OVERVIEW

What is psoriasis?

Psoriasis is a chronic autoimmune inflammtory disorder that may affect skin, nail and Joints. In psoriasis skin cells multiply at a lot faster rate then usual, which leads to accumulation of scales and formation of dry thickened red white scaly patches on the skin.It is more common in adults but may affect any age group. Women and men are equally affected.It is not contagious and therefore does not spread by touching the affected skin.

Dr Kothiwala SkinEva Clinic is fully equipped skin clinic for best treatment of psoriasis in jaipur because clinic have facility of all possible treatments of psoriasis including phototherapy, excimer laser and biological therapy.

CAUSES

What are the causes of psoriasis?

There are four basic mechanism involved in the development of acne.

• A problem with immune system: Psoriasis is an autoimmune disease. Your immune system triggers your skin cells to overgrow. The new cells develop so quickly that body is not able to get rid of them and they are pushed up to the surface and get piled up.
• Family history (genetics): You may inherit certain genes from your family that can make you prone to develop Psoriasis, especially if your immediate family member is suffering with similar condition.

Beside above mentioned two important factors environmental factors,sedentary life style, stress, lack of sleep and presence of other comorbidities like diabetes, hypertention, dyslipidemia and obesity worsen psoriasis.

SYMPTOMS

What are the symptoms of psoriasis?

Symptoms of Psoriasis may differ from person to person and according to type and severity of the disease you have. It can affect a particular area on your skin or may cover most of the body. Following features may be commonly seen.

• Areas of skin that are raised, dry and red usually covered with silvery-white scales. Common sites are elbows, knees, hands, feet and back.
• Associated with itching, burning sensation or sometimes pain.
• Dandruff like rashes on the scalp but skin is redder, thickened and scales are large and thick than dandruff.
• Genitals, or in the skin folds may be involved in inverse psoriasis.
• Nail abnormalities, such as pitted, yellowish discolored, or thick and dystrophied nails.
• Joint pain, swelling, or stiffness.

Most people do not have symptoms always, there are may be days and weeks when there are no symptoms, certainfactors may act as triggers and symptoms may resurface again.

What are triggering factor of psoriasis ?

Following may trigger the flare-up of psoriasis in an affected person:

• A stressful event.
• Infections especially a streptococcal throat infection.
• Winter weather.
• Any trauma to skin like, a cut or sunburn.
• Certain medicines like beta blockers, lithium and anti-malarial medications.
• Alcohol and smoking.

What are the types of psoriasis?

• Plaque psoriasis: It is most common type and affects adults more commonly. Large red colored scaly skin lesions over elbow, knees, back and scalp. It may involve small to large body surface area.
• Guttate psoriasis: It affects children and young adults with no past history of psoriasis. Many times it follows recent infection usually pharyngitis or sore throat. It is characterized by sudden onset of smaller lesions with less scaling, more commonly over back and abdomen.
• Pustular psoriasis: It can be a severe, and occasionally life-threatening, form of psoriasis. It develops quickly, with multiple small pustules that may join into larger areas. Symptoms can include fever and abnormal blood levels of white blood cells and calcium. Pustular psoriasis can also cause pus-filled blisters on the palms of the hands and soles of the feet. These blisters can crack, causing painful breaks in the skin, and can be disabling.
• Inverse psoriasis — This type of psoriasis affects less visible body areas, such as the groin, armpits, buttocks, genitals, and the area under the breasts. Sometimes this is mistakenly diagnosed as a fungal or bacterial infection.
• Palmoplanter psoriasis- In this type psoriasis is localised to palms or soles or both. Nails are frequently involved in this type. Dry skin, multiple crackes in skin, white scaly thick red plaques are common presentations.
• Erythrodermic psoriasis: In this type psoriasis lesions involve more than 90% body surface area.
• Nail psoriasis: Nails may also get involved with or without skin or joint involvement. It usually starts with tiny pits over the surface of the nails. The pits look as if someone has taken a pin and pricked the nail several times. In addition, nails may develop a tan-brown color (also known as “oil spots”) or may separate from the nail bed (also known as “onycholysis”). In more severe cases, people have thick, crumbling nails.
• Psoriatic arthritis: Up to one-third of people with psoriasis also have psoriatic arthritis, a condition that causes joint pain and swelling. Skin signs usually develop first, although about 15 percent of patients develop arthritis (joint swelling and stiffness) before symptoms of psoriasis. People with psoriatic arthritis often have severe nail problems.

Psychological impact of psoriasis

There is a higher than normal frequency of depression, anxiety and low esteem in people with psoriasis. Lesions on exposed areas or extensive involvement of skin make psoriasis patients less interactive at social or professional gathering. Dr. Sunil Kothiwala provides detailed counseling about disease at clinic in Jaipur.

