The hallmark feature of plaque psoriasis is red skin patches with a wavy border covered with clearly defined silvery scales. This occurs in psoriasis because the growth rate of skin cells is up to ten times more rapid than usual, but the removal rate does not occur any faster. As a result, growth of the outmost layer of skin (epidermis), which normally takes from 26 to 28 days to complete, now occurs within three days or so. Normally, skin cells take longer than three days to mature in order to produce an even and flattened appearance. Since this cannot be accomplished within three days, scaling of the skin results. In some cases, the scaly skin may become very thick, especially on the scalp area.
Psoriatic lesions are most commonly found on the following parts of the body:
- elbows and knees
- lower back
- palms of the hands
- soles of the feet
- fingernails and toenails
- skin folds (i.e. armpits, groin, under the breasts)
People with more widespread (extensive) psoriasis may also have lesions on the face and chest. For most people living with psoriasis, the emotional impact is far greater than the physical effects. In general, most psoriatic plaques do not cause bothersome symptoms. Some people with mild to moderate psoriasis will find the affected areas dry and itchy.
Factors that can trigger or worsen psoriasis include excessive alcohol intake, smoking, obesity, stress, viral or bacterial infections, certain medications and trauma.
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