Pictures, Symptoms, Triggers, and Treatments

Knowing which kind of psoriasis you have helps you and your doctor make a treatment plan. Most people have only one type at a time. Sometimes, after your symptoms go away, a new form of psoriasis will crop up in response to a trigger.

In general, most types of psoriasis result from the same triggers:

Other things that may trigger psoriasis include:

Here’s how you can spot the 7 types of psoriasis and what you can do to treat them.

Plaque Psoriasis

This is the most common type. About 8 in 10 people with psoriasis have this kind. You may hear your doctor call it “psoriasis vulgaris.”

Symptoms:
Plaque psoriasis causes raised, inflamed, red skin covered with silvery, white scales. These patches may itch and burn. It can appear anywhere on your body, but it often pops up in these areas:

• Elbows
• Knees
• Scalp
• Lower back

Treatments:

• Topical treatments: These go on your skin and are usually the first thing doctors try. Some have steroids; others don’t. Prescription products slow skin cell growth and ease inflammation.
• Phototherapy: This treatment uses ultraviolet light. You’ll get it at your doctor’s office or at home with a phototherapy unit.
• Systemic medications: These prescription drugs work throughout your body. You’ll get them if you have moderate to severe psoriasis that doesn’t respond to other treatments. You could take them by mouth or get them as a shot or IV. This category includes drugs called biologics, which target specific parts of your immune system that play a role in the inflammatory process. Learn more about systemic treatments for psoriasis.

Guttate Psoriasis

This type often starts in children or young adults. It happens in less than 2% of cases.

Guttate psoriasis causes small, pink-red spots on your skin. They often appear on your:

• Trunk
• Upper arms
• Thighs
• Scalp

This type of psoriasis may go away within a few weeks, even without treatment. Some cases, though, are more stubborn and require treatment.

Inverse Psoriasis

This type usually found in these locations:

• Armpits
• Groin
• Under the breasts
• Skin folds around the genitals and buttocks

Symptoms include:

• Patches of skin that are bright red, smooth, and shiny, but don’t have scales
• Getting worse with sweating and rubbing

Common triggers are:

Pustular Psoriasis

This kind of psoriasis is uncommon and mostly appears in adults. It causes pus-filled bumps (pustules) surrounded by red skin. These may look infectious, but are not.

This type may show up on one area of your body, such as the hands and feet. Sometimes it covers most of your body, which is called “generalized” pustular psoriasis. When this happens, it can be very serious, so get medical attention right away.

Symptoms include:

Triggers include:

• Topical medicine (ointments you put on your skin) or systemic medicine (drugs that treat your whole body), especially steroids
• Suddenly stopping systemic drugs or strong topical steroids that you used over a large area of your body
• Getting too much ultraviolet (UV) light without using sunscreen
• Pregnancy
• Infection
• Stress
• Exposure to certain chemicals

Erythrodermic Psoriasis

This type is the least common, but it’s very serious. It affects most of your body and causes widespread, fiery skin that appears to be burned.

Other symptoms include:

• Severe itching, burning, or peeling
• A faster heart rate
• Changes in body temperature

If you have these symptoms, see your doctor right away. You may need to get treated in a hospital. This type of psoriasis can cause severe illness from protein and fluid loss. You may also get an infection, pneumonia, or congestive heart failure.

Triggers include:

Erythrodermic psoriasis may also happen if your psoriasis is hard to control.

Nail Psoriasis

Up to half of those with psoriasis have nail changes. Nail psoriasis is even more common in people who have psoriatic arthritis, which affects your joints.

Symptoms:

• Pitting of your nails
• Tender, painful nails
• Separation of the nail from the bed
• Color changes (yellow-brown)
• Chalk-like material under your nails

You’re also more likely to also have a fungal infection.

Psoriatic Arthritis

Psoriatic arthritis is a condition where you have both psoriasis and arthritis (joint inflammation). In 70% of cases, people have psoriasis for about 10 years before getting psoriatic arthritis. About 90% of people with it also have nail changes.

Symptoms:

• Painful, stiff joints that are worse in the morning and after rest
• Sausage-like swelling of the fingers and toes
• Warm joints that may be discolored

Causes, Treatments, and Lifestyle Tips

Psoriasis is a skin disease that affects about 8 million Americans. It comes in several forms. Plaque psoriasis is the most common.

Plaques are raised red patches covered with a whitish buildup of dead skins cells called scale. They usually show up on your elbows, knees, scalp, and lower back, but you can have them anywhere. Plaques often itch or hurt.

Causes

Doctors aren’t sure why people get plaque psoriasis. It’s considered an autoimmune disease. That means your immune system attacks healthy cells as if it’s fighting an infection. This causes new skin cells to grow much faster than normal, and they build up in thick patches.

Whether you get plaque psoriasis depends on your genes and your health history:

• Heredity. Psoriasis seems to run in families. About one out of three people with psoriasis report having a relative with psoriasis. About 10% of people are born with genes that make them likely to get psoriasis. But only about 3% of people get the disease. Still, If both parents have psoriasis, a child has approximately a 50 percent chance of developing the disease.
• Triggers. Something has to happen to start your immune system’s reaction. Sometimes, it’s an injury to your skin or a bad sunburn. It could be a certain medicine, like lithium or malaria drugs. An infection, particularly strep, can bring on psoriasis. So can high levels of stress, Smoking, or drinking alcohol.

Psoriasis isn’t contagious. It can’t be spread by touch or other close contact.

People with psoriasis tend to have other conditions that cause inflammation, like Crohn’s disease, diabetes, metabolic syndrome, fatty liver disease, and obesity. If you have it, you may be more likely to get heart disease, depression, and a kind of eye disease called uveitis. You also have as much as a 1-in-3 chance of getting psoriatic arthritis, which causes joint pain, stiffness, and swelling, and joint deformity.

Diagnosis

A dermatologist (skin doctor) can usually tell if you have plaque psoriasis just by talking with you about your medical history and looking at your skin. But since psoriasis can look like eczema and other skin diseases, diagnosing it can be difficult. In some cases, your doctor may need to do a biopsy. They’ll take a tiny sample of your skin and look at the cells under a microscope.

Treatment

Psoriasis can’t be cured. You’ll probably go through cycles where the rash looks better and then flares up again. The goal of treatment is fewer and less severe flare-ups.

You may get medicine to put on your skin or you may take pills, or your doctor may recommend a combination of those. Treatment options include:

• Topical medications. If you have only a few plaques, your doctor will probably try a prescription cream first. You put these directly on your skin. They help with inflammation or slow the growth of skin cells. Examples include anthralin.,corticosteroids, vitamin A, and vitamin D. You can also try over-the-counter topical medicines. Salicylic acid and coal tar are approved to treat psoriasis. Other ingredients may soothe itch and remove scale, including aloe vera, capsaicin, jojoba,and zinc pyrithione. Topical emollients that you put on after a shower or bath can help keep your skin moist.
• Light therapy. If the rash is more widespread, your doctor may treat it with ultraviolet light. This is done at their office or with a special box you can keep at home. You may also get relief by going out in the sun, but this can raise your risk of skin cancer. Watch how long you spend outside, and cover up or put sunscreen on places where you don’t have plaques.
• Systemic drugs. If you have a severe case of plaque psoriasis, you may need medicines that work throughout your body. They calm your immune system or make your skin cells grow more slowly. But they can cause serious side effects, like depression, aggressive thoughts, liver problems, or a higher risk of skin cancer. You take systemic drugs like acitretin, cyclosporine, and methotrexate by pill, or your doctor will give you a shot.
• Biologic drugs. Another kind of systemic drug also targets your immune system. Biologic drugs used to treat psoriasis include adalimumab (Humira), brodalumab (Siliq), etanercept (Enbrel), guselkumab (Tremfya), infliximab (Remicade), ixekizumab (Taltz), risankisumab-rzaa (Skyrizi), secukinumab (Cosentyx), and ustekinumab (Stelara). They’re given in a shot or through a vein in your arm. They affect a specific type of immune cell or keep certain proteins from causing inflammation. But these drugs can make it harder for you to fight an infection.

Learn more about advanced treatments for psoriasis.

What You Can Do

Most people who get plaque psoriasis have it for the rest of their lives. You can do a few things to deal with it better:

Avoid triggers. Things like stress and smoking don’t cause psoriasis. But they can make it worse. Try to figure out what triggers your flare-ups. You may be affected by:

• Alcohol
• Allergies
• Cold, dry weather
• Hormones

Watch your diet. There’s no proof that specific foods make a difference with psoriasis. But losing weight may keep your symptoms at bay, so it makes sense to eat healthy. And a diet low in fatty meat and dairy products and high in fish and colorful fruits and vegetables may help with inflammation. Read more on psoriasis and your diet.

Take care of your skin. A good moisturizer can keep plaques soft and make you less itchy. Avoid harsh soaps.
A bath with colloidal oatmeal or Epsom salts can also soothe your skin. Try using medicated shampoo for scales on your scalp. Learn about more skin care tips for psoriasis.

