Psoriasis is a skin disease that causes red, itchy, scaly patches mostly on the elbows, knees and scalp, but it can also occur on the palms of the hands, soles of the feet, nails, genitals and torso. It is a chronic inflammatory disease that affects one million Canadians, and there are several types of psoriasis that can range in severity.

Psoriasis can look like a few dandruff-like scales, to widespread patches that cover large areas of skin. People who have psoriasis go through cycles of flare ups and remission, with flare ups lasting anywhere from weeks to months. During flare-ups, psoriasis causes itchiness and pain in the inflamed skin. It’s a long term chronic disease with no cure; though there is treatment available to alleviate symptoms.

Signs and symptoms of psoriasis can vary from person to person, common symptoms include:

• Red patches of skin covered with thick, silvery scales
• Small scaling spots (commonly seen in children)
• Dry, cracked skin that may bleed or itch
• Itching, burning or soreness
• Thickened, pitted or ridged nails
• Swollen and stiff joints

According to the Canadian Association of Psoriasis Patients, Psoriasis affects the regeneration of skin cells. In psoriasis, overactive signals in the body's immune system trigger new skin cells to form in three to four days instead of the normal cycle of 28 to 30 days. Because skin cells grow so quickly, they pile up on the skin surface creating painful and itchy red lesions called plaques, which can form silvery scales. Psoriasis is not contagious and cannot be spread from one person to another. What causes the immune system to malfunction isn't quite clear, but researchers believe both genetics and environmental factors play a role.

There are five main types of psoriasis:

1. Plaque psoriasis. The most common form, plaque psoriasis causes dry, raised, red skin patches (lesions) covered with silvery scales. The plaques might be itchy or tender, and there may be few or many. They usually appear on elbows, knees, lower back and legs.
2. Guttate psoriasis. This type primarily affects young adults and children. It's usually triggered by a bacterial infection such as strep throat. It's marked by small, drop-shaped, scaling lesions on the trunk, arms or legs.
3. Inverse psoriasis. This mainly affects the skin folds of the groin, buttocks and breasts. Inverse psoriasis causes smooth patches of red skin that worsen with friction and sweating. Fungal infections may trigger this type of psoriasis.
4. Pustular psoriasis. This rare form of psoriasis causes clearly defined pus-filled lesions that occur in widespread patches (generalized pustular psoriasis) or in smaller areas on the palms of the hands or the soles of the feet.
5. Erythrodermic psoriasis. The least common type of psoriasis, erythrodermic psoriasis can cover your entire body with a red, peeling rash that can itch or burn intensely.

Many people who are predisposed to psoriasis may be free of symptoms for years until the disease is triggered by some environmental factor. Common psoriasis triggers include:

• Weather, especially cold, dry conditions
• Infections (HIV, post-strep throat)
• Stress
• Dry skin
• Certain medications like non-steroidal anti-inflammatory drugs (NSAIDs), high-blood-pressure medications, some antidepressants, antimalarial drugs and others
• Skin injuries like sunburns, cuts, bug bites

Certain risk factors can also make you more prone to developing psoriasis, these include: family history, stress, obesity, smoking, heavy alcohol consumption, and infections. According to the Mayo Clinic, having one parent with psoriasis increases your risk of getting the disease, and having two parents with psoriasis increases your risk even more.

If you think you have psoriasis, consider booking an appointment with one of our GOeVisit practitioners or connecting with our partner Derm Café Canada! Derm Cafe Canada is here to help, providing fully remote specialist care for psoriasis and many other common dermatological conditions.