Psoriasis

What You Need To Know

Hello Rheumatology Fans!

Skin. The biggest organ of the body. Here we will discuss one problem that occurs - Psoriasis - why and when we should be interested in it in MSK.

This will be seperated into 2 articles, first assessment and differential diagnosis. Second adapting treatment.

In This Article

• Introduction (free)

  • Overview of Psoriasis

  • Why MSK Therapists Should Know About Psoriasis

• What is Psoriasis?

  • Definition and Types

  • Pathophysiology: Immune System and Skin Changes

  • Common Symptoms and Signs

• Epidemiology

  • Prevalence and Demographics

  • Risk Factors and Triggers (e.g., Stress, Genetics, Environment)

• Effect On Differential Diagnosis In MSK

Introduction

Overview of Psoriasis

Psoriasis is an auto-immune condition that primarily affects the skin but also has systemic effects. For Musculoskeletal Therapists this is primarily Psoratic Arthritis and the implications of differential diagnosis of joint/tendon/back pain. It does also affect other aspects of health such as socialisation, mental health and comorbidities. It is characterised by rapid skin cell turnover, leading to the formation of thick, scaly patches known as plaques. These are commonly red, itchy, and painful. The most common areas affected include the scalp, elbows, knees, and lower back, although it can occur anywhere on the body.

The cause of Psoriasis is not fully understood much like all the inflammatory conditions, most likely it is a combination of genetic and environmental factors. Stress, infections, medications, and skin injuries are common triggers that can cause flare-ups. There are several types of psoriasis, including plaque psoriasis (the most common form), guttate, pustular, inverse, and erythrodermic psoriasis.

Psoriasis increases the risk of comorbidities such as cardiovascular disease, diabetes, and depression. This is in part due to direct effects of inflammation and also effects on socialisation, relationships, activity levels and sleep.

Why MSK Therapists Should Know About Psoriasis

MSK Therapists play a key role in managing the physical, functional and comorridity challenges faced by patients with psoriasis, particularly those with musculoskeletal involvement. Up to 30% of people with psoriasis develop psoriatic arthritis (PsA). Early diagnosis and intervention can prevent long-term joint damage, improve function, and enhance the quality of life for these patients. This means recognition is vital. Having the skills to assess for Psoriasis is necessary to full assess people with the potential symptoms of PsA (tendon pain, back pain, join pain).

MSK Therapists can also help address other issues caused by psoriasis, such as fatigue, pain, and reduced mobility due to skin discomfort or inflammation. Physical activity and exercise have been shown to reduce systemic inflammation, improve mood, and support cardiovascular health, all of which are important for patients with psoriasis, who are at a higher risk of comorbid conditions like heart disease and obesity.