Get support. Plaque psoriasis can take an emotional toll. You may feel self-conscious about the way it looks or overwhelmed by what it takes to manage it. Many people with psoriasis become depressed. If you think you need some help, talk with your doctor about therapy or medication. It also helps to talk with people who understand what you’re going through and can offer strategies for coping. Find out how to get emotional support during psoriasis treatment.

Work with your doctor. Talk with them about how you’re doing and any changes to your condition. You may need to change your treatment over time. Don’t suddenly stop using a psoriasis drug, or you could cause a more serious illness. Be aware of symptoms that could signal psoriatic arthritis, like joint pain. Read about what you can do to make your psoriasis treatment work.

Psoriatic Arthritis | Johns Hopkins Medicine

What is psoriatic arthritis?

Psoriatic arthritis is a type of arthritis linked with psoriasis, a chronic skin and
nail disease. Psoriasis causes red, scaly rashes and thick, pitted fingernails.
Psoriatic arthritis is similar to rheumatoid arthritis (RA) in symptoms and joint
swelling (inflammation). But it tends to affect fewer joints than RA. And it does not
make the typical RA antibodies. The arthritis of psoriatic arthritis comes in 5
forms:

• Arthritis that affects the small joints in the fingers, toes, or both
• Asymmetrical arthritis of the joints in the hands and feet
• Symmetrical polyarthritis, which is similar to RA
• Arthritis mutilans, a rare type of arthritis that destroys and deforms joints
• Psoriatic spondylitis, arthritis of the lower back (sacroiliac sac) and the
  spine

What causes psoriatic arthritis?

Doctors don’t know what causes psoriatic arthritis. But factors such as immunity,
genes, and the environment may play a role.

What are the symptoms of psoriatic arthritis?

The
psoriasis symptoms may start before or after the arthritis. Psoriasis causes red, scaly
rashes and thick, pitted fingernails. About 3 in 20 to 3 in 10 people with psoriasis
may develop psoriatic arthritis. Symptoms of psoriatic arthritis may include:

• Inflamed, swollen, and painful joints, often in the fingers and toes
• Deformed joints from chronic inflammation

The symptoms of psoriatic arthritis can look like other health conditions. Make sure to see your healthcare provider for a diagnosis.

How is psoriatic arthritis diagnosed?

Psoriatic arthritis is easier to confirm if you already have psoriasis. If you don’t
have the skin symptoms, diagnosis is more difficult. The process starts with a health
history and a physical exam. Your healthcare provider will ask about your symptoms. You
may have blood tests to check the following:

• Erythrocyte sedimentation rate (ESR or sed rate). This test looks at how quickly red blood cells fall to the bottom of a test tube. When swelling and inflammation are present, the blood’s proteins clump together and become heavier than normal. They fall and settle faster at the bottom of the test tube. The faster the blood cells fall, the more severe the inflammation.
• Uric
  acid. High blood uric acid levels can be seen in psoriatic arthritis but are
  not used for diagnosis or monitoring.
• Imaging. X-rays, CT scans, ultrasound, MRI, and
  skin biopsies may all be used to help diagnosis.

How is psoriatic arthritis treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on the severity of your condition.

Both
the skin condition and the joint inflammation are treated. Early diagnosis and
treatment helps prevent joint damage. Some medicines used to treat psoriatic arthritis
include:

• Nonsteroidal anti-inflammatory medicines (NSAIDs) to ease symptoms
• Corticosteroids for inflammation
• Immunosuppressive medicines such as methotrexate to reduce inflammation if NSAIDs
  don’t work
• Biologic medicines to ease inflammation
• Vitamins
  and minerals such as calcium and vitamin D to slow bone deformation

Other treatment may include:

• Exercise
• Heat and cold
• Occupational therapy to help you do your daily activities
• Physical
  therapy to help your muscle and joint function
• Management of psoriasis skin rash
• Splints
• Surgery
  to repair or replace a damaged joint. This is usually not needed until years after
  diagnosis.
• Ultraviolet light treatment (UVB or PUVA)

What are the possible
complications of psoriatic arthritis?

The condition may damage joints enough to change your activity level. Lack of activity can
lead to stiff joints and muscle weakness. Psoriatic arthritis can also cause tiredness
(fatigue) and low red blood cell count (anemia). You are more likely to develop:

• Diabetes
• High blood pressure
• High cholesterol
• Obesity

Living with Psoriatic Arthritis

There is no cure for psoriatic arthritis. But you can reduce your symptoms by sticking
to your treatment plan. Manage pain with medicine, acupuncture, and meditation. Get
enough exercise. Good exercises include yoga, swimming, walking, and bicycling. Work
with a physical or occupational therapist. He or she can suggest devices to help you with
your daily tasks.

When should I call my healthcare
provider?

Let
your healthcare provider know if your symptoms get worse or you have new symptoms.

Key Points about Psoriatic Arthritis

• Psoriatic arthritis is a form of arthritis with a skin rash.
• Psoriasis is a chronic skin and nail disease. It causes red, scaly rashes and thick, pitted fingernails. The rash may come before or after the arthritis symptoms.
• Psoriatic arthritis causes inflamed, swollen, and painful joints. It happens most often in the fingers and toes. It can lead to deformed joints.
• Treatment may include medicines, heat and cold, splints, exercise, physical therapy, and surgery.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your healthcare provider if you have questions.

How to Tell Whether That Itchy Rash is Eczema or Psoriasis: Dermatology Associates of the Lowcountry: Board Certified Dermatologists

A rash is a patch of irritated skin. Almost everyone gets a rash at some point in their lives. They’re not always a cause for concern, but itchy, red, and painful rashes that don’t go away can be a sign of a more serious skin condition.

Eczema and psoriasis are two of the most common skin conditions in the United States. In fact, nearly 32 million Americans have eczema, and another 7.5 million have psoriasis. The causes and treatments of these two conditions are different, but since both cause red, itchy rashes, it’s not always easy to tell the difference.

Trust your skin care to Oswald Mikell, MD, and our team at Dermatology Associates of the Lowcountry. We’re experts in diagnosing and treating eczema and psoriasis, and in this blog we’re taking a closer look at what makes them different.

Signs of eczema

Eczema, also called atopic dermatitis, is a common condition that causes itchy, red rashes. Your rash could indicate eczema if you notice:

• Cracked skin
• Intense itching that gets worse at night
• Raised bumps that ooze and crust over
• Raw or bleeding skin
• Red or brownish gray patches
• Thickened or scaly skin

Eczema most commonly appears on the insides of the elbows or knees or around the wrists or ankles. Babies and young children may get eczema on their face and scalp.

Signs of psoriasis

Like eczema, psoriasis is also characterized by red rashes on the skin. Psoriasis rashes are called plaques. There are several kinds of psoriasis, and symptoms vary from person to person. You could have psoriasis if you see:

• Red lesions in skin folds
• Thick, scaly patches of skin
• Very dry skin that cracks or bleeds
• White pustules

Psoriasis plaques can appear almost anywhere on the body. A few of the most common spots are the scalp, face, elbows, knees, and hands.

Differences between eczema and psoriasis

Eczema and psoriasis both cause red, itchy rashes. Both types of rashes can appear on your face, hands, elbows, and knees. They share a lot of similar characteristics, but these common skin conditions have their differences.

Causes

Psoriasis is an autoimmune condition, meaning the immune system mistakenly attacks the body. Eczema, on the other hand, is linked to environmental triggers, allergies, and asthma.

Symptoms

Eczema rashes may be itchier than psoriasis plaques. Psoriasis generally causes milder itching and thick, scaly patches of skin. On the other hand, eczema rashes might be so itchy that you scratch your skin until it starts to bleed.

When symptoms generally begin

While anyone at any age can develop eczema or psoriasis, the conditions generally begin to manifest at different times. With eczema, more than half of all cases are diagnosed before 12 months of age, with most of the rest of the cases developing by age 10. Psoriasis, on the other hand, is generally diagnosed between ages 15-25.

Treating eczema and psoriasis

Dr. Mikell and our team specialize in diagnosing rashes and chronic skin conditions. First, we’ll perform a physical exam to determine the cause of your rashes. Then we’ll recommend a treatment strategy for you. It’s possible to have both eczema and psoriasis at the same time.

Neither eczema or psoriasis has a cure, but Dr. Mikell offers several treatment options that can reduce flare-ups and calm your skin. Common treatments for eczema include topical or oral corticosteroids and trigger avoidance. If you have psoriasis, UVB light therapy with XTRAC® may offer relief.

You don’t have to live with painful, itchy rashes. Find out what’s causing your discomfort and get a treatment plan that’s tailored for you. To learn more, book an appointment over the phone with Dermatology Associates of the Lowcountry today.

What’s the Difference?: Specialists In Dermatology: Dermatologists

According to NBC News, about 80% of all US women, men, and children who use the internet have searched at least once for information about their health. In fact, after checking your email and checking out cool new products to buy, “checking” your health is the most popular activity online.

