Do you have red, scaly patches like this on your skin? Shall we talk about (Psoriasis)?

Sometimes we have various skin problems, right? Some of them get better in a couple of days, while others can be a bit long-term and cause us trouble. Today we are going to talk about a skin condition like that, which lasts a bit longer, but can be controlled if managed properly. You may have heard of this, or you may have this condition yourself.

What is `(Psoriasis)`? To put it very simply...

Simply put, `(Psoriasis)` is a skin disease that occurs on our skin and lasts for a long time (that's what the word `chronic` means, it doesn't get better all of a sudden). People with this can see red, sometimes scaly patches on their skin (we call it a `rash`). Just imagine, some people also have joint pain, that is, joint swelling, and various changes in their nails.

One of the things that scares many people is that there is no cure for this disease. That's true. But, don't be afraid! With proper diagnosis and treatment, most people can control their symptoms and live a normal, happy life like everyone else. So, don't worry, right?

What are the symptoms of `(Psoriasis)`? How do we recognize it?

Now let's see what symptoms a person with `(Psoriasis)` (pronounced like 'Sora-a-sis') shows. Then you too can understand this.

The main thing is that the skin becomes red, slightly thickened, and raised spots (which we medically call `plaques` ) appear. These spots can sometimes be inflamed, very itchy, or painful . Imagine, there are people who say that sometimes they scratch so much that they can't even sleep. Often, you can see something like silvery, dry scales on top of these spots. Some say they look like fish scales.

These spots can appear anywhere on the body, but they are most common in young children:

• On the face (especially in areas like the forehead and cheeks)
• On the skull (that is, on the skin of the head. This can also make it look like a scaly rash)
• Where the skin touches each other (for example, armpits, inside of elbows, behind the knees)
• In the diaper area for babies

There may be other symptoms in addition to these, see if these sound familiar to you:

• The skin is very dry, cracked , and sometimes even a little bit of peeling can cause bleeding.
• Changes may occur, such as the nails becoming thicker, changing color, developing small pits (called `pitting`), and the nail peeling off the skin.
• Some people may experience symptoms of arthritis, such as joint pain, morning stiffness, and swelling, along with psoriasis. We call this "psoriatic arthritis."

Are there different types of psoriasis? Which ones are especially common in children?

Yes, there are different types of `(Psoriasis)` as well, that is, there are several types. Not everyone has the same `(Psoriasis)`. Each type has its own characteristics. Let's talk about a few types that are especially common in young children. Knowing these types will also help you choose the right treatment.

Plaque psoriasis

This is the most common type of psoriasis. It affects both adults and children. As mentioned earlier, it is characterized by red, thick plaques (plaques) with silvery scales. These are most often seen on the knees, elbows, lower back, and scalp. They can be very itchy, painful, and can sometimes crack and bleed, which can be a bit annoying.

Guttate psoriasis

This type often appears after an illness, especially a throat infection (such as strep throat). It causes small, red, water-drop-like spots to appear all over the body, especially on the chest, back, arms, and legs. Sometimes these spots can also be seen on the face, scalp, and ears. It often affects children.

Inverse psoriasis

This is where the skin gets pinched together and folds together (for example, under the armpits, between the buttocks, under the breasts, in the groin, and around the genitals), causing smooth, shiny, red, slightly ulcerated, and painful patches. As mentioned earlier, there is less peeling, as these areas are more moist. However, there may be inflammation and pain.

Psoriasis of the face, scalp, and nappy area

Psoriasis is relatively common in these areas among children. Although it may look like scabies when it appears on the scalp, it is different. Psoriasis in the diaper area can sometimes get better after the child has become toilet trained and stopped using diapers.

Why does this `(Psoriasis)` develop? What are the causes?

A question that many people ask is, "Why did I get this?" or "How did my child get this?" In fact, the exact cause of psoriasis is still not 100 percent known . However, there are a few things that medical experts do know.

The main thing is that our body's disease-fighting system, the `Immune system`, is involved in this. Think of it like our immune system, which is like the soldiers in our body. They normally fight off germs that cause disease. But in the body of someone with `(Psoriasis)`, these soldiers are acting a little wrong. It's like they start attacking our own skin cells.

