Psoriasis (commonly known as “Sedef Hastalığı”) is a chronic inflammatory skin disease driven by a combination of genetic predisposition, immune system dysfunction, and environmental triggers. It manifests as raised, red patches covered with silvery-white scales (plaques) and follows a lifelong course marked by flare-ups and remission. Beyond skin involvement, psoriasis can affect nails and joints, with up to 30% of patients developing psoriatic arthritis. Common sites include the knees, elbows, scalp, lower back, hands, feet, and genital area.
Erythematous, scaly plaques with well-defined edges.
Itching, burning, or soreness in affected areas.
Nail changes: Pitting, thickening, or separation from the nail bed.
Joint pain, stiffness, or swelling (indicative of psoriatic arthritis).
Immune factors: Overactivation of T-cells and inflammatory cytokines (e.g., TNF-α, IL-17).
Stress: Emotional or physical stress exacerbates flares.
Infections: Streptococcal infections (e.g., strep throat).
Medications: Beta-blockers, lithium, antimalarials.
Skin trauma: Koebner phenomenon (new lesions at injury sites).
Lifestyle factors: Smoking, obesity, alcohol consumption.
Environmental factors: Cold, dry weather.
Treatment is tailored to disease severity, location, and patient-specific factors (e.g., age, comorbidities):
Topical Therapies:
Corticosteroids: Reduce inflammation and scaling.
Vitamin D analogs (e.g., calcipotriene): Slow skin cell growth.
Calcineurin inhibitors (e.g., tacrolimus): For sensitive areas (face, genitals).
Keratolytics (e.g., salicylic acid): Remove excess scales.
Phototherapy:
Narrowband UVB: Slows cell turnover and reduces inflammation.
Excimer laser: Targets localized plaques.
Systemic Therapies:
Immunosuppressants: Methotrexate, cyclosporine (for moderate-severe cases).
Biologic Therapies:
TNF-α inhibitors (e.g., adalimumab, infliximab).
IL-17/IL-23 inhibitors (e.g., secukinumab, ustekinumab).
JAK Inhibitors (e.g., tofacitinib): Block inflammatory signaling.
Lifestyle Modifications:
Weight management, smoking cessation, and stress reduction.
Moisturizers and gentle skincare to protect the skin barrier.
Psoriasis is linked to comorbidities (e.g., cardiovascular disease, diabetes).
A dermatologist can:
Distinguish psoriasis from mimics (e.g., eczema, fungal infections).
Screen for psoriatic arthritis and systemic involvement.
Optimize treatment to balance efficacy and safety, especially with biologics.
Provide holistic care addressing physical and emotional impacts.