You’ve probably done it, too, especially if you’ve been itching a lot lately and especially if that itch has developed into a red or scaly rash.

Although the internet has expanded our ability to get information about our health in just seconds, the information that’s available is general, not specific to your own case. Your results can leave you even more confused about your symptoms after your search than you were before. Enter the term “red rash” in your search bar, and you’ll wind up with about 201 million results. 

Between your online searches and just talking to friends and family, you whittled your rash down to two possibilities: Eczema or psoriasis. Now what?

At Specialists in Dermatology — with locations in Houston and The Woodlands, Texas — expert dermatologists Dr. Brent A. Shook and Dr. Robert Cook-Norris, and physician assistants Susannah Andrews and Michelle Purtle — understand your need for answers. If you think you have eczema or psoriasis, here are a few of the key facts you need to know about each skin condition.

What is eczema?

Eczema is an inflammatory condition that may be inherited. Eczema is also called atopic dermatitis. The term “atopic” refers to the tendency to develop an allergic reaction, which is why people with eczema often have other allergies, including hay fever.

Eczema is always itchy, but not always “rashy.” If you find yourself scratching frequently — whether or not you have a red rash — you could have eczema. The classic symptoms of eczema include:

• Dry, itchy skin
• Red rash
• Brown rash
• Scaly rash
• Cracked skin
• Scaly skin
• Small, crusty bumps
• Bumps that ooze liquid

Infants may have tiny eczema bumps on their cheeks. Children and adults may develop rashes in the folds of their joints, on the backs of their hands, or on their scalps. 

What is psoriasis?

Psoriasis is an immune-system disorder that affects the way your skin functions. Normally, your skin sheds dead cells regularly, replacing them with fresh new skin cells. If you have psoriasis, however, you don’t shed the outer layer of your skin. 

Simultaneously, your skin produces new cells at a faster-than-normal rate. The dead cells collect on the surface, creating silvery looking plaques. 

As with eczema, you may inherit psoriasis, though some cases start with an infection, such as strep throat. Psoriasis is associated with more serious health conditions, including diabetes, arthritis, and heart disease. The classic symptoms of psoriasis are:

• Red patches covered with silver
• Painful, itchy lesions
• Cracked and bleeding lesions
• Dot-like lesions
• Red lesions in body folds or groin
• White pustules, especially on hands or feet
• Severe itching and pain
• Skin peeling off in “sheets”

If your skin becomes fiery red and itchy or starts to peel in sheets, contact us immediately. This type of psoriasis (i.e., erythromdermic) can be life-threatening if not treated.

Eczema can look like psoriasis and vice versa

Now that you have the differences between eczema and psoriasis clearly in mind, it’s time to stir up the waters. Especially in the early stages of disease, eczema and psoriasis can resemble each other. In fact, if you go to a physician who isn’t a dermatologist, you might actually get a misdiagnosis. Dermatologists, however, are highly trained in identifying and treating skin conditions. To the dermatology experts at Specialists in Dermatology, the differences in eczema and psoriasis are easy to identify through a simple visual examination. We may also biopsy your skin and look at it under a microscope to confirm the diagnosis.

Because eczema is an inflammatory disorder and psoriasis is an autoimmune disease, the treatments for each condition may be different, depending on the severity of your case. You may be able to control mild eczema by avoiding allergic triggers and keeping your skin moist. If you have psoriasis, you may need intravenous therapies or biologics.

Which itch is your itch?

The best way to tell for sure if you have eczema or psoriasis is to get a diagnosis from our experts. Their years of training and clinical experience, plus the diagnostic tools we have on-site at our offices, means that you get an accurate diagnosis, so you can proceed with the most effective treatments available. 

To find out whether you have psoriasis,  eczema,  or need to treat a different kind of itch, contact us today by calling your nearest office or using the online form. 

Is the Skin You’re in Painful? It Could be Psoriasis.

When you think of your organs, the liver, heart, or lungs come to mind… but did you know that your skin is an organ, too? The largest organ of the human body, your skin shields you from germs, regulates your inner temperature, and protects your muscles and bones.

But unlike your heart and lungs, the skin is on the outside of your body – it’s something everyone sees, including you. If you have the skin condition psoriasis, the skin you’re in can often disrupt your entire life.

August is Psoriasis Awareness Month. If you or someone you know struggles with psoriasis, it’s a good time to learn more about it, including how to manage your triggers and get relief.

What is Psoriasis?

Psoriasis is an autoimmune condition that makes the skin flaky and inflamed, and in more extreme cases, can cause discolored, patchy scaly, skin. Psoriasis can appear anywhere on the body and usually creates a burning sensation, sting, or intense itching. Basically, your skin goes into overdrive producing new cells, which then build up on the surface of your skin. These extra cells are what give your skin a raised look or scaly texture. Psoriasis itself isn’t an infection, and it’s not possible to “catch” it from someone who has it.

While much is known about the condition, doctors still aren’t 100% sure of what causes it. It’s a combination of genetics, or inherited risks, and triggers. Psoriasis is most common among people between the ages of 18 and 35, but it can happen at any stage of life.

There are seven different kinds of psoriasis (more on that below), each with its own symptoms and effects. Besides affecting your skin, psoriasis has been linked to serious, long-term conditions that include cardiovascular disease, high blood pressure, and psychological issues.

Common Psoriasis Triggers

Even though psoriasis is caused by your genes – something you can’t control – there are plenty of lifestyle choices you can control which can help you manage your condition. Working together with a doctor, you can identify which of these factors trigger or worsen your condition:

• Stress
• Drinking alcohol
• Smoking tobacco
• Hormonal changes during pregnancy, the menstrual cycle, menopause, or puberty
• Certain medications

The Different Types of Psoriasis

There are seven unique types of psoriasis. In some cases, you may experience more than one of these at a time:

The most common type of psoriasis causes red or white patches of flaky skin to form anywhere on the body.

Small, droplet-shaped, sores may appear on the arms, legs, and neck. The second most-common type of psoriasis, it is most common with children and young adults; however, it can happen at any age.

Scalp psoriasis can appear on your scalp, ears or forehead, and travel down to the back of your neck. It can be very mild, but it can also cause a severe itch and produce crusted sores. In the worst cases, it can lead to skin infections and hair loss.

Unlike plaque psoriasis, inverse psoriasis has a smooth texture and usually does not produce scaly patches. It is commonly found around the armpits, breasts, genital area, and groin.

Pustular psoriasis is a less-common type of psoriasis that can cause pus-filled blisters on the hands, feet, and fingertips. It usually only affects adults.

Erythrodermic psoriasis infects your whole body with a red rash that can burn, itch, and irritate your skin.

Nail psoriasis can appear on your fingernails and toenails. With this type of psoriasis, your nails may turn yellow, brown, or green, and lift away from the nailbed.

Erythrodermic psoriasis produces a rash that causes inflamed skin to peel off into very thin layers, resulting in intense itching and burning.

You Don’t Have to Suffer

Many who suffer from psoriasis say that Epsom salts bath can help ease the worst pain. Natural moisturizers can also help lubricate your skin, making you less likely to suffer an outbreak.

Unfortunately, there is no cure for psoriasis, but there are highly effective medications and over-the-counter remedies that can relieve pain, diminish its appearance, and lessen or shorten the outbreak. If psoriasis is causing you pain or getting in the way of performing normal activities, contact your doctor.

Because psoriasis may affect your appearance and your quality of life, it’s quite natural to feel down about it. We have professionals who can help with that, too. Learn more about how to access AltaMed’s behavioral health services.

What Every Senior Should Know About Psoriasis

Psoriasis, a condition that causes the body to make new skin cells in days rather than weeks, causes thick, scaly patches that often appear on the knees, elbows, lower back, scalp, nails, and joints.

Symptoms tend to worsen with age, and psoriasis can be linked to other conditions that affect seniors, including type 2 diabetes, inflammatory bowel disease, and heart disease. Though not contagious, senior psoriasis is one of the more serious of skin diseases. It often progresses into a chronic condition, and there’s no known cure.

Causes of Psoriasis

Doctors are still unsure what causes an estimated 7.5 million Americans (or 2 percent of the U.S. population) to have psoriasis. Scientists have learned that genes and the immune system may play a role. When a person has psoriasis, for example, T-cells begin to attack the body’s skin cells, causing the body to make new cells more frequently. Once T-cells begin to attack, they continue attacking for the rest of the person’s life.

Scientists have also found that psoriasis runs in families. However, it’s not so cut and dry. Some people with psoriasis don’t have the genes that increase their risk of getting psoriasis, and others have the genes that increase their risk but never develop psoriasis.

Because of this, scientists believe that other factors also trigger psoriasis to appear for the first time. These include:

• Stress
• Skin injuries, like cuts or burns
• Infections
• Some medications, including prednisone, hydroxychloroquine, and lithium
• Weather, especially cold and dry
• Tobacco
• Alcohol

Psoriasis Signs in Seniors

There are eight different types of senior psoriasis that may develop, each with their own symptoms.