Simply put, some cells in the immune system become overactive and signal skin cells to grow new ones very quickly, within a few days. Normally, it takes several weeks for skin cells to grow, grow, die, and fall off. But in `(Psoriasis)`, this process happens in a few days. Then the new skin cells are not being shed as quickly as the old cells are being produced. That's when those new cells pile up one on top of the other and become visible on the surface of the skin as `(plaques)`, scaly patches. Do you understand how that happens?

Also, some genes have been found to be linked to psoriasis. This means that it can be hereditary. About 40% of people with psoriasis have a family member, such as their mother, father, or siblings, who has the disease. But not everyone develops the disease just because they have the genes. Other factors also play a role.

This can start in anyone, at any age. There is no gender difference. The most important thing to remember is that this is not a disease that can be spread from one person to another by touching, being close to, eating together, or sharing clothes! Therefore, there is no reason to isolate or distance yourself from someone with `(Psoriasis)`.

What are these `(Psoriasis)` `Flare-Ups`?

Psoriasis symptoms can sometimes go away completely and the skin can be clear. However, symptoms can suddenly return, with more patches, more itching, and more inflammation. This sudden worsening of symptoms is called a 'flare-up' or 'outbreak' . A flare-up can be very distressing.

Now let's see what things can cause these `(Psoriasis)` symptoms to worsen or increase. By knowing these, we can try to avoid them as much as possible.

• Infections: Especially throat infections (strep throat) and common colds and coughs. Many people report that psoriasis flares up after these.
• Some medications: For example, `(Lithium)` (a medication used to treat some mental illnesses), `(beta-blockers)` (a medication used to treat high blood pressure), and some medications used to treat malaria. So if you start taking any new medication, don't forget to tell your doctor that you have `(Psoriasis)`.
• Stress: This is a major factor that can lead to many diseases. Psoriasis can worsen during exam times, work problems, and family problems.
• Skin injury: A scratch, cut, burn, or insect bite can sometimes cause a new psoriasis patch to form at that location. This is called the Koebner phenomenon.
• Cold and dry weather: During the winter, windy days, the skin can become dry and psoriasis can worsen.
• Drinking alcohol: It has been clearly found that drinking alcohol worsens psoriasis.
• Smoking: Smoking is another major factor that increases the risk of this disease.

How does a doctor accurately diagnose psoriasis?

If you or your child has any of the symptoms mentioned above, it's best to see a doctor. Doctors usually diagnose psoriasis by examining your skin, scalp, and nails . The appearance of the patches, their location, and the nature of the scaling can help your doctor determine if it's psoriasis.

In addition, the doctor will ask you a few questions. For example:

• Does anyone else in your family have this type of skin disease?
• If it's a child, has he or she recently had any illness, such as a fever or sore throat?
• Have you started any new medication?
• How long have these spots been there? Do they itch? Are they painful? Things like that.

In most cases, the doctor can diagnose psoriasis by examining you in this way and listening to the details you provide.

However, very rarely, that is, very rarely , sometimes if the appearance of the spots is a little unclear, a doctor may take a small piece of skin (a very small piece, nothing to worry about) and send it to a laboratory to be looked at under a microscope. This is called a skin biopsy . This ``biopsy`` allows the doctor to know with 100 percent certainty whether it is ``Psoriasis`` or something else with similar symptoms (for example, a fungal infection, ``eczema``).

What are the treatments for `(Psoriasis)`?

Okay, now let's see what kind of treatment is available for this condition `(Psoriasis)`. `(Psoriasis)` is often treated by a dermatologist . He is the one who decides the most appropriate treatment for your condition. Sometimes, if you also have joint problems (`Psoriatic Arthritis`), as mentioned earlier, a doctor who treats problems related to the immune system (`rheumatologist`) can come to help.

There are several treatment options. Your doctor will choose the treatment based on many factors, including the type of psoriasis you have, how widespread it is, your age, and your general health.

