasis increases your risk. 
• Immune system challenges: certain conditions that activate the immune system, like infections, can trigger psoriasis.
• Medications: some medications, including beta-blockers, lithium, and antimalarials, might provoke or worsen psoriasis symptoms.
• Stress: stress is a well-known factor that can initiate or exacerbate psoriasis.
• Body weight: higher body weight or obesity increases the risk of developing psoriasis and can also influence its severity and response to treatment.
• Lifestyle choices: smoking and excessive alcohol intake are linked to a higher likelihood of experiencing psoriasis.

Our aim is not only to treat your psoriasis but also to empower you with knowledge about what might trigger your condition. Understanding these factors can help us devise a tailored approach to managing your symptoms more effectively. To manage this condition, make an appointment with Dr Evelyn at Lumine Dermatology & Laser Clinic.

How is psoriasis diagnosed?

• Personalised consultation: we provide a personalised consultation to discuss your condition, treatment options, and how lifestyle factors unique to living in Singapore can impact psoriasis. We will perform a thorough physical examination focusing on the skin, scalp, and nails—areas commonly affected by psoriasis.
• Skin biopsy: psoriasis is a clinical diagnosis. Rarely, we may perform a skin biopsy to differentiate psoriasis from other similar skin conditions. We only do so if the psoriasis has an atypical presentation.
• Laboratory tests: our comprehensive diagnostic process may include laboratory tests, such as blood tests, to identify associated conditions like diabetes mellitus or hyperlipidaemia. These tests help us understand the broader health context, as psoriasis can be linked with other systemic conditions.

What are the treatment options for psoriasis?

At Lumine Dermatology & Laser Clinic, psoriasis treatment is personalised to fit your unique health profile. Although there is no cure, the aim is to manage your symptoms effectively, aiming for remission and minimising the impact of flare-ups on your life.

Our tailored treatment approach for psoriasis includes:

• Topical and oral medications: topical medications such as anti-inflammatory steroid creams and vitamin D analogues can alleviate redness and itching for mild to moderate psoriasis. In more severe cases, other medications like oral apremilast, acitretin, methotrexate, and cyclosporine are considered.
• Biologics: biologic therapy offers targeted and effective relief for individuals with moderate to severe forms of the condition. At Lumine Dermatology & Laser Clinic, we are experienced in administering and monitoring the side effects of various biologic therapies (e.g. risankizumab, ixekizumab, ustekinumab) for psoriasis.
• Moisturisers: regular use of moisturisers helps keep the skin hydrated and reduce scaling.
• Lifestyle modifications: lifestyle changes, such as stress management techniques and avoiding triggers that worsen psoriasis, can help prevent flare-ups.

At Lumine Dermatology & Laser Clinic, your health and comfort are our top priorities. We are dedicated to offering suitable treatment options for psoriasis.

Frequently asked questions

What is causing my psoriasis?

As a dermatologist treating psoriasis, I recognise the frustration and confusion accompanying this condition. Psoriasis is a complex condition, and its exact cause remains a topic of ongoing research and debate. However, we have identified that psoriasis results from a combination of genetic, immunological, and environmental factors.

On a cellular level, skin cells divide rapidly, leading to the appearance of thickened, scaly, and inflamed plaques on the skin. While we cannot change our genetic makeup, we can modify the environmental triggers that aggravate psoriasis.

How can psoriasis be cured?

At Lumine Dermatology & Laser Clinic, we believe in a comprehensive approach to managing psoriasis. We focus on a combination of treatments tailored to each patient's individual needs. Our goal is not only to improve symptoms but also to enhance overall well-being and quality of life.

There is a wealth of treatment options for psoriasis, which include lifestyle modifications, skin care, topical medications, oral treatments, phototherapy, and biologics.

How do you stop psoriasis from spreading?

Psoriasis is not contagious and does not spread from one person to another. However, if the condition is unstable, different parts of the body can start developing psoriatic plaques. In this case, it is usually important to identify any underlying potential triggers for psoriasis and manage them, as well as institute systemic treatment in the form of oral medication, phototherapy, or biologics if topical medications cannot completely control psoriasis.

Does psoriasis go away on its own?

Psoriasis is not known to go away on its own. While it may clear up on its own sometimes, psoriasis is likely to return after a while. Treatment is vital to control and suppress psoriasis flare-ups so they don’t worsen. Biologic treatment can also induce long-term remission in psoriasis.