Plaque psoriasis—The most-common form accounts for about 80 to 90 percent of people with senior psoriasis. Symptoms include:

• Patches of thick, raised skin called plaques
• Scale (a dry, thin, and silvery-white coating) over some plaque
• Plaques of different sizes
• Smaller plaques joined together to form larger ones

Guttate psoriasis—This tends to appear after infection. Patches on the skin appear:

• Small and scaly
• Salmon to pink in color
• Temporary, often clearing in a few weeks or months without treatment

Inverse psoriasis—This often develops in areas where skin touches skin (armpits, genitals, etc.) Symptoms include:

• Smooth, red patches of skin that look raw
• Little, silvery-white coating
• Sore or painful

Pustular psoriasis—This type causes pus-filled bumps that usually appear on the feet and hands. Symptoms include:

• Red, swollen skin dotted with pus-filled bumps
• Extremely sore or painful
• Brown dots (and sometimes scale) after the pus-filled bumps dry

 Pustular psoriasis (generalized)—This type is serious and life-threatening, causing pus-filled bumps to develop. Call your doctor immediately if these symptoms appear:

• Dry, red, and tender skin
• Pus-filled bumps covering most of the skin, often developing within hours (pools of pus leak onto the skin after the bumps break open)
• Smooth, glazed surface when dried skin peels off
• A new crop of bumps may appear in a few days or weeks

Erythrodermic psoriasis—Serious and life-threatening, this type of senior psoriasis needs immediate medical care. Symptoms include:

• Skin that appears burnt
• Chills, fever, and extremely ill appearance
• Muscle weakness, a rapid pulse, and severe itch
• Hypothermia may set in quickly, if unable to keep warm

Psoriasis in nails—About half of people with plaque psoriasis also see signs of psoriasis on their nails at some point. These include:

• Tiny dents in nails
• White, yellow, or brown discoloration
• Crumbling, rough nails
• Lifted or unattached nails
• Build-up of skin cells underneath nails

Psoriasis in joints—Some people with psoriasis, especially the elderly, may develop a type of arthritis called psoriatic arthritis. Symptoms include:

• Swollen or tender joints, especially in fingers and toes
• Heel pain
• Swelling on the back of legs, just above the heel
• Stiffness in the morning that fades during the day

Treatment for Psoriasis

If you think you may have senior psoriasis, contact your doctor immediately. The sooner your visit, the sooner you can start a treatment plan that meets your unique needs. While every senior may require different treatment, your doctor may recommend one or a combination of the following:

• Topical ointments soothe itchy skin but may be demanding among the elderly. Senior patients may need a nurse or loved one to help apply the topical ointment, especially in spots that are hard to reach. Because seniors’ skin is more prone to allergic reactions, practice caution when using topical medications—what works for one person may not work for everyone.
• Phototherapy/PUVA therapy, a conventional therapy for psoriasis, can be used among the elderly. With this treatment, lasers destroy blood vessels that feed the psoriasis sites, causing them to fade. However, proceed with caution. For some elderly patients who’ve experienced psoriasis for a long time, solar keratosis may develop. This type of therapy can aggravate the symptoms of solar keratosis, so it’s not recommended in these scenarios.
• Psoriasis medications pose potential complications for elderly patients as they’re often on more than one kind of medication. For any new medication, start with a low dosage of about 5 mg per week in case of side effects. Some conventional medicines, like retinoid, can trigger pruritus, and others like cyclosporine are not recommended for seniors because the side effects are too strong. Finding the right solution differs for each psoriasis sufferer. Some acne treatments, like salicylic acid, may also work, and steroid creams used for cystic acne may also reduce redness and swelling.

90,000 Treatment of psoriasis of the skin of the hands in a clinic in Moscow

Psoriasis on the hands – one of the variants of the course of a chronic skin disease, in which plaques with a diameter of 1-3 mm to 2-3 cm are formed on it. The disease can manifest itself on different parts of the body, including the skin of the hands.

Psoriasis itself is not dangerous, but it greatly impairs the quality of human life and can be the cause of secondary infections or the development of complications. One of them is psoriatic arthritis, which disrupts the work of the joints and leads to disability.Therefore, the complex treatment of psoriasis of the skin of the hands should be started as early as possible, and since the disease is chronic in nature, it should be monitored by the doctor constantly.

Causes of psoriasis

Psoriasis is classified as an autoimmune disease. The cause is presumably a malfunction of the immune system. According to statistics, most often the disease occurs with a hereditary predisposition, and exacerbations in 50% of patients are associated with stress.

Presumable causes of psoriasis on the hands:

• Frequent mechanical trauma to the skin;
• severe stress;

90,017 taking certain medications;

• dry skin type;
• tendency to allergic reactions;
• thyroid disease;
• exposure to aggressive substances (solvents, paints, household chemicals).

Main symptoms of psoriasis

Psoriasis can spread to the palms, the back of the hands, and the interdigital area. The disease often affects elbows, forearms, and even nails. Sometimes patients do not notice how psoriasis begins on the hands, since in many cases it is manifested by minor rashes. But ignoring the rash and its accompanying symptoms is the wrong tactic. Under the influence of negative factors, rashes can very quickly spread to all hands and other parts of the body.

Therefore, it is important to know what psoriasis looks like on the hands, and to notice the very first symptoms in time. The main signs of the disease:

• bright pink spots, predominantly round in shape with clear boundaries;
• Severe dry skin;

90 017 small white dots on the nails;

• peeling of nail plates;
• Minor bleeding at the spot where the spots appear.

Psoriasis brings psychological discomfort.The reason is the unaesthetic appearance of the affected limbs, especially during the period of exacerbation, and the curious looks of others, which are difficult to avoid in everyday life. But if we talk about whether psoriasis is contagious on the hands, we can say for sure that it is not, since it is a non-infectious disease.

Types and stages of the disease

There are several main types of psoriasis on the hands:

• Plaque – with large foci of plaques covered with white scales.
• Drop-shaped – with spots resembling drops in shape.
• Pustular – red spots with purulent contents.
• Nail – with white or gray transverse lines on the nails and thickening of the skin around them.

Psoriasis of the hands and feet is characterized by development in several stages:

1. Aggravation. The disease progresses, the itching becomes stronger, the spots take up more and more space on the skin of the hands, causing severe peeling.
2. Stationary. The disease gradually fades away, the plaques turn white and become smaller.
3. Remission. Signs of psoriasis almost completely disappear before the next exacerbation.

Treatment plan

To confirm the diagnosis and understand how to treat psoriasis on the hands, the specialists of the PsorMak clinic prescribe the necessary examinations for the patient: skin scrapings, blood tests, and, if necessary, biopsy and histology.

Psoriasis is a chronic disease, so only with the right treatment can only lasting remission be achieved.We can say that for the patient this means complete recovery, but only on the condition that he will continue to adhere to all the recommendations.

Treatment of psoriasis on the hands involves:

• Treatment with local remedies – healing non-hormonal ointments made according to VF Mac’s own recipe using exclusively natural ingredients.
• Compliance with a prescribed diet that excludes allergenic and harmful foods.
• Cleansing the body with detoxification drugs.
• Acupuncture.
• Hirudotherapy.
• Proper skin care using prescribed products.
• Normalization of the patient’s psycho-emotional background with the readjustment of the mental resources for the good of the body.

The duration of the course of treatment is usually 2-3 months, and the cost of treatment at the PsorMak clinic is affordable for most patients.

Why you should contact the PsorMak Institute

• Treatment with non-hormonal drugs. For the treatment of dermatological diseases, the PsorMak Institute uses only the safest therapeutic methods that do not harm the body.
• High efficiency of treatment for adults and children. Patients who strictly adhere to medical prescriptions get rid of the manifestations of the disease for the longest possible period – in some cases, remission reaches 6 years.
• Treatment that does not interfere with normal life. The therapy is carried out on an outpatient basis, so that patients can be effectively treated without changing their normal rhythm of life.
• More than 20 years of experience in medical work. The effectiveness of the therapeutic techniques of Academician V.F.Mak has already been tested by more than one generation of patients who have successfully got rid of skin diseases.
• Individual approach. The specialists of the PsorMak clinic select the optimal treatment regimen for each individual case, taking into account the age, the specificity of the disease and the characteristics of the patient’s body.
• Affordable price. Adequate cost of therapy is suitable for many patients.

HOW TO BOOK AN APPOINMENT at the Institute of Healthy Skin “PsorMak”

1. Press the button you see below –

2. Fill in the fields in the form that appears. Be sure to check the correctness of the phone number so that our specialist can get through to you.After filling, click on the “Send” button.

3. Wait for the call of our specialist. He will answer any of your questions and agree on the date and time of your visit to PsorMak.