There are three main categories of treatment:

1. Topical treatments: These are often used first.

• Moisturizers: These help reduce skin dryness and control itching and peeling.
• Creams and ointments containing ``Corticosteroids``: These reduce inflammation, redness, and rapid cell division. But these should only be used as directed by your doctor, and for as long as necessary.
• Vitamin D analogues: These also control the growth of skin cells.
• Calcineurin inhibitors: These can be used on sensitive areas such as the face and skin folds.
• Shampoos and lotions containing `Salicylic acid` or `Coal tar`: These help to remove scales from the scalp (Psoriasis).

2. Light therapy (`Light therapy` / `Phototherapy`):

• This involves directing a specific type of ultraviolet light (`UV light`) at the skin. This can be done either in the sun (under control) or with special equipment at a medical center. However, for some children and some people, sunlight can make their ``(Psoriasis)`` condition worse. Therefore, this is something that should definitely be done under the supervision of a doctor.

3. Oral or injectable medications (`Systemic medications`):

• These are usually given to people with more severe psoriasis, or those who are unable to control their condition with other treatments. These include medications such as methotrexate, cyclosporine, and acitretin, as well as newer injectable medications called biologics. These medications can cause side effects, so your doctor will monitor you closely while you are taking them.

A doctor may try one treatment and then switch to another if it doesn't work. Or they may recommend a combination of treatments (such as creams and light therapy). Not everyone gets the same results from the same treatment. Sometimes it can take a while to find the right treatment for you. Also, a treatment that works for a while may not work for you later. So it's important to be patient and trust your doctor .

How can parents help? (If your child has Psoriasis)

For some children, psoriasis is just a minor annoyance that can have a big impact on their daily activities. But for others, it can be a really difficult medical condition, both physically and mentally . So there are a lot of things you can do as a parent.

To help manage symptoms and reduce those aforementioned 'flare-ups', it's a good idea for your child to do these things. You can encourage them to:

• Teach them to wash their hands often and stay away from people who are sick. This will help prevent infections that can cause flare-ups.
• Help your child manage stress . Things like engaging in a hobby that they enjoy, exercising (running, jumping, playing), doing yoga, and meditating can help. Talk to them and listen to what's on their mind.
• Completely avoid smoking and drinking alcohol (these are not good for a young child, and they are also very harmful for psoriasis).
• Help maintain a healthy weight . Eat a balanced diet, and reduce sugary drinks and fatty foods. It has been found that people who are overweight may experience more severe symptoms of psoriasis.
• Help your doctor use moisturizers daily as recommended. It is best to apply them when the skin is damp, such as after a bath.
• Teach them to be careful of things that can scratch or injure the skin.

Children and young people with psoriasis may feel embarrassed, sad, angry, or embarrassed about the appearance of their skin. They may also be afraid that their friends will make fun of them or make them feel left out. Help your child understand that this is a common condition that affects many people , that it is not their fault , and that it can be controlled with treatment. Help them build their self-confidence.

Whether your child's psoriasis is mild or severe, learn about the disease together . Ask questions and seek information from your doctor. If necessary, see a therapist or join a support group with other people with psoriasis and their families. This will help them understand that they are not alone.

Talk to your doctor for more information. There is also a lot of valuable information online on reputable websites like the National Psoriasis Foundation and TalkPsoriasis.

So, what are the most important things to remember from what we talked about today?

Okay, so let's remind you again of some of the things we talked about in this `(Psoriasis)` that you need to keep in mind.

• Although psoriasis is a long-term skin disease, it is not contagious . This is the most important thing.
• Although the exact cause of this is not yet known , immune system function and genetic influences are thought to be the main factors.
• If diagnosed correctly and treated under the advice of a specialist , symptoms can be well controlled and a normal life can be led.
• Treatment methods may vary from person to person. It is important to be patient and trust your doctor .
• Flare-ups can be reduced by identifying and avoiding triggers.
• It is also very important to take care of mental health.

Finally, you are not alone! There are many people living with psoriasis in Sri Lanka and around the world. Get proper medical advice, get proper treatment, and stay mentally strong.

If you or your child has any of these symptoms, it's important to see a dermatologist for advice . Starting treatment early can go a long way in controlling the condition. Don't be afraid to ask your doctor any questions you may have.

` Scalp, Psoriasis, Psoriasis, Skin Diseases, Dermatology, Psoriasis Treatment, Psoriasis Symptoms, Skin Diseases in Children