Everything You Need to Know About Psoriasis

SPEAKER_1 (0:00)

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SPEAKER_2 (0:16)

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Ellie Rashid (0:46)

August is psoriasis awareness month here in the UK, and psoriasis is a condition that affects 125 million people globally. And I see psoriasis every single week in my NHS clinic. I do a severe psoriasis and eczema clinic on a weekly basis, where I see patients that are really struggling and may need some help with some medical therapies that we can offer.

Hello, and welcome to the After Hours Skin Clinic. Now, if you've been here before, you'll realize that something's a little different. I'm Dr. Ellie Rashid, and I'm usually here with my right-hand woman, Dr. Emma Craythorne. But she's away on her holidays at the moment, so it's just me. Hello. If you don't know me yet, I'm a consultant dermatologist with a PhD in regenerative dermatology. And right here is my favorite clinic. It's where we unpack the evidence, challenge the trends, and answer the questions that don't always fit into a 10-minute consultation. This is the other side of dermatology, the questions that you want to ask your dermatologist, but you don't have time. And if you don't have one, well, you do now.

This episode is all about psoriasis. So now, have a listen to this.

Alys (1:56)

Well, my psoriasis is really bad. I was on 55% coverage or something crazy, like over half my body had psoriasis on it, and I'd bleed onto sheets and bleed through clothes. It was just really unpleasant. I think that's part of psoriasis, which people don't understand. Hi, I'm Alys. I've had psoriasis for around 20 years now. I got diagnosed as a kid, and I have some questions that have followed me along my psoriasis journey that I'd love to get some answers to. And I also hope that, I don't know, I hope these questions also maybe will help other people who are in a similar situation to me, or maybe just want to learn a little bit more about psoriasis, or have just got diagnosed. So I'd really love to hear your thoughts. Thank you.

Ellie Rashid (2:39)

So today, that's exactly what we're going to do. So let's start with what psoriasis is. So psoriasis is an inflammatory skin condition. And essentially what's happening is there's a genetic propensity towards having this.

And our skin cells, they go from the bottom of the top layer of skin to the top of the top layer of skin. And that transition time is usually around three to four weeks. And in psoriasis, that transition time is much, much faster. And for some people, it can even be three or four days. And where the skin usually sheds off that top layer of skin, that process doesn't happen. So you get this compacting or this scale arising on this inflammatory base that often looks red and inflamed, or on other skin tones, it can look brown or purple. And the scaliness that develops, that silvery sort of scale that can develop, then sheds off. So the commonest thing that people complain about is actually there's just flakes and scale all over their home. So they're having to vacuum twice a day, it's all over the bed. And where it's inflamed, it can also be a little bit sore. It can be slightly itchy.

These plaques can bleed and as Alys mentioned in her clip, you can have blood all over the sheets or on the sofa. So you might be sitting down on someone's cream-colored sofa and be conscious of the fact that you may be bleeding from your psoriasi form plaques onto their chair or sofa. So it can have a really big impact on people. Psoriasis can also affect people's fingernails, where there are a few features. You get lifting of the nail plate, something called onycholysis. You can get pitting of the nail plate itself, and you can get this thickening up with scale underneath the nail plate as well, so that nail plates lifts off the nail bed. People can also suffer with psoriatic arthritis, where they've got this inflammatory arthritis that can affect their joints.