Psoriasis – Causes – NHS

Psoriasis occurs when skin cells are replaced more quickly than usual. It’s not known exactly why this happens, but research suggests it’s caused by a problem with the immune system.

Your body produces new skin cells in the deepest layer of skin. These skin cells gradually move up through the layers of skin until they reach the outermost level, where they die and flake off. This whole process normally takes around 3 to 4 weeks.

However, in people with psoriasis, this process only takes about 3 to 7 days. As a result, cells that are not fully mature build up rapidly on the surface of the skin, causing flaky, crusty red patches covered with silvery scales.

Problems with the immune system

Your immune system is your body’s defence against disease and it helps fight infection. One of the main types of cell used by the immune system is called a T-cell.

T-cells normally travel through the body to detect and fight invading germs, such as bacteria. But in people with psoriasis, they start to attack healthy skin cells by mistake.

This causes the deepest layer of skin to produce new skin cells more quickly than usual, triggering the immune system to produce more T-cells.

It’s not known what exactly causes this problem with the immune system, although certain genes and environmental triggers may play a role.

Genetics

Psoriasis runs in families, so you may be more likely to get psoriasis if you have a close relative with the condition, but the exact role genetics plays in psoriasis is unclear.

Research has shown that many different genes are linked to the development of psoriasis, and it’s likely that different combinations of genes may make people more vulnerable to the condition.

However, having these genes does not necessarily mean you’ll develop psoriasis.

Psoriasis triggers

Many people’s psoriasis symptoms start or get worse because of a certain event, called a trigger. Knowing your triggers may help you avoid a flare-up.

Common psoriasis triggers include:

• an injury to your skin, such as a cut, scrape, insect bite or sunburn – this is called the Koebner response
• drinking excessive amounts of alcohol
• smoking
• stress
• hormonal changes, particularly in women – for example, during puberty and the menopause
• certain medicines – such as lithium, some antimalarial medicines, anti-inflammatory medicines including ibuprofen, and ACE inhibitors (used to treat high blood pressure)
• throat infections – in some people, usually children and young adults, a form of psoriasis called guttate psoriasis develops after a streptococcal throat infection, but most people who have streptococcal throat infections don’t develop psoriasis
• other immune disorders, such as HIV, which cause psoriasis to flare up or appear for the first time

Psoriasis is not contagious, so it cannot be spread from person to person.

Page last reviewed: 09 May 2018
Next review due: 09 May 2021

Where Can Psoriasis Occur? | Short Hills Dermatology

You spend so much time taking care of your skin, cleansing, applying the best skincare products, protecting your skin from harmful UV rays by liberally applying sunscreen in every season. When your dedication to your skin’s health and appearance is marred by the appearance of a red, scaly patch, it can be very upsetting. Especially when your dermatologist diagnoses psoriasis, which is currently not curable. As an inflammatory skin disease, psoriasis arrives most unwelcomely, and then you live by the cycles of flareups and gradual healing – a time that can have you covering up and feeling out of sorts.

The amount of discomfort you feel, and the embarrassment you may endure, is greatly affected by where your psoriasis occurs on your body. The most common locations of psoriasis are: the scalp, knees, elbows and torso, notably the lower back. But psoriasis can develop anywhere on your body, including your nails, palms, soles, genitals, and very infrequently on the face. Often the lesions appear symmetrically, which means in the same place on the right and left sides of the body.

You may be among those whose psoriasis occurs on your back or on your legs, spots that are easier to cover up with clothing, or yours may peek out of the top of your shirts, extending onto your neck, or on your forearms, putting you in ¾ sleeves during summer. Psoriasis on your scalp can be visible through your hair, and leave copious amounts of white flakes on your shoulders. Any part of the body has its psoriasis discomfort and appearance challenges, and some sufferers say that when their psoriasis flares up, they experience depression.

It can be very upsetting to know that psoriasis is a chronic immune system condition. It occurs when a person’s immune system misfires and skin cells begin to regenerate at an excessively rapid rate. Normal skin cells are created in the lower layers of the skin, then rise to the surface as they mature and are shed over a period of 28 to 30 days. When someone has psoriasis, however, the cells are created, mature and rise, and are shed in less than a week. Because those new cells can’t be sloughed off quickly enough, they accumulate on the surface of the skin, forming a raised layer of inflamed and scaly patches. And some people with psoriasis also develop a related form of joint pain known as psoriatic arthritis. Psoriasis episodes tend to flare up in cycles, leaving you with the unnerving mindset of worrying when your next flare-up will occur, and will it occur before an important family celebration, a big career-making work event, a job interview, a charitable gala for which you are front and center as a member of the board.

