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Flexural Psoriasis - Definition, Causes, Symptoms and Treatment


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Flexural Psoriasis is a non-infectious auto-immune disease, caused by activation of T-cells within the skin. It is more frequent and severe in people who are overweight because it is in the skin folds where it is particularly prone to irritation from rubbing and sweating. It is a chronic disease characterized by thick, red, silvery, scaled patches of skin. Flexural Psoriasis is a form of psoriasis found in the armpits, groin, under the breasts and in other flexion creases such as those around the genitals and buttocks. It can occur at any time of life, but most commonly appears in the early 20s, and can occur in both men and women and tends to occur more in fair skinned people. Due to the moist nature of the skin folds the appearance of the psoriasis is slightly different. It tends not to have silvery scale, but is shiny and smooth. There may be a crack in the depth of the skin crease. Flexural psoriasis is more frequent and severe in people who are overweight because it is in the skin folds where it is particularly prone to irritation from rubbing and sweating. Also called inverse psoriasis.

Most patients experience depression, which in turn increases the symptoms of Psoriasis, and in return leads to more anxiety and stress. The plaques are sometimes infected with the fungi candida albicans. It sometimes appears at the site of injuries or scars. Around 6 per cent of the people who have psoriasis also get psoriatic arthritis in the joints. Psoriatic arthritis primarily occurs in fingers and toes, but is also quite common in the back bone. Psoriasis is a chronic disease, which means you may have it for months or years. However early treatment may minimise the severity of the disorder. Flexural psoriasis responds quite well to topical treatment but often recurs. Weak topical steroids may clear flexural psoriasis but it will usually recur sometime after discontinuing treatment. Systemic agents are rarely required for limited flexural psoriasis and phototherapy is relatively ineffective because the folds are hidden from light exposure.

Causes of Flexural psoriasis

Several factors are thought to aggravate psoriasis. These include stress and excessive alcohol consumption. Individuals with psoriasis may also suffer from depression and loss of self-esteem. Psoriasis is a condition which runs in families, but the exact way in which the disease moves from generation to generation has not yet been established. However, exposure to certain stimuli or damage to the skin, may cause an outbreak of psoriasis in persons who have this genetic predisposition. There are certain times in life when the tendency to develop psoriasis is increased - for example, during puberty or in women during or after the menopause.

Common causes and risk factors of Flexural psoriasis:

  • Streptococcal Infection.
  • Sun exposure.
  • Steroids and some other medications.
  • Smoking.
  • Psychological factors, such as stress.
  • Hormonal factors.

Signs and Symptoms of Flexural psoriasis

There are several types of psoriasis. Symptoms for each type may vary in severity and appear in a wide array of combinations. Flexural or inverse psoriasis which is where the condition appears as smooth but inflamed patches of skin in the skin folds, but especially around the genitals, the armpits and under the breasts. It is affected by friction and sweat, and is vulnerable to fungal infections because of its appearance in the skin folds.

Sign and symptoms may include the following :

  • Red, raised skin patches.
  • Patches often occur in the same area on both sides of the body.
  • Sensitivity to friction and sweating.
  • Outbreaks most frequent on the elbows, knees, scalp, buttocks, and lower back.
  • Nail disorders.

Treatment for Flexural psoriasis

Sunshine may help to clear psoriasis. It is found that in many people it improves dramatically during sunny holidays. Calcipotriol cream is an effective and safe treatment for psoriasis in the flexures and should be applied twice daily. Doctors gives a advice to use proper medicine. A cleansing fast that consists of seven days of fruit juice and water is sometimes recommended as the first step in the treatment process since Flexural Psoriasis is a metabolic illness.

Treatment may include:

  • People with severe flexural psoriasis may require systemic drugs such as methotrexate to control the condition.
  • Patients often prefer to use topical steroids as these are clean, easy to use and soothing. Topical steroids are very useful for treating flexural psoriasis.
  • Rest, particularly bed rest, is beneficial for flexural psoriasis.
  • Steroid creams and ointments are considered very effective for the treatment of flexural psoriasis.
  • Emollients may include keratolytic agents such as urea or salicylic acid, that are very effective for the treatment of flexural psoriasis.