The Dermatology Practice.

What Is Psoriasis?

Psoriasis is a chronic skin disease characterised by an increased rate of skin cell turnover, resulting in thick scales appearing on the skin. The affected skin becomes dry and unsightly. Itching is often experienced in our hot and humid climate.

Psoriasis usually presents with red scaly patches on the scalp, body and limbs. The scaly patches on the scalp are usually thicker and more extensive than ordinary dandruff. Common sites of the body affected are the elbows, the knees and the back.

As part of our skin, nails also show changes like “pitting” of their surface in up to 50% of people with psoriasis. Joint pains and swelling are associated in 5 – 40% in more extensive psoriasis.

The cause of psoriasis is partially genetic and partially environmental. There is usually, but not always, a genetic predisposition, i.e. a family member or distant relative who has a history of psoriasis. In such patients, certain environmental factors are then necessary to trigger off the appearance of psoriasis. Some of these factors include physical and emotional stress, which are well known to aggravate psoriasis. Throat infections or flu may also trigger off the disease as well. Some drugs e.g. certain anti-hypertensives may provoke the appearance of psoriasis.

Psoriasis usually starts in the 20s (early onset) or in the ages of 50 onwards (late onset).

Is Psoriasis contagious?

No. It is definitely not contagious

Will I pass my psoriasis to my children?

Not necessarily so. Psoriasis is a hereditary disorder but only about 10% of people with psoriasis have a family member affected by psoriasis. The causation of psoriasis is multi-factorial and inherited genes do not always express disease without the appropriate environmental triggers.

Is Psoriasis a rare skin disease?

No, psoriasis is not an uncommon skin disease. It is estimated that 1-2% of the population in Singapore have psoriasis

What Treatments Are Available For Psoriasis?

  1. Topical Creams / Scalp Solutions
  2. Most people with psoriasis have mild disease and get considerable relief with moisturizing creams and ointments. These include topical steroids and non-steroidal vitamin D3 derivatives e.g. calcipotriol or tacrolimus.

  3. Phototherapy
  4. Psoriasis responds to ultraviolet (UV) light treatment. Ultraviolet light, either UVB or UVA have been found to be effective in clearing psoriasis if used in gradually increasing doses over a period of several months. Regular treatments 2 to 3 times a week is required for phototherapy to be effective.

  5. Oral Drugs
  6. Your dermatologist may prescribe oral medications where necessary. Examples of such drugs are methotrexate and ciclosporin. These drugs have potential side effects. Patients who are taking such drugs will require regular blood tests to monitor for any side effects e.g. blood counts and blood tests for liver or kidney function.

  7. Biologics
  8. Biological therapy, or Biologics for short, are new drugs recently available in the market which help to control extensive or stubborn disease.. They are administered as an injection. They work by neutralizing the part of the immune system that causes psoriasis, e.g. anti-IL17, anti-IL23, anti-TNF alpha. These drugs are very effective and safe in the treatment of many psoriasis patients. Some examples of biologics include guselkumab, risankizumab, secukinumab and ixekizumab