Living in fear of your psoriasis flare-ups makes for an anxiety- and stress-ridden existence, which then increases the odds that your psoriasis will return. And the moment when you see those dry, raised, red skin lesions, you are reminded, ‘Something is wrong with me,’ or ‘I have a disease.’ And perhaps equally distressing: ‘Everyone will see. ’

It’s extremely difficult to live with a chronic disease of any kind, particularly one that creates visible signs that your system is ‘not quite right.’ But take heart in knowing that your dermatologist has ways to treat and lesson the symptoms of many kinds of psoriasis. Many women and men who hid or dealt with their psoriasis on their own, with hats, high necks, long skirts and long sleeves, and perhaps with over the counter creams that only frustrated them or created the mildest of improvement, find themselves experiencing improvement in their psoriasis appearance and discomfort, via top-quality prescription creams and other treatments. Soon, those patches fade, and with your dermatologist’s help, you learn that you are not powerless, that your psoriasis can be managed, and that there are many promising therapies, including newer biologic drugs, on the way.

https://www.medicinenet.com/psoriasis/article.htm

https://www.psoriasis.org/about-psoriasis/faqs

https://www. mayoclinic.org/

Psoriasis: Symptoms and Complications

When it comes to describing the symptoms of psoriasis, most people think about the red, scaly rash associated with plaque psoriasis, the most common form of the disease. But there are other types of psoriasis, each with its own characteristic signs and symptoms. In addition, certain forms of the autoimmune disease can easily be mistaken for other conditions and, as such, require expert evaluation to reach the correct diagnosis.

Illustration by Verywell

Frequent Symptoms

The symptoms of psoriasis are directly linked to the type of disease involved. While dermatological (skin) symptoms are common, they can vary in appearance and may not even occur in some cases. In fact, some types of psoriasis are limited to the nails, joints, or specific parts of the body.

Psoriasis symptoms will develop in acute episodes called flares. The flares are typically spurred by a “trigger” such as stress, medications, or a skin injury.  Other events are idiopathic (of unknown origin), developing suddenly and resolving just as quickly. Even if psoriasis symptoms are persistent, there will be episodes in which the condition will suddenly worse and improve.

Plaque Psoriasis

Plaque psoriasis accounts for around 80% of all cases and is considered the “classic” form of the disease. Plaque psoriasis is defined by:

• The appearance of superficial red patches of skin covered with white to silvery scales
• Itching
• Cracking
• Dryness

Plaque psoriasis.
DaveBolton / Getty Images

The patches can appear anywhere on the body but are most common on flexor surfaces (areas of skin opposite a joint, such as the inside of an elbow or the back of a knee). The rash also can show up on the scalp, face, and around or inside the ears. The reddened plaques will sometimes consolidate and cover greater portions of the body.

Although the scales on the surface of skin tend to shed easily, the ones just below are more tenacious and can bleed easily if scratched. This can lead to a classic finding called the Auspitz sign in which the tiny pinpoints of bleeding create a pattern similar to scabies.

When plaque psoriasis affects the scalp, it can easily be mistaken for dandruff (seborrheic dermatitis). However, with psoriasis, the affected skin will be dry with a silvery sheen; with seborrheic dermatitis, the skin will almost always be oily. Psoriasis on the scalp may be mild, with small patches on the back of the head and neck, or generalized, affecting the whole head.

When occurring on the face, psoriasis may affect the eyebrows, upper lip, and hairline. Very rarely, psoriasis can develop on the gums or inside the nose, cheeks, or lips. These lesions are often whitish or grey and can interfere with chewing and swallowing. While similar to aphthous ulcers, psoriatic lesions tend not to have a consolidated center.

Psoriasis in the ear can be problematic as the flakes can gradually accumulate inside the ear canal. Symptoms may include pain, itching, ear wax blockage, and hearing loss.

Nail Psoriasis 

More than 50% of people with skin psoriasis also have nail psoriasis, characterized by the overproduction of keratinocytes in the nail matrix. On the flip side, 5% of people with nail psoriasis will not have any signs of skin psoriasis, according to the National Psoriasis Foundation (NPF).

Psoriasis of the nails.
Trevor Knowles / Getty Images 

The symptoms of nail psoriasis are similar to other nail diseases, including onychomycosis (nail fungus). They include:

• Pitting (small dents or pits on the surface of the nail plate)
• Distal onycholysis (lifting of the nail from the nail bed)
• “Oil drops” (a translucent, yellow-red discoloration in the nail bed)
• Subungual hyperkeratosis (thickening and scaling of the nail)
• Leukonychia (white patches on the nail plate)

At its worst, nail psoriasis can cause the nail to become thick, crumbly, and unsightly. This may not only cause embarrassment but interfere with a person’s ability to walk.

