Plaque Psoriasis Causes, Signs & Symptoms, Treatments

Plaque psoriasis constitutes about 90 % of psoriasis cases.   Now psoriasis is a long-lasting autoimmune skin disease that has adverse symptoms. It has no one possible cure although there are various efficient ways to control the symptoms. Psoriasis affects all over the body predominantly. Plaque psoriasis is one such variant of psoriasis.

Plaque psoriasis most common kind of psoriasis is complained by 85 to 90 percent of the population. Also called psoriasis Vulgaris. Red bordered patches with silvery plaque centers are the characteristic appearances of plaque psoriasis. In India, the prevalence of psoriasis is far more in men than in women. Men in their thirties or forties are more prone to psoriasis.

Research records in our country showed upto2.8 percent prevalence. Various factors cause psoriasis. Ethnicity, genetics, lifestyle, and medications used. Patients are seen from 28 years onwards. Plaque psoriasis is seen worsening in seasons like monsoons and winters. It is most evident in Indians living in the south and north America apart from the natives. 50 percent of the people living with plaque psoriasis also have scalp psoriasis reportedly. It is also closely diagnosed along with psoriatic arthritis. 

Signs and Symptoms of Plaque Psoriasis:

  • Plaque psoriasis shows red lesions. Unlike the other types of psoriasis, these lesions are well defined, demarcated, and round. 
  • The lesions are red and are bordered. While the center of the lesion is filled with silvery patches. The skin is all inflamed and plaque is seen in raised, thick lesions. The lesions are spherical and relatively bigger. Plaque psoriasis is classified between mild to severe based on the spread over the body and the number of lesions. A piling up of cells occurs in the skin, forming scales. The cells thus form patches of silvery scales bordered by redness. The redness in the area is caused by the inflammation produced in the skin. 
  • Plaque psoriasis happens in patches. If the patches occupy within 3 percent of the body surface it is considered mild plaque psoriasis. If it is anywhere between the 3 onwards to 10 percent the severity is determined as moderate plaque psoriasis. If the plaque patches cover more than 10 percent of the body it is considered severe plaque psoriasis.
  • There is also an itch associated with the plaque. There will be irritation and pain too. Scratching can lead to broken skin and bleeding. The patches shed off in scales and plaques.
  • Mostly confined to areas like scalp, eyebrows, knees, eyebrows, near the genitals, and inner parts of the body. However, the spread is not confined but can go over all the body. 
  • Studies show that plaque psoriasis can develop from areas of injuries, bites, and scratches.
  • Once the old patches go away, it is not necessarily that new patches relapse in the same location. 

Causes for plaque psoriasis:

If the skin affected by the plaque psoriasis is microscopically examined, the epidermis shows layers of cells. Apart from that, the epidermis is seen to develop ridges and produce a lot of protein called keratin. The layers underneath show a lot of neutrophils, lymphocytes, and dilated blood capillaries. Digging deep into the physiology behind these changes in the skin, we can see there is a lot of inflammation and immune system actions happening against the skin cells.

Our Immune system: 

As we know psoriasis is caused by a mistaken impulse of our immune system. Which is otherwise called an autoimmune reaction. The skin cells receive a signal to produce new cells. So they overproduce cells which form as plaques. The fighter cells of our immune system attack the healthy skin cells. Inflammatory reactions happen in the skin layers. This ends up with red and inflamed skin along with a pile of overgrown skin cells.

Lymphocytes, cytokines, activated genes, and neutrophils come to the site and bind with the skin cells to fight them. And this results in increased and irregular keratin production in the skin and the dilation of the blood vessels that run in the skin. Each cell of the immune system outrages chemical and physical changes in the skin. That is why psoriasis is said to be unyielding and does not have a definite cure.

Twin studies and genetics has been greatly investigating the genetic lead for psoriasis. 70 percent of identical Twins, 20 percent of non-identical twins have a risk of developing psoriasis. Reportedly one-third of the people living with psoriasis have a family history of the disease. Scalp psoriasis and psoriasis arthritis are closely associated with plaque psoriasis.

The other triggers for psoriasis can be long-term usage of nonsteroidal inflammatory drugs, corticosteroids, hormonal therapy, contraceptive pills, malarial medications, antibiotics, and pregnancy. 

Treatments for Plaque Psoriasis:

  • There is no one-shot cure for psoriasis. However, to smoothen the impacts, there are certain ways prescribed. A physician determines the plaque psoriasis by the scaly plaques and patches on the skin. For further investigation, if needed a biopsy will be prescribed by the dermatologist.
  • The first line of psoriasis treatment is the topical one. Also for patients with mild disease, topical agents are the mainstay. 
  • The topical applications are made of vitamin D derivatives, salicylic acid, corticosteroids, keratolytic. Even in severe diseases, biologics are given as topical applications, as they proved to show results. 
  • Oral medications prescribed of the class called DMARDs involving methotrexate, acitretin, cyclosporine, and the advanced but small apremilast are a few.
  • Ultraviolet B rays band is the light treatment prescribed for plaque psoriasis.
  • Also, biologics injections are given intravenously to act against the interleukins responsible for the disease. Ustekinumab, secukinumab, brodalumab, lebrikizumab, secukinumab, etc belong to them. All these are approved for the treatment of psoriasis arthritis too.

Managing Plaque Psoriasis:

Managing plaque psoriasis can be easier if followed by the guidance of a dermatologist. The drugs and treatment alone do not suffice. 

Moisturizing the skin, restraining from scratching, hydrating the body always, adequate exposure to sunlight, using body care products with salicylic acid and vitamin D, eating healthy, drinking lots of water, etc. should be followed.

 Psoriasis management demands a disciplinary lifestyle too because it can potentially cause multiple comorbidities.

Although, as the treatment takes a good time, and the shedding begins. The medications and care still need to be taken to prevent future remissions. 

Psoriasis is not contagious, but it takes a toll on the emotional and mental state of the patient. It disturbs the aesthetics. The right treatment and right care are necessary to prevent the worsening.

Also, Read Ayurvedic Treatment for Psoriasis

References:

https://www.sciencedirect.com/topics/medicine-and-dentistry/psoriasis-vulgaris

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5761022/

https://emedicine.medscape.com/article/1108072-overview

https://pubmed.ncbi.nlm.nih.gov/32427307/

https://pubmed.ncbi.nlm.nih.gov/32110559/

https://en.wikipedia.org/wiki/Psoriasis