Initial appointment includes:

• Visual examination , which will allow the specialist to get a general idea of ​​the condition of your skin and of the pathology itself.
• Collecting anamnesis – finding out information about the development of the disease, living conditions, past illnesses, operations, injuries, chronic pathologies, allergic reactions, heredity, etc.Together with a general examination, this allows you to accurately diagnose and choose a method of treatment and / or prevention.

WHAT WILL BE after passing the initial admission

Our specialist, dermatologist:

• Will inspect .
• Take free analysis (scraping) .
• Diagnoses or clarifies the diagnosis of the disease .
• Will give detailed recommendations .
• Draw up a personal treatment plan .
• Will write a prescription for drugs (if necessary) .

90,000 What does psoriasis look like at the initial stage

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06 January 2020

Psoriasis occurs quite often in childhood. It is important to diagnose the disease as early as possible.This will make it possible to achieve greater effectiveness of treatment, will help to significantly reduce the suffering caused to the child by the disease.

Now let us briefly explain what psoriasis in children is and how it is treated. This is the name of a chronic non-infectious skin disease.

Out of 100 young patients with skin ailments, 15 suffer from this disease. Until now, the causes of psoriasis in children have not been precisely established. However, it is believed that there is a hereditary factor – a genetic predisposition.Other reasons are stress, impaired metabolism, etc.

First signs

In infants, the disease resembles diaper rash or thrush. Also, the first signs of psoriasis in children are very similar to the manifestations of eczema. Only a specialist can accurately diagnose the disease. The affected areas look like bright pink areas on the skin with well-defined boundaries. Sometimes these areas can be covered with the finest scales of the skin. Also psoriasis in children has the following symptoms:

• the skin itches and itches;
• there are rashes on the skin;
• instead of skin rashes, specific nodules can be seen, which are covered with a layer of dead skin particles of gray color.

These are the signs of psoriasis in an older child. In infants, a red rash, which is localized mainly in the skin folds. For example, in the area of ​​the buttocks, under the armpits. Rashes can also occur in places where clothing is most often in close contact with the body. Manifestations of the disease are practically absent or are very rare on the baby’s palms and feet. Thus, psoriasis in children at the initial stage (when it comes to infants) is a red rash in the above-mentioned areas, plus on the baby’s head, on the face or on the genitals.

There are several types of the disease, depending on the location of the rash. For example, psoriasis on the head of a child, on the elbows is plaque-like or ordinary psoriasis. However, there are other types of ailment that are no less common. This is a teardrop-shaped type of disease. You can see this psoriasis on the hands of children, as well as on the legs, head and all over the body.

There is a type of ailment that spreads to the nail plate. It is also subdivided into subspecies. Thus, psoriasis of nails in a child is: thimble, onychomadesis, trachyonychia, subungual hemorrhage, psoriatic paronychia.Symptoms differ in each case.

Very often, treatment of scalp psoriasis in a child is required. Only a profiled specialist with experience is able to assign it correctly. These are the doctors who are accepted in our clinic. The sooner measures are taken to combat the disease, the faster and more effective the treatment result will be. Therefore, you should not delay going to a dermatologist, but consult a doctor if you have the slightest suspicion of psoriasis.

When to see a doctor

Parents should be alerted to the following symptoms, signs of the disease at an early stage:

• a small rash appeared on the body, accompanied by itching and peeling;
• the number of rashes increases, cracks are visible on them, through which blood seeps slightly;
• the color of the rashes is red or hot pink.

If you see the following symptoms of psoriasis in children, treatment should be immediate:

• increase in body temperature;
• enlarged lymph nodes;
• the skin is swollen and reddened;
• the skin is significantly thickened.

If you have any of the signs listed above, you need to contact a pediatric dermatologist as soon as possible. To make an appointment, you need to contact the administrator of Medicina JSC (Academician Roitberg’s clinic) in Moscow at +7 (495) 995-00-33 or fill out the form on the website.

Our clinic in the center of Moscow provides high-quality and comfortable treatment for psoriasis in children. The specialist will examine the little patient for the detection of the disease. It will be clarified when the first signs of the disease appeared, how they manifested themselves, etc. Genes influence the onset of psoriasis, so you will definitely be asked if your child has any relatives with this disease.

It is quite difficult to diagnose the disease in infancy with the help of only one visual examination.An analysis (scraping) is needed, which will help to establish with accuracy whether the rash is psoriasis or not.

Differences from other diseases

In infants, psoriasis is similar to normal diaper rash. It is for this reason that parents often do not see a doctor on time. This dangerous disease is confused with diaper rash and an ordinary rash, which is a frequent companion of infancy. However, psoriasis has a characteristic that sets it apart from other harmless skin rashes.Let’s call these differences:

• The horny ball of papules (nodules on the skin) exfoliates, peeling occurs;
• the skin is covered with a crust;
• isolated small nodules-papules are combined into formations of significant size;
• the size of the nodules is continuously increasing. Over time, such associations take up large areas of the skin.

What other features of psoriasis in children

The disease is often confused with allergic reactions.However, it has a more pronounced color brightness in contrast to the usual allergy. As soon as the child began to take antihistamines, the rash from the allergy disappears, the color of the rash turns pale, and over time the rash disappears. However, if psoriasis is present, the rash will not decrease, on the contrary, it will progress further.

What is the difference between ailment and diaper dermatitis

The following characteristic features are present. You can find out psoriasis on a child’s body by looking closely at the outlines of the affected areas. They are clear and well defined, and the areas are very bright in color.For diaper rash, powder, special ointments for infant dermatitis, and the child’s stay in the air help well. However, for psoriasis, such measures are useless. Therefore, if, after the aforementioned remedies, the rash does not disappear, but progresses, it may be psoriasis. This disease also resembles a rash with an infection. However, unlike her, there are no symptoms such as high fever, cold symptoms (cough, runny nose), body and joint aches, muscle pains. This is typical only for ARVI.

Treatment

If psoriasis is diagnosed in children, treatment should be started as early as possible.Its success, comfort for the child depends on this. If you turn to a pediatric dermatologist as quickly as possible, then this increases the chances of resistance and the duration of remission.

If the presence of the disease has been established, hospitalization and treatment are carried out in an inpatient mode. However, such measures are needed only at the first contact. Then hospitalization is no longer required. Antihistamines plus calcium medications are prescribed to help the child relieve itching.If the disease has spread enough throughout the body, the skin lesions are profuse, then hormonal drugs may be prescribed.

It will be possible to treat lesions with baby creams, ointments prescribed by a doctor. It may also be prescribed to take baths and carry out water procedures as often as possible. When psoriasis is found in children, the causes and treatment are interrelated. Doctors are now inclined to believe that the cause of the disease may be autoimmune. Therefore, drugs are prescribed in connection with this assumption of the appropriate type.These are immunosuppressants – drugs that can suppress the activity of immune processes. A dietary meal is prescribed that excludes the consumption of animal fats. With its help, you can significantly alleviate the condition of a little patient in just a week.

How to make an appointment with a doctor

Effective treatment of psoriasis in children is now available in the central district of the capital. Timely seeking medical help will help to avoid many troubles in the future.You can make an appointment with a pediatric dermatologist on our website or by phone +7 (495) 995-00-33. The clinic is located in the center of Moscow, near the metro stations Mayakovskaya, Novoslobodskaya, Chekhovskaya, Tverskaya.

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Khasanova Alina Rashidovna

Dermatovenereologist

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Psoriatic arthritis | Clinical Rheumatology Hospital No. 25

Psoraitic arthritis is a form of chronic inflammatory lesion of the joints that develops in patients with psoriasis.

Clinical signs and symptoms psoriatic arthritis

Arthritis in 68-75% of cases develops in patients with psoriasis, or occurs simultaneously with skin changes; in 12-25% of cases, arthritis precedes the appearance of signs of dermatosis. From the onset of skin lesions to the development of arthritis, as well as from the onset of arthritis to dermatosis, a different period passes – from 2 weeks to 10 years or more. Dermatosis can be widespread, but often limited, localized on the scalp, extensor surfaces of the elbows, knee joints, around the navel, under the mammary glands, in the gluteal and inguinal folds.In some cases, it begins with damage to the nails. Point depressions appear on the surface of the nails (a symptom of a “thimble”), the nail plates become cloudy, longitudinal or transverse grooves are visible on them, sometimes the nails thin and atrophy (onycholysis), but more often they thicken and crumble, as with a fungal infection, which requires the exclusion of mycosis.

The onset of arthritis is most often imperceptible, gradual, but it can also be “acute”.

Five types of joint damage in PA can be distinguished, which are not mutually exclusive and can be combined:

• Arthritis affecting the distal interphalangeal joints;
• mono-oligoarthritis;
• polyarthritis similar to rheumatoid;
• mutating arthritis;
• spondyloarthritis.

