Psoriasis affects around 2.3% of the Spanish population and, although it usually appears between the ages of 15 and 35, it can develop at any age. It is a non-contagious disease, but it can be passed down from parents to children. Currently, more than one million people in our country are affected by psoriasis, out of the more than 125 million worldwide who suffer from it.
What is Psoriasis? Psoriasis is a skin disease that accelerates the natural process of generating skin cells, causing an accumulation of cells on the surface of the skin. This excess of skin cells manifests as scaly red patches that cause irritation and itching. It is a chronic inflammatory skin disease that can occasionally affect the joints as well. Although the skin lesions caused by psoriasis can appear anywhere on our body, including mucous membranes and nails, they usually occur in areas where the skin is close to the bone (elbows, knees, scalp, sacral region, etc.).
Types of Psoriasis Psoriasis can manifest in various forms, from small scaly patches on the skin that may go unnoticed to lesions that affect the entire body surface. The location can vary greatly, and there are different types of psoriasis, including the following:
Plaque Psoriasis: It is the most common form and produces intense pink-colored lesions with scales on the skin, in the form of „plaques”, that cause irritation and itching. They can appear anywhere on the body, especially on the elbows, knees, scalp, genitals, and soft tissue of the mouth.
Guttate Psoriasis: It is characterized by small, scaly pink patches in the shape of „drops” on the skin of the arms, legs, back, and scalp. These lesions are smaller than plaques and not as thick, with milder scaling.
Inverse Psoriasis: It is a type of psoriasis that causes smooth pink-colored patches that mainly affect sensitive areas of the skin, such as the armpits, groin, under the breasts, and around the genitals.
Erythrodermic Psoriasis: This type of psoriasis can cover the entire body with a reddish skin rash and peeling, causing intense itching and burning sensation.
Pustular Psoriasis: It is a rare type of psoriasis that can occur in large areas of the skin (generalized pustular psoriasis) or in small areas on the hands, feet, and fingertips. It usually manifests quickly, with the skin becoming red and very sensitive, and blisters filled with pus appearing within a few hours. These blisters can appear and disappear frequently. Generalized pustular psoriasis can also cause fever, chills, diarrhea, and intense itching.
Psoriatic Arthritis: In addition to the pink and scaly skin, psoriatic arthritis causes inflammation and pain in the joints, typical symptoms of arthritis. Psoriatic arthritis can affect any joint and can be mild or severe. Usually, psoriasis at younger ages tends to be more severe, has a worse prognosis, and is more commonly associated with other comorbid (coexisting) diseases. This is the case with psoriatic arthritis, which affects up to 30% of people with psoriasis, and those with more severe psoriasis are more likely to develop it. In these cases, early diagnosis is extremely important because, if left untreated, it can cause irreversible damage to the joints.
Psoriasis: Causes While the exact causes of psoriasis are still unknown, it is known to be an autoimmune inflammatory disease that originates from an immune system disorder. Psoriasis is not hereditary, but there is a genetic predisposition for its development, as one-third of patients have a family history, which seems to show a genetic component. However, there are other factors that are crucial for the onset of this disease. According to Alejandro Muñoz, our expert in Psychoneuroimmunology (the study of the interaction between psychological processes and the nervous, endocrine, and immune systems) and Director of Aesthesis, this disease will only manifest in a metabolic and immune-inflammatory context where the presence of unhealthy lifestyles is determinant. Thus, the causes of psoriasis are multiple, but among its triggers, stress, poor nutrition, and unhealthy habits such as alcohol and smoking stand out. In this regard, Gregorio Carretero, a doctor and coordinator of the Psoriasis Group of the Spanish Academy of Dermatology and Venereology (AEDV), agrees that one of the first therapeutic objectives to consider with a person suffering from psoriasis is to correct unhealthy lifestyles, such as alcohol and tobacco consumption or coping behaviors that lead to stress in daily life. Alejandro Muñoz adds that psoriasis and its symptomatic expression can be compensated by introducing changes in lifestyle, such as: processing and managing emotional stress in a therapeutic space, recognizing aggressive foods by measuring pulse or using a glucose meter or performing a food intolerance test, always interpreted by a nutritionist, exercising daily, on an empty stomach, in the first hour of sun exposure, and outdoors, following a diet based on fruits, vegetables, white meat, and wild blue fish (not from fish farms), avoiding the use of corticosteroids that promote metabolic inflammation due to neuroendocrine imbalance.
Psoriasis: Psychology The AEDV emphasizes that „psoriasis can be a devastating disease at a psychological level, especially when it affects visible areas like the face, hands, or genital area.” That is why, in many cases, psoriasis inevitably affects the quality of life of those who suffer from it. A study conducted by Acción Psoriasis (Association of Psoriasis, Psoriatic Arthritis, and Family Patients) revealed that numerous vital areas of patients are affected by psoriasis, highlighting the high relationship between psoriasis and psychology: Social Activities: Up to 61% of people who participated in the study stated that the visibility of the skin lesions caused by the disease can provoke rejection from others, affecting their social relationships. In addition, there may also be a loss of interest or avoidance of social activities. Mood: This disease can cause an initial emotional shock when facing a diagnosis that entails chronicity. Furthermore, in the study, 59% of those affected stated that the lack of a definitive solution for the disease generated negative feelings, which leads to considerable discouragement in people who suffer from it. Self-esteem: Psoriasis symptoms can generate rejection towards one’s own body and the disease, which can lead to a alteration of self-image and, at times, influence clothing choices in order to hide it. In the study, patients’ self-esteem was affected in 36% of cases, a fairly high percentage. Intimate Relationships: According to Acción Psoriasis, skin lesions in the genital areas are common, significantly influencing mood as they can affect patients’ attitude towards intimate relationships or diminish their satisfaction. 20% of the patients in the study stated that psoriasis had notably affected their sexual relationships. Nervousness or Restlessness: Up to 30% of the study participants had these symptoms, a striking percentage. The lack of a definitive treatment to eradicate psoriasis and the impact the disease has on patients’ daily lives are factors that contribute to the presence of anxiety symptoms. Possible Sleep Disorders: Itching, redness, and cracks in the skin can cause problems in falling asleep or getting restful sleep. In the study, one in four patients stated that psoriasis affected their sleep or caused difficulties in sleeping. Concentration Problems and Fatigue:…
