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All about psoriasis

One of the most common skin disorders, psoriasis comes in various forms and needs specific treatments, says Dr Lesley Hickin

What is psoriasis?
Most skin disorders do not pose a serious threat to your health, but can affect the quality of your life and require long-term treatment. Psoriasis is a genetically determined inflammatory condition of the skin, with unknown cause, and is common in Western countries, Australia, South America and parts of Africa and Asia. It is one of the most common of the inflammatory skin disorders and is important because of its persistent or recurrent nature and its severity in a number of those affected.

Who does it affect?
Psoriasis affects one to two per cent of the population and can begin at any age from very young to very old. The commonest time for it to appear is in the 15-20 age group, but it also appears for the first time frequently in people over 70. In general, the earlier it appears the more severe the disease is likely to be in terms of frequency and severity of attacks. There are several different types of the disease, affecting people at various ages, and there are some drugs that can provoke an attack in a susceptible person, including antidepressants, beta blockers and drugs used to prevent malaria.

What causes psoriasis?
You cannot 'catch' psoriasis from someone who has it, but it often runs in families. The way it is inherited is not clear-cut. If one parent is affected there is a 30 per cent chance that a child will develop the condition, with two affected parents the risk is 60 per cent. With identical twins (the 'gold standard' for working out inheritance of a disease) the chances of both twins having psoriasis is 70 per cent. The current theory about the cause of psoriasis is that something triggers the immune system in an affected person and the control of cell division at the skin surface is altered.

What does it look like?
Each individual lesion (called a plaque) has a well-defined border and is raised above the skin surface. Plaques vary enormously in size and shape. They often begin as discs but as adjacent plaques merge become more irregular. The affected skin is red, and often has large silvery scales stuck to the surface.

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