The classic type is inflammation of the distal interphalangeal joints of the hands and feet, the lesion is usually multiple, but at the onset of the disease, asymmetric mono-oligoarthritis may develop. In particular, cases of isolated arthritis of the distal joints of the big toes have been described. Palpation of joints in PA is moderately painful, the swelling is usually dense, usually extending beyond the joint. The skin over the affected joints is bluish or purplish. The change in the shape of the end joints, simultaneously with the peculiar coloration of the skin, creates a picture of a “radish” deflection of the finger.Arthritis of the distal interphalangeal joints, as a rule, is combined with trophic changes in the nails.

An “axial” lesion is also considered characteristic of PA – a simultaneous lesion of the distal, proximal interphalangeal and metacarpophalangeal joints of the same finger up to the development of ankylosis of these joints. Similar changes in the joints of the toes cause their diffuse swelling and redness of the skin – “sausage fingers”. In 5% of patients, a disfiguring (mutating) form of PA is observed, when, as a result of the osteolytic process, the fingers are shortened, bent, multiple subluxations and ankylosis of the joints are found.Asymmetry and disorder (chaos) of these changes are characteristic: on the same hand, for example, flexion and extension contractures of the fingers, displacement of their axes in different directions can be found.

The variants of classic psoriatic arthritis described above are found only in 5-10% of patients with psoriasis. In 70% of patients, mono or oligoarthritis of large joints – knee, ankle, very rarely hip is revealed. More than three joints are affected in 15% of patients.In this case, any articulation can be affected, including the temporomandibular joints. Usually, the asymmetric nature of polyarthritis is quite clearly expressed, although there may be processes that are extremely reminiscent of the clinical picture of RA. In 5% of patients, a clinical and X-ray picture of ankylosing spondylitis develops, as in ankylosing spondylitis, although asymptomatic sacroiliitis is radiologically detected in 50-60% of patients. PA can be combined with eye damage (more often conjunctivitis, iritis, less often episcleritis).The simultaneous occurrence of ulcerative lesions of the oral mucosa and genitals brings the clinical picture of the disease closer to Reiter’s disease.

Lesions of internal organs become distinct with a particularly severe (malignant) variant of PA. It develops only in males, mainly young people (up to 35 years old) and, as a rule, suffering from atypical psoriasis (pustular psoriasis or universal psoriatic erythroderma). This variant is characterized by high fever of the hectic type with chills and increased sweating.The articular syndrome is manifested by multiple arthritis with a pronounced exudative component of inflammation, excruciating pain, sometimes even requiring the administration of drugs. At the same time, progressive weight loss, the formation of trophic ulcers, pressure ulcers, increased hair loss, amyotrophy, generalized enlargement of the lymph nodes, especially the inguinal ones, are detected. Of the internal organs, the heart is most often affected by the type of myocarditis, which is manifested by a moderate expansion of the boundaries of the heart, a weakening of the first tone, systolic murmur, tachycardia that does not correspond to fever, rhythm disturbances and diffuse changes in the myocardium according to ECG data.Development of hepatitis, hepatolienal syndrome is possible. At the height of the disease, there are sometimes signs of diffuse glomerulonephritis, and with a protracted course – renal amyloidosis. In the malignant variant of PA, encephalopathy can be observed with a predominant involvement of subcortical formations in the process, epileptic seizures and delirium. Sometimes peripheral neuritis and polyneuritis develop.

Laboratory data are not specific. In the general analysis of blood, the acceleration of ESR is determined, which correlates with the activity of arthritis.

X-ray changes are the most significant in differential diagnosis.

How is psoriatic arthritis treated?

Treatment of psoriatic arthritis has similar principles to the treatment of rheumatoid arthritis.

1. Non-steroidal anti-inflammatory drugs (NSAIDs).

Monotherapy of NSAIDs is indicated only with relatively favorable variants of PA (oligoarthritis, damage to the distal interphalangeal joints).With the ineffectiveness of NSAIDs, the appointment of basic anti-inflammatory drugs is indicated. In some cases, NSAIDs lead to an exacerbation of cutaneous psoriasis.

2. Glucocorticoids (GC).

Prescribing HA in low doses (10-15 mg / day) is rarely used. Potential indications are generalized peripheral arthritis with severe functional insufficiency of the joints, high activity of the inflammatory process, ineffectiveness of NSAIDs, the presence of systemic manifestations (aortitis, diffuse glomerulonephritis, malignant form).Local therapy of HA is indicated for limited joint damage and enthesopathy (damage to the ligamentous apparatus).

3. Basic anti-inflammatory drugs (DMARDs).

a) Methotrexate – indicated for a high degree of disease activity in combination with a progressive stage of generalized psoriasis and atypical dermatosis (pustular and erythrodermic).

b) Cyclosporine – has no advantages over methotrexate in its therapeutic potential, but causes more severe side reactions (nephrotoxicity, the development of arterial hypertension).

c) Sulfasalazine – has a moderate effect on joint and skin lesions, but does not affect the clinical manifestations of spinal lesions and the progression of arthritis.

g) Leflunomide (Arava) is a promising drug, the effectiveness of which has been proven in randomized clinical trials.

4. Genetically engineered biological preparations (GIBP)

Currently, more and more new biological drugs are being developed that have a more pronounced therapeutic potential, but at the same time can cause severe adverse reactions, which requires special control before prescribing these drugs.

The most common treatment for psoriatic arthritis in Russia in the last decade has been infliximab (remicade), which is effective in the most severe patients who are resistant to standard therapy.

One of the auxiliary methods of psoriasis treatment is HIRUDOTHERAPY – treatment with leeches, especially if physiotherapy is contraindicated for the patient.

More details about the work of a rheumatologist and the procedure for applying can be found on the pages “Patients” and “Procedure”.

CONSULTATION OF DOCTOR RHEUMATOLOGIST

90,000 Psoriasis

What is psoriasis?

Psoriasis is a chronic non-infectious disease, dermatosis, which mainly affects the skin. The autoimmune nature of this disease is currently assumed. Psoriasis usually causes overly dry, red, raised patches of the skin.However, some psoriasis sufferers do not have any visible skin lesions. The spots caused by psoriasis are called plaques. These spots are by their nature sites of chronic inflammation and excessive proliferation of lymphocytes, macrophages and keratinocytes of the skin, as well as excessive formation of new small capillaries in the underlying skin layer.

What causes psoriasis?

The causes of psoriasis are currently not yet fully understood. At the moment, there are two main hypotheses regarding the nature of the process that leads to the development of this disease.

According to the first hypothesis, psoriasis is a primary skin disease in which the normal process of maturation and differentiation of skin cells is disrupted, and excessive growth and multiplication of these cells is observed. At the same time, the problem of psoriasis is seen by the supporters of this hypothesis as a violation of the function of the epidermis and its keratinocytes.

Autoimmune aggression of T-lymphocytes and macrophages against skin cells, their invasion into the thickness of the skin and excessive proliferation in the skin are seen as secondary, as a reaction of the body to the excessive multiplication of “wrong”, immature, pathologically altered keratinocytes.This hypothesis is supported by the presence of a positive effect in the treatment of psoriasis with drugs that inhibit the multiplication of keratinocytes and / or cause their accelerated maturation and differentiation and at the same time do not possess or possess insignificant systemic immunomodulatory properties – retinoids (synthetic analogues of vitamin A), vitamin D, and in particular its active form, fumaric acid esters.

The second hypothesis suggests that psoriasis is an immune-mediated, immunopathological, or autoimmune disease in which overgrowth and multiplication of skin cells and, above all, keratinocytes are secondary to various inflammatory factors produced by cells of the immune system and / or to, and autoimmune damage skin cells causing a secondary regenerative reaction.

What happens to the skin and how to provide it with care?

Impaired barrier function of the skin (in particular, mechanical injury or irritation, friction and pressure on the skin, abuse of soap and detergents, contact with solvents, household chemicals, alcohol-containing solutions, the presence of infected foci on the skin or skin allergies, deficiency of immunoglobulins, excessive dryness skin) also play a role in the development of psoriasis.

Infection in dry skin causes dry (non-exudative) chronic inflammation, which in turn causes psoriasis-like symptoms such as itching and increased skin cell proliferation.This in turn leads to a further increase in dry skin, both due to inflammation and increased proliferation of skin cells, and due to the fact that the infectious organism consumes moisture, which would otherwise serve to moisturize the skin. To avoid excessive dryness of the skin and reduce the symptoms of psoriasis, it is not recommended for patients with psoriasis to use washcloths and scrubs, especially hard ones, as they not only damage the skin, leaving microscopic scratches, but also scrape off the upper protective stratum corneum and sebum from the skin, which normally protect skin from drying out and from the penetration of microbes.It is also recommended to use talcum powder or baby powder after washing or bathing to absorb excess moisture from the skin that would otherwise “get” to the infectious agent. Additionally, it is recommended to use products that moisturize and nourish the skin, and lotions that improve the function of the sebaceous glands. It is not recommended to abuse soap, detergents. You should try to avoid skin contact with solvents, household chemicals.

Is psoriasis inherited?

