Health Tips

Topic 1: Understanding Psoriasis

Welcome to DOC2US Psoriasis Health Tips Section. There will be 12 topics and we will be releasing 1 topic each month.

“I got a rash. It’s burning and it’s so unsettling! Is it eczema?”

“No, it’s psoriasis. See, there’s a thick layer of skin with silvery scales.”

Although commonly mistaken for one another, they are quite different. Itching tends to be more profound for eczema.¹ While patients with psoriasis may also experience itchiness, they normally report additional pain secondary to cracks in the skin.¹

It can be confusing to differentiate between eczema and psoriasis. Here is an overview of the differences:

IT’S NOT YOUR TYPICAL RASH…

Psoriasis is a chronic, systemic inflammatory autoimmune condition that affects many parts of the body, primarily the joints and skin.^3,4,5 It can be hereditary but worry not, it is non-contagious.^4,5 It is found in approximately 1 – 3% of the general population around the world.³

SHOULD I BE CONCERNED?

According to The Eleventh Report of the Malaysian Psoriasis Registry 2007-2019 by the National Dermatology Registry (DermReg) Malaysia, 23,803 patients with psoriasis were registered within a span from October 2007 to December 2019.⁶ Among them, 91.5% were adults and 55.4% were males.⁶ Most of them were Malays (55.4%), followed by Chinese (18.9%), Indians (16.4%), ethnic groups of Sabah (6.1%), ethnic groups of Sarawak (1.8%) and Orang Asli (0.1%).⁶

According to the Global Report on Psoriasis by the World Health Organization (WHO), a majority of the developed countries report a prevalence between 1.5 and 5% and psoriasis is found to be most common among those aged 50 to 69 years old⁷.

WHAT ARE THE SIGNS AND SYMPTOMS?

TYPES OF PSORIASIS

Plaque psoriasis

Image credit to MedicalNewsToday

• Most common form of psoriasis that affects approximately 80-90% of patients⁵
• Characterized by abnormal raised red rashes covered with silvery-white scales⁵
• Symmetrically distributed rashes tend to be irregular and circular in shape⁵
• Commonly found on the scalp, elbows, trunk, knees, buttocks, soles and palms⁵

Guttate Psoriasis

Image credit to MOH CPG

• Affect <2% of psoriasis patients⁵
• Often characterized by numerous, small salmon-pink spots on the skin⁵
• Mostly found in children and adolescents, usually after an upper respiratory tract infection³

Pustular Psoriasis

Image credit to MOH CPG

• Generalized
  • Characterized by a widespread erythematous rash with pustules ⁵
  • Can be life-threatening, but uncommon ⁵
  • Can be associated with fever and chills⁵
• Localized
  • Localized pustules at the palms or soles of the feet ⁵
  • Non-life-threatening ⁵

Inverse Psoriasis

Image credit to Healthline

• Characterized by red patches of skin with none or minimal scales⁵
• Commonly found in the skin folds of the genital and perineal areas⁵

Erythrodermic Psoriasis

Image credit to UpToDate

• Characterized by widespread erythematous rashes with different severity of scaling^3,5
• Can be life-threatening⁵
• Commonly associated with fever⁵

WHAT ARE THE CAUSES?

Nobody knows for sure the exact cause of psoriasis, but it is believed that genetic and immune factors play a role.⁸ Those with a family history of psoriasis is at higher risk of developing psoriasis.⁸ A triggering event such as stress, illness and skin injury may cause a change in the immune system, resulting in the onset of psoriasis symptoms.⁸

Stay tuned for the next topic in this series: Diagnosis of Psoriasis.

Kindly fill up this survey form https://forms.gle/6PWeZ6B8b1sRrDpN6 for us to improve in our future articles.

A WORD FROM DOC2US

If you have any questions related to psoriasis, you can consult our professional doctors and healthcare professionals on DOC2US. DOC2US is a mobile application that allows you to talk to a doctor or any healthcare professionals via text chat at any time and from anywhere. For better communication, you can even send our online doctor images or voice messages related to your medical inquiry.

Download DOC2US app on Apple App Store, Google Play Store and Huawei App Gallery; or use our web chat at https://web.doc2us.com/

Note: DOC2US is not for medical emergencies. In the event of urgent medical conditions, please call 999.

Disclaimer: As a service to our users and general public, DOC2US provides health education contents. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinicians.

CP-297720 March 2022

REFERENCES

1. National Psoriasis Foundation. Psoriasis or Eczema?. https://www.psoriasis.org/advance/psoriasis-or-eczema-atopic-dermatitis/. Website accessed: 21^st February 2022
2. Mega Kulim. Eczema and Psoriasis. http://megakulim.com.my/2021/07/18/eczema-and-psoriasis/ Website accessed: 6^th January 2022
3. MOH Clinical Practice Guidelines. Management of Psoriasis Vulgaris (June 2013). https://www.moh.gov.my/moh/attachments/9004.pdf. Website accessed: 6^th January 2022
4. Psoriasis - PORTAL MyHEALTH http://www.myhealth.gov.my/en/dewasa-psoriasis/ Website accessed: 6th January 2022
5. Psoriasis Signs And Symptoms | MIMS Malaysia https://specialty.mims.com/psoriasis/signs%20and%20symptoms.Website accessed: 6th January 2022
6. Malaysia Psoriasis Registry. The Eleventh Report of the Malaysian Psoriasis Registry 2007-2019. https://www.dermatology.org.my/DermReg/AnnualReports/MPR_REPORT_2007-2019.pdf Website accessed: 28^th February 2022
7. World Health Organization (WHO). Global report on Psoriasis. https://apps.who.int/iris/bitstream/handle/10665/204417/9789241565189_eng.pdf.psoriasis?sequence=1#:~:text=Psoriasis%20affects%20people%20of%20all,100%20million%20individuals%20affected%20worldwide. Website accessed: 21^st February 2022
8. National Psoriasis Foundation: https://www.psoriasis.org/causes/ Website accessed: 21^st February 2022

Written by

Woong Yi Xin