Psoriasis – Causes, Symptoms, Diagnosis, And Treatment
What is psoriasis?
Psoriasis is a skin disease characterized by patches of abnormal skin. This condition causes cells to build up rapidly on the surface of the skin. These extra skin cells form scaly, red, dry, and itchy patches on the skin. Most people with psoriasis have thick, red skin with flaky, silver-white patches called scales.
Psoriasis is very common. Anyone can develop it, but it most often begins between ages 15 to 35. Psoriasis doesn’t spread from person to person.
What causes psoriasis?
Psoriasis seems to be hereditary, which means it is passed down through families. Doctors think it may be an autoimmune condition. This occurs when the immune system mistakenly attacks and inflames or destroys healthy body tissue.
Normal skin cells grow deep in the skin and rise to the surface about once a month. When you have psoriasis, this process takes place in 2 weeks rather than in 3 to 4 weeks. This results in dead skin cells building up on the skin’s surface, forming the patches of scales.
The following conditions may trigger an attack of psoriasis or make it harder to treat:
- Infections from bacteria or viruses, including strep throat and upper respiratory infections
- Dry air or dry skin
- Injury to the skin, including cuts, burns, and insect bites
- Some medicines, including antimalaria drugs, beta-blockers, and lithium
- Too little sunlight
- Too much sunlight (sunburn)
- Drinking too much alcohol
Psoriasis may be worse in people with the weak immune system because of:
- Autoimmune disorders (such as rheumatoid arthritis)
- Cancer chemotherapy
What are the symptoms of psoriasis?
The symptoms of psoriasis can appear suddenly or slowly. Many times, they go away and then come back.
The main symptom of psoriasis is irritated, dry, red, flaky patches of skin. The medical term for the patches is plaques. Plaques are most often seen on the elbows, knees, and middle of the body. But they can appear anywhere, including on the scalp, palms, and soles of the feet.
The skin may feel and look like:
- Dry and covered with silver, flaky skin (scales)
- Pink-red in color (like the color of salmon)
- Raised and thick
The following are the other symptoms:
- Genital sores in males
- Joint pain or aching
- Nail changes, including thick nails, yellow-brown nails, dents in the nail, and a lifting of the nail from the skin underneath
- Severe dandruff on the scalp
There are 5 main types of psoriasis:
- Erythrodermic psoriasis: In this type, the skin redness is very intense and covers a large area.
- Guttate psoriasis: In this type, small, pink-red spots appear on the skin. This form seems to be linked to strep infections.
- Inverse psoriasis: In this type, skin redness and irritation occur in the armpits, groin, and in between overlapping skin.
- Plaque psoriasis: This is the most common type of psoriasis. In this type, thick, red patches of skin are covered by flaky, silver-white scales.
- Pustular psoriasis: In this type, white pus-filled blisters (pustules) are surrounded by red, irritated skin.
How is psoriasis diagnosed?
Your doctor can usually diagnose psoriasis by looking at your skin. Sometimes, a skin biopsy is done to rule out other possible conditions. If you have joint pain, your doctor may order x-rays.
How is psoriasis treated?
The goal of treatment is to control your symptoms, prevent infection, remove scales, and stop skin cells from growing too quickly. Doctors generally treat psoriasis with topical medicines, systemic treatment by oral medicines or injections, or phototherapy.
Topical medicines: Mostly, psoriasis is treated with topical medicines, which are applied or placed directly on the skin or scalp. Your doctor may recommend one or more of the following topical medicines:
- Cortisone creams and ointments
- Creams or ointments that contain coal tar or anthralin
- Creams to remove the scaling (usually salicylic acid or lactic acid)
- Dandruff shampoos (over-the-counter or prescription)
- Prescription medicines containing vitamin D or vitamin A (retinoids)
Systemic treatment: If you have very severe psoriasis, your doctor will likely recommend medicines that suppress the immune system’s faulty response. These medicines include methotrexate or cyclosporine. Retinoids can also be prescribed.
Newer drugs called biologics may also be prescribed when other treatments do not work.
The following biologics are approved for the treatment of psoriasis:
- Adalimumab (Humira)
- Etanercept (Enbrel)
- Infliximab (Remicade)
- Ustekinumab (Stelara)
- Secukinumab (Cosentyx)
- Apremilast (Otezla)
- Ixekizumab (Taltz)
Phototherapy : Sometimes, your doctor may recommend phototherapy:
- This is treatment in which your skin is carefully exposed to ultraviolet light.
- It may be given alone or after you take a drug that makes the skin sensitive to light.
- Phototherapy for psoriasis can be given as ultraviolet A (UVA) or ultraviolet B (UVB) light.
Other treatments: If you have an infection, your doctor will prescribe antibiotics.
Home-care: Following are some home-care tips that may help:
- Taking a daily bath or shower. Try not to scrub too hard because this can irritate the skin and trigger an attack.
- Oatmeal baths may be soothing and may help to loosen scales. You can use over-the-counter oatmeal bath products. Or, you can mix 1 cup (240 mL) of oatmeal into a tub (bath) of warm water.
- Keeping your skin clean and moist, and avoiding your specific psoriasis triggers may help reduce the number of flare-ups.
- Sunlight may help your symptoms go away. Be careful not to get sunburned.
- Relaxation and anti-stress techniques. The link between stress and flares of psoriasis is not well understood.
- Limiting the alcoholic beverages you drink may help keep psoriasis from getting worse.
This feature is for informational purposes only and is not intended to substitute the expert guidance of a doctor. We advise seeing a doctor if you have any health concerns.