Flexural Psoriasis - Symptoms and Treatment

Flexural Psoriasis is a non-infectious auto-immune disease, caused by activation of T-cells within the skin. Flexural Psoriasis is also called Inverse Psoriasis. It 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. This type of psoriasis appears as smooth, dry areas of skin that are red and inflamed but do not have the scaling associated with plaque psoriasis. Flexural psoriasis is more frequent and severe in people who are overweight because it is in the skin folds where it isparticularly prone to irritation from rubbing and sweating. Also called inverse psoriasis. 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 (fissure) in the depth of the skin crease. The deep red colour and well-defined borders characteristic of psoriasis may still be obvious. 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. Stronger topical steroids need to be used with care, only for a few days, thinly and very accurately applied to the psoriasis. If the psoriasis has cleared, stop the steroid cream. The steroid cream may be used again when the condition recurs. Calcipotriol cream is an effective and safe treatment for psoriasis in the flexures and should be applied twice daily. If it irritates, it can be applied once daily and hydrocortisone cream 12 hours later. Systemic agents are rarely required for limited flexural psoriasis and phototherapy is relatively ineffective because the folds are hidden from light exposure.

Flexural Psoriasis is also called Inverse Psoriasis. Flexural Psoriasis is characterized by intense inflammation and little scaling. The name is derived from the Greek word Psora and means, �to itch�. It is the growth of too many skin cells. Where the normal skin matures in 20 to 30 days, the skin of a person with psoriasis takes only 3 to 6 days to mature. Psoriasis affects 1-3 percent of the world population and is not limited to a certain age group. People over 50 are more at risk but children; especially girls may also suffer from it. It is very common under people with fair skins and rarely affects dark skinned people. Flexural Psoriasis is also called Inverse Psoriasis, and is more common with overweight persons because it appears in the skin folds where most rubbing takes place. The illness is also associated with mental well being. 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.

Causes of Flexural Psoriasis

Common Causes of Flexural Psoriasis :

• A bacterial or viral infection can cause a flexural psoriasis.
• In 30-35% cases of flexural psoriasis, the main cause is heredity.
• Sometimes even mild injuries to the skin such as abrasions can trigger a psoriasis flare.
• The emotional stress such as depression and anxiety are strongly associated with psoriasis flare-ups
• Certain medicines, including lithium salt and beta blockers have been reported to trigger or aggravate the disease.
• Environmental factors are thought to trigger psoriasis in people who have a genetic tendency toward the disease.

Symptoms of Flexural Psoriasis

Some common Symptoms of Flexural Psoriasis :

• Sensitivity to friction and sweating.
• Smooth, vivid red, moist patches without a scaly surface.
• Pain and itchiness in the affected area.
• Nail disorders may be found in peoples with flexural psoriasis.
• Frequent shedding of silvery scales
• Itching.

Treatment of 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.
• 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. Topical steroid lotions may be applied under affected nails for onycholysis.
• Emollients may include keratolytic agents such as urea or salicylic acid, that are very effective for the treatment of flexural psoriasis.
• Soaking in warm water with a bath oil or tar solution can often help cure psoriasis and lift the scale. Bland soaps or soap substitutes may be useful. Antiseptics are not necessary and may irritate.
• Take supplements of vitamin E.
• Aspirin
• A diet of grains, nuts, seeds, vegetables and fruit should be followed.
• Use moisturizes instead of soap to prevent the skin from becoming too dry.
• Vitamin D compound creams are effective and can be applied to the skin folds daily.

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