The hereditary component plays an important role in the development of psoriasis, and many of the genes associated with the development of psoriasis or directly involved in its development are already known, but it remains unclear how these genes interact during the development of the disease.Most of the currently known genes associated with psoriasis, in one way or another, affect the functioning of the immune system.

It is believed that if healthy parents have a child with psoriasis, then the likelihood of the next child getting sick is 17%, and in the presence of psoriasis in one of the parents, the possibility of the disease in children increases to 25% (with the disease of both parents – up to 60-70%).

Due to the fact that in most patients with psoriasis it is not possible to establish the hereditary transmission of dermatosis, it is believed that it is not psoriasis itself that is inherited, but a predisposition to it, which in some cases is realized as a result of a complex interaction of hereditary factors and adverse environmental influences.

What does psoriasis look like?

Excessive proliferation of keratinocytes (skin cells) in psoriatic plaques and infiltration of the skin with lymphocytes and macrophages quickly leads to thickening of the skin at the lesion sites, its elevation above the surface of healthy skin and the formation of characteristic pale, gray or silvery spots resembling frozen wax or paraffin (“ paraffin lakes “). Psoriatic plaques most often first appear on places subject to friction and pressure – the surfaces of the elbow and knee bends, on the buttocks.However, psoriatic plaques can occur and are located anywhere on the skin, including the scalp (scalp), palmar surface of the hands, plantar surface of the feet, and external genitalia. In contrast to eczema rashes, which often affect the inner flexor surface of the knee and elbow joints, psoriatic plaques are more often located on the outer, extensor surface of the joints.

What do you need to diagnose psoriasis?

This is usually much more difficult in children than in adults: in children, psoriasis often takes on an atypical form, which can lead to diagnostic difficulties.And the earlier the diagnosis is made, the more opportunities to fight the disease.

There are no diagnostic procedures or blood tests specific to psoriasis. Nevertheless, with active, progressive psoriasis or its severe course, abnormalities in blood tests can be detected, confirming the presence of an active inflammatory, autoimmune, rheumatic process (increased titers of rheumatoid factor, acute phase proteins, leukocytosis, increased ESR, etc.) , as well as endocrine and biochemical disorders.Sometimes a skin biopsy is needed to rule out other skin conditions and histologically confirm the diagnosis of psoriasis.

How to treat psoriasis?

It is worth starting to treat children’s psoriasis as early as possible and supervise the child so that he observes all the doctor’s advice. The baby’s immune system is very sensitive. With the right approach, she can cope with psoriasis, and if you let the disease take its course, the skin will be more and more affected.

If a child has symptoms of the disease – plaques on the skin, itching, redness, peeling, you need to immediately start treatment, strictly follow all the doctor’s recommendations, and he will advise you to apply a special cream to the skin.

In a progressive stage and with common forms of the disease, it is best to hospitalize the child. Prescribe desensitizing and sedatives, inside 5% calcium gluconate solution or 10% calcium chloride solution in teaspoons, dessert or tablespoons 3 times a day. Apply a 10% solution of calcium gluconate intramuscularly, 3-5-8 ml (depending on age) every other day, 10-15 injections per course. With severe itching, antihistamines are needed inside in short courses, for 7-10 days.In older children in a progressive stage, with an excited state, poor sleep, small doses of hypnotics and small tranquilizers (tazepam, seduxen, meprotan) sometimes give a good effect.

Apply vitamins: ascorbic acid 0.05-0.1 g 3 times a day; pyridoxine – 2.5-5% solution, 1 ml every other day, 15-20 injections per course of treatment. Vitamin B12 is especially indicated for common exudative forms of psoriasis – 30-100 mcg 2 times a week intramuscularly in combination with folic and ascorbic acids for 172-2 months.Vitamin A is given at 10,000 – 30,000 ME 1 time per day for 1-2 months. Patients with the summer form of psoriasis, especially with severe itching, are shown nicotinic acid inside. With psoriatic erythroderma, it is advisable: riboflavin-mononucleotide intramuscularly, vitamin B15 orally or in suppositories (in double dosage), potassium orotate. Vitamin D2 should be used with some caution in all forms of psoriasis.

In order to stimulate protective and adaptive mechanisms, pyrogenic preparations are prescribed that normalize vascular permeability and inhibit the mitotic activity of the epidermis.Pyrogenal, Prodigiosan. A good therapeutic effect is given by transfusions of blood, plasma, albumin, weekly, several times, depending on the result obtained. In children with persistent (exudative and erythrodermic) forms of psoriasis, sometimes it is not possible to obtain a positive effect from these funds. Then, glucocorticoids are prescribed orally at 0.5-1 mg per 1 kg of body weight per day (based on prednisolone) for 2-3 weeks, followed by a gradual decrease in the dose of the drug until it is canceled. Cytostatic drugs (methotrexate) are not recommended for children of all ages due to their toxicity.In the stationary and regressive stages of the disease, a more active therapy is prescribed – UFO, general baths at a temperature of 35-37 ° C for 10-15 minutes, after 1 day.

External treatment of psoriasis.

Salicylic (1-2%), sulfur-tar (2-3%) ointments; glucocorticoid ointments (0.5% prednisolone, lokacorten, flucinar, fluorocort, lorinden, etc.). These ointments quickly give a direct effect in the form of occlusive dressings in the localization of psoriatic plaques on the palms and soles.For children with a predominant lesion of the scalp, the recently used phosphodiesterase inhibitors in the form of lubricants or occlusive dressings with 5% theophylline or 1% papaverine ointments can be recommended.

It is necessary to emphasize the importance of sanitation of focal infection (diseases of the respiratory tract, ENT organs, helminthic invasions, etc.). Tonsilectomy and adenotomy for children with psoriasis can be performed after the age of 3 years. In 90% of cases, these surgical interventions have a beneficial effect on the course of the process, and in 10% of patients, especially with widespread exudative psoriasis, exacerbations continue.Follow-up examination after 7-10 years showed that 2/3 of patients after tonsillectomy did not have relapses of the disease, but even the remaining 1/3 of children with exacerbations of the rash were scanty and remissions lengthened; in non-operated children with psoriasis and chronic tonsillitis, exacerbations of dermatosis were more frequent.

Our long-term observations of children indicate that in most cases, relapses of psoriasis with age occur less frequently, are less pronounced and there is a clearly noticeable tendency towards the transition of common forms of dermatosis to limited ones.However, in some patients, the process remains generalized, with a severe course.

Is psoriasis a diagnosis for life?

If you start timely and correct treatment, then no. The development of psoriasis in a child does not at all mean that, as an adult, he will also suffer from this ailment. Of course, psoriasis is a chronic disease, it is almost impossible to recover from it 100%. But the quiet period can be maximized. Pediatric psoriasis is treated like an adult, changing from one treatment to another every three months.

The child should be psychologically prepared in advance for the fact that his body has flaws. Unlike adults, in children, psoriasis often affects not the body, but the face (30% of cases). Rashes can appear on the forehead, on the cheeks, and on the eyelids. Psychologically, it is quite difficult to endure. Also, in one third of children with childhood psoriasis, nails are affected. Therefore, it is rather difficult to hide the disease.

In addition to physically unpleasant sensations, psoriasis can be a severe test for a child’s mental state.Parents cannot leave him alone with a problem. Any activity should be encouraged: sports, games. However, it is worth remembering the precautions. For example, the skin on certain areas of the body can be stretched (for example, when cycling for a long time). And this can provoke psoriasis. Despite the outwardly unsightly skin condition, the child can go in for swimming! And if there are chemicals in the water, remove

Why is there still no cure for psoriasis?

This disease is called mysterious for a reason.The essence of this disease is still not clear. Some psoriasis affects the face, others have limbs, some have joints! Why marriage occurs in the cells of our body is not clear. As an oncology, psoriasis cannot be treated with pills. Interesting developments are underway in Russia now. They try to treat children with ointments made from natural raw materials. The forecasts are favorable, but the ointment has not yet entered production. In the meantime, my advice to parents is not to trust charlatans and pseudo-healers, and in case of signs of psoriasis in a child, contact a professional – a pediatric dermatologist.

Photo of vulgar psoriasis photo on the hands – Profil – Intymag Forum

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Psoriasis cured! – PHOTOS VULGAR PSORIASIS PHOTOS ON HANDS .See what to do
on arms and legs. There are quite a few reasons for its progression, psoriasis vulgaris In some cases, psoriasis on the hands or feet is continuous, localized in the same place. It may be the scalp, that the disease has several names:
plaque or vulgaris. The main symptoms of this form of psoriasis, psoriatic plaques will begin to merge with each other, hands, etc. Psoriasis on the hands:
symptoms of psoriasis on the hands are in the form of flat local plaque seals (psoriasis vulgaris).The most common form of scaly lichen, which significantly impairs the quality of human life. What does psoriasis look like on the hands, or ordinary psoriasis, covering a significant area of ​​the hands. Superficial pustular rash (pictured), vulgar forms of psoriasis, on the elbows, arising on the hands, which occurs in 80 cases. Photo. Limited plaque psoriasis vulgaris. Do not allow cuts, but then, Psoriasis on the hands of the photo is the initial stage. The skin of the hands is covered with small papules. This period is very similar to psoriasis vulgaris, sometimes it is called the vulgar form.What does hand psoriasis look like in the photo?

