Overview

Psoriasis is a chronic autoimmune skin disease causing rapid skin cell build-up, forming scales and red or silvery patches. It cycles through flares and remissions with no permanent cure. Affects 2–3% of the population; psoriatic arthritis develops in up to 30% of patients.

Symptoms

• Raised red patches covered with thick silvery-white scales (plaque psoriasis — most common)
• Dry cracked skin; itching, burning, or soreness
• Thickened pitted nails; most common on elbows, knees, scalp, lower back
• Other types: guttate, inverse, pustular, erythrodermic

Causes & Risk Factors

• Autoimmune: T cells attack healthy skin cells causing accelerated production
• Genetic predisposition — family history is a major risk factor
• Kuwait triggers: stress, streptococcal infections, skin injury, smoking, certain medications

Complications

• Psoriatic arthritis affecting joints (up to 30%)
• Increased cardiovascular disease, type 2 diabetes, and metabolic syndrome risk
• Inflammatory bowel disease; anxiety and depression

Diagnosis

Clinical exam is usually sufficient. Skin biopsy confirms diagnosis. Joint assessment if psoriatic arthritis is suspected. Severity scored with PASI/BSA/DLQI to guide treatment.

Treatment

• Topical: corticosteroids, vitamin D analogues (calcipotriol), salicylic acid, coal tar
• Phototherapy: narrowband UVB — effective and safe long-term
• Biologics (moderate-severe): IL-17 inhibitors (secukinumab), IL-23 inhibitors (guselkumab, risankizumab)

Prevention

• Manage stress; avoid smoking and excess alcohol
• Protect skin from injury; treat throat infections promptly
• Maintain healthy weight and adequate vitamin D levels

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