Guttate Psoriasis

Bumps resulting from a guttate psoriasis rash can be described as:

• Small
• Raised
• Pink
• Teardrop-shaped

The rash can appear suddenly on the torso, arms, or legs, usually following a viral or bacterial infection like strep throat, chickenpox, or the common cold. It is more common in children given that they are more prone to these infections.

Inverse Psoriasis 

Inverse psoriasis, also known as intertriginous psoriasis, is a relatively rare form of the disease affecting skin folds. Inverse psoriasis typically occurs behind the ears, under the breasts, between the buttocks, or in the groin or armpits.

Because these areas tend to be moist, the patches won’t be scaly. Rather, skin affected by inverse psoriasis appears:

Pustular Psoriasis 

As the name suggests, pustular psoriasis is characterized by pus-filled lesions rather than scaly plaques. The pus, composed of dead white blood cells and lymph fluid, isn’t contagious.

Pustular psoriasis: palmar pustulosis.
DermNet / CC BY-NC-ND

There are several subtypes of pustular psoriasis. In the focal form of the disease, the rash appears only on small areas of the body, such as the palms, soles, fingers, or toes.

Von Zombusch psoriasis is a more serious form that can cover large areas of skin. It usually starts with generalized redness and tenderness, after which white pustules appear in flexural areas of skin (such as the backs of the knees or the inside of the elbows, armpits, or groin).

Other symptoms of Von Zomzusch psoriasis include fever, chills, dehydration, rapid heart rate, fatigue, weight loss, and muscle weakness. If left untreated, the disease can spread to the bloodstream and become fatal. 

Erythrodermic Psoriasis

Erythrodermic psoriasis is a rare and severe form of the disease characterized by the massive shedding of skin from all over the body.  Rather than smaller scales, the skin will come off in large sheets. Erythrodermic psoriasis often looks similar to a severe burn or a drug-induced case of Stevens-Johnson syndrome (SJS) or toxic epidermal necrosis (TEN).

Erythrodermic psoriasis can also cause:

• Severe itching and pain
• Tachycardia (abnormally rapid heart rate)
• Fluctuations in body temperature
• Dehydration

If left untreated, erythrodermic psoriasis can be life-threatening, leading to severe infections (such as sepsis or pneumonia) or congestive heart failure.

Complications

Beyond its effect on the skin and nails, psoriasis may directly or indirectly affect other organ systems, most specifically the eyes and joints.

Eye Problems 

Psoriasis can cause eye problems, as the scaling and dryness around the eyes can cause the eyelids to curl up unnaturally. This can lead to eye dryness, redness, itchiness, and blurring. The altered shape of the eyelid can also cause the eyelashes to scrape against the cornea (the fluid-filled layer at the front of the eye).

Psoriasis is also associated with uveitis (inflammation of the middle layer of the eye), the symptoms of which include:

• Conjunctivitis (pink eye)
• Sensitivity to light
• Eye pain
• Blurred vision
• Floaters (floating spots in the field of vision)

People with psoriasis are more likely to have recurrent bouts of uveitis than those without. This places them at greater risk of eye damage and vision loss, particularly in severe cases where psoriasis flares are frequent.

Psoriatic Arthritis

With psoriatic arthritis, the characteristic skin rash is accompanied by inflammation of the joints. As with other types of psoriasis, psoriatic arthritis can cause joints to enlarge and become misshapen over time. Uveitis and nail arthritis may also co-occur.

Psoriatic arthritis is different from osteoarthritis (“wear-and-tear” arthritis) in that it can affect connective tissues as well as the joints themselves. Unlike rheumatoid arthritis, in which the same joints on both sides of the body are typically affected, psoriatic arthritis may develop symmetrically or asymmetrically, often in tandem with other skin and nail symptoms.

Psoriatic arthritis has been closely linked to cardiovascular disease. In fact, according to a 2016 study from Ireland, heart attacks are the leading cause of death for people living with psoriatic arthritis today.

When to See a Doctor

If you suspect you have psoriasis, it is important to see a doctor rather than trying to self-diagnose the disease. In some cases, what appears to be psoriasis can end up being an entirely different condition such as lupus or squamous cell skin cancer. A dermatologist trained in skin health and disease is by far the best specialist to make the diagnosis.