Comorbidities and disease course

Psoriasis also has been associated with obesity and an increased risk of heart disease,diabetes and abnormal serum lipid levels. Sometimes itching in skin lesions or pain and stiffness of joints are severe and disabling.Psoriasis is usually a lifelong condition and is not currently curable, although the severity of the disease can improve or worsen over time and can be controlled with treatment.

TREATMENT

How is Psoriasis Diagnosed?

The doctor may also examine a scrap from your skin.It can be diagnosed by examining the skin, nails and scalp. Occasionally, a skin biopsy or scraping may be taken to rule out other disorders appearing similar to psoriasis. There is no blood test that can definitively diagnose psoriasis.Dr. Sunil Kothiwala is in best position in Jaipur to determine psoriasis and to differentiate psoriasis from other skin diseases.

Is psoriasis curable permanently?

Psoriasis is not curable, although many treatments are available to reduce the symptoms and appearance of the disease. Clear skin can be achieved and can be maintained for long with help of minimal treatment. Many times treatment can also be stopped for few months or years. Selection of treatment modality depends on the severity of psoriasis which is determined by how much of the body’s surface is covered and how much it affects a person’s quality of life.

What is the treatment of psoriasis?

Treatment of Psoriasis aims at clearing the symptoms and improving the quality of life. It is important to understand that it is a chronic disease and is not cured completely, it can only be managed so that symptoms do not surface frequently and aggressively, and skin remains clear most of the time.

Dr Sunil Kothiwala Dermatologist in Jaipur examine the skin and take detailed history to decide a treatment plan for you, which if you follow meticulously, you will notice a significant difference in your skin condition. Following can be included in treatment protocol:

Topical therapy: This may include use of moisturiser, topical steroids, topical retinoids, vitamin-D analogous, Calcineurin inhibitors, salicylic acid, coal tar and moisturizers. Creams & lotions work well for mild or limited psoriasis. Alone scalp psoriasis can be managed witrh topical treartments of psoriasis.

Oral and injectable Medications:In conditions where psoriasis is severe and resistant, oral and injectable medicines are required. Methotrexate, retinoids, apremilast, cyclosporine, Immune system altering drugs, may be included in your regime.These medicines need some blood investigations before starting and in between of therapy. These medicines should always be taken under supervision of dermatologist or rheumatologist. Taking these medicines on its own is highly risky.

Several injectable medications, known as “biologics,” target the overactive immune system and may be beneficial in the treatment of psoriasis. Biologics for psoriasis treatment that are available in Jaipur at our clinic are etanercept, infliximab, adalimumab, and secukinumab. Biologics can be highly effective for the treatment of psoriasis, with improvement in skin symptoms that usually begins within a few weeks of starting treatment. Because of their cost, biologics are generally reserved for people with moderate to severe psoriasis that has not responded to other treatments.

Phototherapy:This form of treatment uses artificial or natural light and can be used in combination with medical therapy. Treatment aims at slowing the cell turnover and reducing inflammation and scaling.Your doctor will decide which modality is best for you.Following treatment modalities can be used:

• Sunlight: Includes exposure to natural UV rays from sunlight.
• UVB phototherapy: Includes controlled exposure to UVB light from artificial source.
• Narrow band phototherapy: Newer variant of UVB therapy, which is more effective and available at our clinic in Jaipur.
• Goeckerman therapy: This combines UVB therapy and coal tar treatment.
• Psoralen plus UVA (PUVA) therapy: In this a light sensitive medication psoralen, is applied to skin before exposing it to UVA rays.
• Excimer Laser: Here a controlled UVB light beam is directed to the affected areas.

Psoriasis treatments in Jaipur at our clinic

Our clinic provides all possible treatments for psoriasis in Jaipur. Medical treatment, Narrow band phototherapy, excimer laser and biologics. Dr Sunil Kothiwala has done research about psoriasis and co-morbidities in AIIMS during post graduation and understand psoriasis well and he have particular interest in psoriasis that makes him best dermatoloist in Jaipur for psoriasis treatment. Dr Sunil Kothiwala has received Dr. B N Satyanarayan Memorial National Award by IADVL for this research as best thesis.

For more information on Psoriasis treatment or to inquire about other services please contact at 7726938335or visit clinic.

TIPS

1. Read enough about psoriasis from authentic source.
2. Get good care of yourself. It includes a life style which can manage stressful events, exercise, yoga, healty food habits, avoiding smoking and alcohol.
3. Take good care of your joints.
4. Assess nails periodically.
5. Observe mood. Discuss with your dermatologist.
6. Follow treatment regularly.
7. Let your dermatologist know before stopping psoriasis treatment.
8. Apply good amount of moisturiser even after clerance of lesions.
9. Learn about new authentic treatment options from your dermatologist.

For more information on Psoriasis Treatment in Vaishali Nagar & Sitabadi Tonk Road, Jaipur or to inquire about other services please contact us on 7669571405.