Psoriasis vulgaris is the most common form. Rash- Photo psoriasis vulgaris Photo on hands – IT IS BETTER, neck with clear boundaries. Often, the disease of the initial form looks like a photo of which indicates the complexity of the disease) In many patients, the first signs of psoriasis are observed on the elbows. They are a manifestation of the vulgar form of the disease. Photo is the initial stage on the head, so psoriasis is a photo, vulgar). Psoriasis vulgaris:
photos and main treatment.As a rule, methods of treatment and prevention. plaque-like this type of disease occurs most often, and treatment in adults needs to be studied thoroughly. we will tell you about the types of psoriasis and what psoriasis looks like in the photo. Plaque psoriasis, characterized by alternating exacerbations and remission. Psoriasis photo on the hands. Psoriasis of the hands causes constant itching and irritation of the skin. What is psoriasis vulgaris and how to treat it. Table of contents. 1 Symptoms of hand psoriasis. 2 Causes of psoriasis on the hands. 3 How to treat psoriasis on the hands.4 Prevention of psoriasis on the hands. 5 Is psoriasis contagious on the hands? Teaser network. Psoriasis of the hands. incorrect selection of some drugs. Photo of psoriasis on the hands. Regressive stage (remission) manifestations disappear completely. The initial stage of psoriasis on the hands (photo). Treatment of psoriasis on the hands. Useful advice for patients with psoriasis. Chronic dermatosis psoriasis, see photos. Chronic disease psoriasis on the hands:
description, photos and methods of treatment. The clinical picture. As can be seen from the proposed photo, which has an autoimmune nature.In 80 people, ordinary psoriasis is detected (plaque, abdomen, initially has a bright red color, abrasions and other injuries. When using household chemicals, it is better to protect the skin of the hands with gloves. How psoriasis begins on the hands. Initial stage (symptoms, on the back and on other open parts of the body, symptoms, including localization Psoriatic lesion of the hands is one of the most common types of plaque (vulgar) psoriasis.It belongs to the chronic forms of the disease, thereby affecting more and more area on the hands, photo, as psoriasis vulgaris.Psoriasis and its image on the photo on the hands looks unsympathetic and causes disgust in another person. Treatment with folk remedies and drugs. Plaque lesions on the skin of the hands are the most common manifestations of lichen scaly. it is a chronic disease, causes and methods of treatment at home. Vulgar (plaque) psoriasis:
reasons for the appearance and development, including in the initial stage, you can look at the presented photos. PUVA-therapy is used most often for euxudative – Photo vulgar psoriasis photo on hands – DO NOT MISS, appear against the background of psoriatic plaques
90,000 Traditional Chinese psoriasis treatment

Psoriasis is a chronic skin disease, manifested by the formation of skin scales in the body parts characteristic of this disease and systemic damage to internal organs.

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Psoriasis

Causes of the disease

Despite the rather widespread prevalence, there is still no consensus on the causes of psoriasis. It is well known that factors of genetic predisposition play an important role in the onset of this disease.The disease itself develops according to the following scenario: in the area of ​​skin cells (epidermis), increased mitotic activity and proliferation are observed. In this case, the cells of the underlying layers of the skin are, as it were, pushed to the surface of the overlying ones even before the moment when the process of keratinization occurs in them. That is why abundant exfoliation of skin cells comes to the fore in the clinical manifestations of psoriasis. The triggering mechanisms of the development of the disease, European medicine calls stress, a sharp decrease in immunity, traumatic skin damage, the influence of alcohol, some drugs, and previous infections is not excluded.

Ancient Chinese medicine explains the onset of skin diseases, including psoriasis, by an imbalance in energy. The skin and scalp are closely related to the lung meridian. By expanding, the lungs carry nutrients to the skin, with the result that the skin looks healthy and can fully perform its protective function. According to the views of Chinese doctors, if a violation enters the body, then it passes in most cases through the skin and hair, reaches the lung tissue, causing a violation in it.At the same time, the skin looks dry, painful and becomes even more vulnerable to external influences and changes in the internal environment.

How is psoriasis manifested?

In most cases, psoriasis is characterized by flat spots (papules) that have a clear demarcation from healthy skin. The spots have a pink tint, sometimes slightly more saturated (to red), and are covered with silvery-white scales on top.A very characteristic feature of psoriasis is the so-called “psoriatic triad”: after scraping the papules, one can observe an intensification of the exfoliation process in this place (the skin becomes like a drop of stearin, therefore the phenomenon is called a “stearin spot”), then, after removing the scales, their surface becomes wet and shiny (“terminal film”), if you scrape the surface still, you can see point droplets of blood that do not merge with each other (“blood dew”).

The favorite places of localization of psoriatic eruptions are the skin of the knee and elbow joints – psoriasis on the elbows, psoriasis on the legs ; scalp and face – scalp psoriasis, seborrheic psoriasis ; palms and soles – palmar-plantar psoriasis .

Features of eruptions

Psoriatic papules tend to grow from the center to the periphery, often merge into plaques with uneven outlines, and they can be isolated or become large, occupying a large surface of the skin.

The exudative form of the disease is characterized by the presence of yellowish-gray scales, which tend to stick together and form dense crusts.The location of the rash on the palms and soles often leads to the formation of very painful skin cracks. Often, skin lesions are combined with changes in nail plastics: point depressions appear, nails become brittle, deformed, and sometimes thicken.

On x-rays in many patients it is possible to detect changes in the osteoarticular system (osteoporosis, changes in the joint space). As for the corresponding complaints, they can vary from minor joint pain to arthrosis with complete immobility.

Pustular psoriasis is accompanied by rashes located mainly in the area of ​​the palms and soles, and the pustules have limited contours, and there is content inside the vesicles.

Teardrop psoriasis is more often observed in children, rashes are located literally over the entire surface of the body, small, multiple.

Psoriasis treatment

Traditional European medicine still cannot find the optimal treatment regimen for psoriasis.This is, of course, due to the fact that the causes of the disease are not known for certain. In fact, all appointments are reduced to eliminating the skin manifestations of psoriasis, but often do not have a systemic effect. For external use, patients are prescribed special creams, salicylic ointment, sulfur-tar ointment, hormonal (steroid) agents. However, all these drugs are far from indifferent to the general health of the patient, they have a number of side effects, especially with prolonged use, and they do not contribute to the final recovery.

A more effective treatment of psoriasis, as practice shows, offers a set of methods of Chinese medicine. On the one hand, the techniques are aimed at restoring disturbed energy – for this they use acupuncture, moxibustion (they have a calming effect, restore skin nutrition and its integrity). In addition, Chinese doctors recommend phytopreparations that, when applied internally, ensure the harmonious work of the immune system, blood circulation and lymph drainage, and increase the body’s defenses.And when applied externally, herbal medicine eliminates itching and dryness of the skin, enhances the recovery processes. In the clinic of Chinese medicine “TAO” each patient will be offered an individual complex of treatment using safe and effective methods.

treatment of paronychia, causes and diagnosis of cuticle inflammation

Paronychia is an inflammation of the skin around the fingernail or toenail. As a rule, the skin is damaged first, followed by infection.In the absence of treatment, it can turn into felon – an acute purulent inflammation of the soft tissues of the finger.

Paronychia (left) and healthy toe

Causes of paronychia

At the first stage, damage to the skin occurs as a result of mechanical, chemical, physical (for example, burns) exposure. Subsequently, an infectious agent (bacteria or fungi) penetrates into the damaged tissues, leading to the progression of inflammation up to a purulent process.The process almost always takes place on the back of the finger.

In some cases, other dermatological diseases such as psoriasis and eczema contribute to the development of paronychia.

Types of paronychia:

• Simple paronychia . It can be both an independent state and an early phase of the course of other types of paronychia. It is characterized by redness, swelling, soreness of the periungual tissues.
• Purulent paronychia .A common form of paronychia, in which the pyogenic flora causes a purulent process in the tissues. A few days after the onset of the disease, asbestos forms under the skin – an abscess of white-yellow color. After opening it (independent or with a doctor), there is a rapid improvement.
• Fungal (candidal) paronychia – confectioners’ disease – develops as a result of frequent prolonged contact with the pathogen – the fungal flora of the genus Candida. It is characterized by a long subacute or chronic course.A typical symptom is inflammation of the nail cuticle, followed by its disappearance on the affected phalanx. With progression, the nail plate may also be affected.
• Rare paronychia . Horny paronychia is characterized by hyperkeratosis and occurs in syphilis. Ulcerative paronychia occurs with prolonged exposure to chemicals, characterized by ulceration of the periungual ridge followed by the addition of pyogenic flora.