Psoriasis

Psoriasis is a chronic autoimmune condition that causes the rapid buildup of skin cells. This buildup causes scaling on the skin's surface, resulting in red, inflamed patches covered with silvery-white scales. These patches, called plaques, can be itchy and painful.

Psoriasis is not contagious. It's a long-term condition that tends to come and go in cycles. While there's no cure, various treatments can help manage symptoms and improve quality of life. The condition affects people of all ages but most commonly appears between ages 15 and 35.

Symptoms vary depending on the type of psoriasis:

Common Symptoms:

• Red patches of skin: Covered with thick, silvery scales
• Dry, cracked skin: That may bleed
• Itching, burning, or soreness: In affected areas
• Thickened, pitted, or ridged nails: Nail changes
• Swollen and stiff joints: In psoriatic arthritis

Types of Psoriasis:

• Plaque psoriasis: Most common, raised red patches
• Guttate psoriasis: Small, drop-shaped spots
• Inverse psoriasis: Smooth red patches in skin folds
• Pustular psoriasis: White pustules surrounded by red skin
• Erythrodermic psoriasis: Widespread redness (rare, serious)

Common Locations:

• Scalp
• Elbows and knees
• Lower back
• Palms and soles
• Face
• Genital area

Seek emergency care if:

• Widespread redness covering large areas
• Severe pain or discomfort
• Signs of infection (pus, increasing redness, fever)
• Severe joint pain and swelling

Managing psoriasis involves:

1. Moisturize Regularly:

   • Use thick moisturizers
   • Apply after bathing
   • Helps reduce scaling and itching
   • Choose fragrance-free products

2. Avoid Triggers:

   • Stress: Practice stress management
   • Skin injuries: Avoid cuts, scrapes, sunburns
   • Infections: Treat infections promptly
   • Medications: Some medications can trigger flares
   • Weather: Cold, dry weather may worsen symptoms
   • Alcohol: May trigger flares in some people

3. Sunlight (with caution):

   • Moderate sun exposure may help
   • Avoid sunburn (can trigger flares)
   • Use sunscreen on unaffected areas
   • Discuss with doctor

4. Bathing:

   • Warm (not hot) baths
   • Add bath oils or oatmeal
   • Pat dry, don't rub
   • Apply moisturizer immediately after

5. Avoid Scratching:

   • Keep nails short
   • Use cold compresses for itching
   • Consider anti-itch medications
   • Scratching can worsen condition

6. Healthy Lifestyle:

   • Balanced diet
   • Regular exercise
   • Adequate sleep
   • Stress management
   • Maintain healthy weight

7. Follow Treatment Plan:

   • Use medications as prescribed
   • Don't stop treatment abruptly
   • Report side effects
   • Attend follow-up appointments

• Widespread severe redness
• Signs of severe infection
• Severe joint pain and swelling
• Difficulty moving joints

• Symptoms not improving with treatment
• New or worsening symptoms
• Signs of infection
• Need to adjust treatment
• Questions about medications
• Psoriatic arthritis symptoms

• Symptoms well-controlled
• Following treatment plan
• No new concerns
• Regular follow-up scheduled

Diagnosing psoriasis involves:

1. Physical Examination:

   • Visual inspection of skin
   • Check nails
   • Assess joints (if psoriatic arthritis suspected)
   • Medical history

2. Skin Biopsy (if needed):

   • Small sample of skin examined
   • Helps confirm diagnosis
   • Rules out other conditions

3. Blood Tests (if psoriatic arthritis suspected):

   • Inflammatory markers
   • Rheumatoid factor (usually negative)
   • Other arthritis tests

4. Family History:

   • Psoriasis can run in families
   • Helps with diagnosis

Treatment depends on severity and type:

1. Topical Treatments (mild to moderate):

   • Corticosteroids: Reduce inflammation
   • Vitamin D analogs: Slow skin cell growth
   • Retinoids: Reduce inflammation
   • Calcineurin inhibitors: Reduce inflammation
   • Coal tar: Reduces scaling and itching
   • Salicylic acid: Removes scales

2. Light Therapy (Phototherapy):

   • UVB light therapy
   • PUVA (psoralen plus UVA)
   • Natural sunlight (with caution)
   • May require multiple sessions

3. Oral Medications (moderate to severe):

   • Methotrexate: Suppresses immune system
   • Cyclosporine: Suppresses immune system
   • Retinoids: Reduce skin cell production
   • Biologics: Target specific immune responses

4. Biologic Medications (severe cases):

   • Injectable medications
   • Target specific parts of immune system
   • Used when other treatments fail
   • Require monitoring

5. Lifestyle Modifications:

   • Stress management
   • Healthy diet
   • Regular exercise
   • Avoid triggers

6. Psoriatic Arthritis Treatment (if present):

   • Anti-inflammatory medications
   • Disease-modifying medications
   • Physical therapy
   • Joint protection

While psoriasis cannot be prevented, you can reduce flares:

• Manage Stress: Practice stress-reduction techniques
• Avoid Skin Injuries: Protect skin from cuts and scrapes
• Treat Infections Promptly: Especially strep throat
• Avoid Triggers: Identify and avoid your triggers
• Healthy Lifestyle: Diet, exercise, sleep
• Follow Treatment Plan: Keep condition under control
• Regular Check-ups: Monitor condition

In psoriasis:

1. Immune System Activation: Immune system mistakenly attacks healthy skin cells
2. Rapid Cell Growth: Skin cells grow much faster than normal
3. Cell Buildup: Dead skin cells accumulate on surface
4. Plaque Formation: Red, scaly patches form
5. Inflammation: Affected areas become inflamed

Causes:

• Genetics: Family history increases risk
• Immune system: Autoimmune condition
• Triggers: Stress, infections, medications, injuries
• Environmental factors: Weather, lifestyle

• Most common age of onset (15-35)
• May affect work and social life
• Stress management important
• May need treatment adjustments

• May have had condition for years
• May have other health conditions
• May need medication adjustments
• Higher risk of complications

• Higher risk of psoriatic arthritis
• May have other autoimmune conditions
• Higher risk of cardiovascular disease
• May need coordination of treatments

No. Psoriasis is not contagious. You cannot catch it from or spread it to others.

There's no cure, but treatments can effectively manage symptoms. Many people have periods of remission where symptoms clear or improve significantly.

Psoriasis is a chronic condition, but symptoms can be well-controlled with treatment. Many people have periods of clear skin.

Some people find that certain foods trigger flares, but there's no universal psoriasis diet. Maintaining a healthy weight and balanced diet is generally recommended.

Yes. Exercise is beneficial and doesn't worsen psoriasis. In fact, it may help reduce stress, which can trigger flares. Just be careful to avoid skin injuries.