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Cutaneous psoriasis is a chronic inflammatory disease of the epidermis. It is characterised by the appearance of red patches on the body, covered by white scales. The scales are small flakes of dead skin that are shed.
It is a disease that affects 2 to 3% of the population, i.e., around 2.3 million people in France. It can be seen at any age but most often occurs between 20 and 40 years of age. It is not contagious and progresses in flare-ups.

It is a disease linked to a background of genetic predisposition: in 30% of patients, psoriasis was found in the family and several genes have been identified. On top of this predisposition, favourable environmental factors intervene such as infections (particularly in children) certain medicines, stress or psychological shock. Alcohol and tobacco are aggravating factors for the disease.
Psoriasis affects social life and is difficult for the patient to accept. The aesthetic impact is significant and patients may feel negatively about how others see them. It can lead to a depressive state.

 

The different types of psoriasis

Psoriasis is a skin disease that takes different forms depending on the location and appearance of the plaques on the skin. Severity is extremely variable depending on the type of psoriasis and the affected skin surface.

bras atteint de psoriasis en plaque

Plaque psoriasis

is the most common form, it accounts for more than 80% of cases. Well-circumscribed red patches covered with white scales affect the elbows, knees and lower back in particular. They are frequently accompanied by an affected scalp and nails.

corps atteint de psoriasis en gouttes

Guttate psoriasis

is a form often seen in children and adolescents. It is characterised by the appearance, often after a sore throat, of small patches of less than one centimetre in diameter, mainly on the trunk and upper arms and thighs.

nombril atteint de psoriasis inversé

Inverse psoriasis

is characterised by redness without scaling in the body folds: the navel, groin folds, genital areas, armpits, belly folds or even under the chest. It is less noticeable but very painful.

homme atteint de psoriasis sur le visage

Facial psoriasis

is not very common but very obvious. It may take the shape of an eye mask or also affect the T-zone (forehead and nose), which makes it difficult to differentiate from seborrheic dermatitis.

main atteinte de psoriasis palmoplantaire

Palmoplantar psoriasis

is a form located only on the hands and feet. It manifests as redness, thickening of the skin with dryness and cracking in the palms and soles. It is very disabling and painful.

femme atteinte de psoriasis au cuir chevelu

Scalp psoriasis

may be the only manifestation of psoriasis. As before, it manifests as more or less red patches that shed in white flakes. These localise freely at the edge of the scalp and behind the ears. This often causes itching that leads to scratching.

ongle atteint de psoriasis

Nail psoriasis

can be isolated. It manifests as pitting that gives nails the appearance of the surface of a thimble, small bleeds under the nail, sometimes with detachment from the nail bed or thickening of the nail.

pied atteint de psoriasis

Pustular psoriasis

is a specific, highly inflammatory and painful form. It is characterised by pustule formation on top of the red plaques. It localises freely to the palms and soles, but can also affect other parts of the body.

corps atteint de psoriasis érythrodermique

Erythrodermic psoriasis

is the most severe but also the most rare form of disease. In this case, psoriasis is generalised over the whole skin surface, with no areas of healthy skin. It is accompanied by fever and chills.

Credits  : French Psoriasis Association

Psoriasis is not just a skin disease.

In 20% of cases, cutaneous psoriasis is associated with psoriatic arthritis. This can affect the axial joints of the spine and pelvis or the peripheral joints of the knees, feet, hands, etc. One or more joints may be affected. It is an inflammatory rheumatic disease that causes joint pain, especially during the night with stiffness upon waking. There is no relationship between the intensity of skin lesions and the existence of rheumatism. Psoriatic arthritis can also occur in the absence of skin lesions.
Obesity and diabetes are also more common in patients with psoriasis.

Psoriasis prevention and treatment

As it is a disease with a genetic predisposition, a definitive cure cannot be envisaged. However, psoriasis is getting better !

docteur qui ecrit

Treatment

Many treatments lead to resolution of plaques and flare-ups. Topical treatment may be sufficient in forms which are not widespread.
In more severe forms, there are very effective systemic treatments, in tablet or injection form.
Exposure to natural sunlight in moderation or in a cabinet under medical supervision is also a useful treatment.

photo de Avene

Hydrotherapy

Looking at alternative treatments, hydrotherapy may be beneficial. It must be prescribed by a doctor to be covered by health insurance. The intensive treatment offers relief, an opportunity to take care of yourself and the keys to managing your disease.

3 femmes faisant de la marche à pied

A healthy lifestyle

In order to limit flare-ups, it may also be helpful to avoid stress (if possible) and adopt a healthy lifestyle. It is also beneficial to moisturise your skin well twice a day and use a lipid-enriched cleanser.

 

French Psoriasis Association

This is a patient association. Its main missions involve :

  • restore hope,
  • improve the care pathway,
  • encourage research,
  • raise awareness about psoriasis and psoriatic arthritis

For more information : www.francepsoriasis.org/