PSORIASIS Not Just Skin Deep, Impacts Mind Too

Dry skin and a burning sensation, along with scaly and bleeding patches — these are among the conditions experienced by psoriasis patients, a chronic skin disease.

Their condition often worsens when exposed to scorching sunlight or hot environments, leading patients to feel self-conscious in public.

According to experts, psoriasis occurs when the immune system becomes overactive, causing skin cells to grow too rapidly. When these cells accumulate on the surface, they appear as thick, red, scaly rashes.

To date, the exact cause of psoriasis is still not fully understood. However, besides immune system irregularities, studies have also found genetic and environmental factors to play a role.

IMMUNE SYSTEM

Commenting on the disease, Consultant Dermatologist at Sunway Medical Centre Velocity (SMCV) Dr Nur Ashikin Ahmad, said psoriasis is not fully classified as an autoimmune disease but rather an inflammatory skin condition triggered by excessive immune responses.

She explained that this occurs when the immune system attacks the patient’s own skin cells, indirectly causing skin cells to regenerate too quickly — within just a few days instead of several weeks in non-patients.

Consultant Dermatologist at Sunway Medical Centre Velocity (SMCV) Dr Nur Ashikin Ahmad

“If someone has a family member with psoriasis, their risk of developing it is higher. We also find that women tend to develop psoriasis at a younger age compared to men.

“This disease often flares up during periods of stress or emotional pressure, bacterial infections, as a side effect of certain medications such as high blood pressure drugs (beta-blockers), malaria medication, or when steroids are suddenly discontinued, as well as from alcohol consumption and smoking,” she told Bernama.

Dr Nur Ashikin added that psoriasis is different from eczema, though it can be difficult to distinguish between the two, as both cause red and itchy skin.

“Dermatologists note clear differences: psoriasis tends to cause thick, red, scaly rashes usually found on the elbows and knees. It also commonly affects the scalp and body, with itching generally being moderate.

“Eczema, on the other hand, usually occurs in the folds of the elbows and behind the knees. Patients often experience intense itching that can disrupt sleep and daily activities. Unlike psoriasis, eczema rarely causes joint pain or brittle nails,” she explained.

SKIN RASHES

According to Dr Nur Ashikin, individuals with psoriasis often present with thick, dry, scaly rashes that may itch and typically appear symmetrically on both sides of the body.

“Psoriasis can also manifest differently depending on its type: guttate psoriasis (small drop-shaped patches), inverse psoriasis (occurring in body folds such as the armpits, under the breasts, and groin), and pustular psoriasis (red, swollen skin with pus-filled blisters).

“There is also erythrodermic psoriasis, the most severe form, where nearly the entire body becomes red, scaly, itchy, and painful. This condition can be life-threatening if left untreated,” she said.

She advised individuals to seek a dermatologist’s consultation if they notice early signs of psoriasis such as persistent red, scaly rashes that do not heal despite using moisturising creams.

Psoriasis is not fully classified as an autoimmune disease but rather an inflammatory skin condition triggered by excessive immune responses.

Other symptoms may include nail changes such as brittleness, thickening, or pitting, as well as unexplained joint pain, especially if it occurs alongside skin rashes.

“Some patients only experience skin issues, while others may have both skin and nail problems. Some develop all three: skin, nail, and joint involvement.

“If these signs appear, it is crucial to seek early diagnosis and treatment from a dermatologist,” she stressed.

TREATMENT

Dr Nur Ashikin said treatment for psoriasis varies for each patient depending on several factors, including disease severity (mild, moderate, or severe), the presence of psoriatic arthritis, and other conditions such as heart disease, diabetes, or kidney problems.

To treat skin rashes, steroid-based anti-inflammatory creams are commonly used to reduce inflammation, along with topical treatments containing salicylic acid to soften and remove thick scales.

If topical treatments are ineffective, or for patients with moderate to severe psoriasis, other     treatments may be considered. These include phototherapy (using special UVB light to reduce inflammation and slow skin cell growth) and oral immunosuppressants such as methotrexate (MTX)  or cyclosporine, which help control the overactive immune system.

“For widespread psoriasis or cases involving the joints, more aggressive treatment is required, such as biologic injections — modern therapies that specifically target parts of the immune system and are highly effective for severe psoriasis.

“However, patients should be cautious of online medications containing hidden steroids, which can be harmful if used without medical supervision,” she warned.

Dry skin and a burning sensation, along with scaly and bleeding patches.

She added that to date, there is no permanent cure for psoriasis.

Nevertheless, current medications and modern therapies are effective in controlling inflammation, reducing symptoms, and preventing long-term complications.

She also advised psoriasis patients to maintain a healthy diet and body weight, as obesity can worsen the condition.

“Fat cells produce chemicals that can trigger skin inflammation. Avoid foods high in saturated fats, sugar, and processed items, as these can also increase inflammation.

“Instead, consume antioxidant-rich and omega-3 fatty acid foods such as leafy greens, fruits, fish, and nuts, which may help reduce psoriasis symptoms,” she added.

SUPPORT

Dr Nur Ashikin acknowledged that psoriasis is not only a skin-related condition but also significantly affects patients’ emotions and self-esteem.

Psoriasis is not only a skin-related condition but also significantly affects patients’ emotions and self-esteem.

Many feel ashamed, insecure, and stressed due to the social stigma surrounding their skin condition, she said.

Therefore, patients are encouraged to seek counselling or psychological support for emotional well-being.

“Joining support groups or psoriasis associations can help patients feel less isolated. Sharing experiences with others in the same situation can boost morale and self-confidence.

“Additionally, managing symptoms with proper treatment is essential. Seeing a dermatologist for effective, up-to-date therapies can help control flare-ups. When symptoms are managed, patients feel more comfortable, reducing the impact of social stigma,” she said.

-- BERNAMA