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You will know that is it time to see a dermatologist when:

• Psoriasis symptom flares are frequent or worsening
• The range of symptoms is expanding or affecting other parts of the body
• The symptoms are causing discomfort or interfering with your quality of life
• The symptoms are causing you embarrassment or distress

To find a dermatologist near you, ask your doctor for a referral or use the online locator offered by the American Academy of Dermatology.

Frequently Asked Questions

How is psoriasis treated?

Depending on the severity of symptoms, psoriasis can sometimes be treated with topical creams alone. For larger areas or for psoriasis that is also accompanied by joint pain (psoriatic arthritis), other therapies may be necessary. Treatment options for psoriasis include steroid creams, moisturizers, vitamins, light therapy, retinoids, and immune therapies.

What causes psoriasis?

Psoriasis is an immune disease that causes a person’s skin cells to grow and build up faster than normal. This condition has a genetic element, meaning it is often passed down in families. Symptoms can be triggered by stress, skin injuries, bacterial infections, certain prescription medications, and changes in weather.

Causes, Symptoms and Treatment Options

Medically reviewed by Drugs.com. Last updated on May 3, 2021.

What is Psoriasis?

Psoriasis is a chronic skin disorder that causes scaling and inflammation.

Psoriasis may develop as a result of an abnormality in the body’s immune system. The immune system normally fights infection and allergic reactions.

Psoriasis probably has a genetic component. Nearly half of patients have family members with psoriasis.

Certain medications may trigger psoriasis. Other medications seem to make psoriasis worse in people who have the disease.

Symptoms

Psoriasis causes skin scaling and inflammation. It may or may not cause itching. There are several types of psoriasis:

• Plaque psoriasis. In plaque psoriasis, there are rounded or oval patches (plaques) of affected skin. These are usually red and covered with a thick silvery scale. The plaques often occur on the elbows, knees, scalp or near the buttocks. They may also appear on the trunk, arms and legs.
• Inverse psoriasis. Inverse psoriasis is a plaque type of psoriasis that tends to affect skin creases. Creases in the underarm, groin, buttocks, genital areas or under the breast are particularly affected. The red patches may be moist rather than scaling.
• Pustular psoriasis. The skin patches are studded with pimples or pustules.
• Guttate psoriasis. In guttate psoriasis, many small, red, scaly patches develop suddenly and simultaneously. Guttate psoriasis often occurs in a young person who has recently had strep throat or a viral upper respiratory infection.

About half of people with skin symptoms of psoriasis also have abnormal fingernails. Their nails are often thick and have small indentations, called pitting.

A type of arthritis called psoriatic arthritis affects some people with psoriasis. Psoriatic arthritis may occur before skin changes appear.

Diagnosis

Your doctor will look for the typical skin and nail changes of this disorder. He or she can frequently diagnose psoriasis based on your physical examination.

When skin symptoms are not typical of the disorder, your doctor may recommend a skin biopsy. In a biopsy, a small sample of skin is removed and examined in a laboratory. The biopsy can confirm the diagnosis and rule out other possible skin disorders.

Expected Duration

Psoriasis is a long-term disorder. However, symptoms may come and go.

Prevention

There is no way to prevent psoriasis.

Treatment

Treatment for psoriasis varies depending on the:

• Type of psoriasis
• Amount and location of affected skin
• Risks and benefits of each type of treatment

Treatments for psoriasis include:

• Topical treatments. These are treatments applied directly to the skin.
  • Daily skin care with emollients for lubrication. These include petroleum jelly or unscented moisturizers.
  • Corticosteroid creams, lotions and ointments. These may be prescribed in medium and high-strength forms for stubborn plaques on the hands, feet, arms, legs and trunk. They may be prescribed in low-strength forms for areas of delicate skin such as the face.
  • Calcipotriol (Dovonex) slows production of skin scales.
  • Tazarotene (Tazorac) is a synthetic vitamin A derivative.
  • Coal tar
  • Salicylic acid to remove scales
• Phototherapy. Extensive or widespread psoriasis may be treated with light. Phototherapy uses ultraviolet B or ultraviolet A, alone or in combination with coal tar.
  • A treatment called PUVA combines ultraviolet A light treatment with an oral medication that improves the effectiveness of the light treatment.
  • Laser treatment also can be used. It allows treatment to be more focused so that higher amounts of UV light can be used.
• Vitamin A derivatives. These are used to treat moderate to severe psoriasis involving large areas of the body. These treatments are very powerful. Some have the potential to cause severe side effects. It’s essential to understand the risks and be monitored closely.
• Immunosuppressants. These drugs work by suppressing the immune system. They are used to treat moderate to severe psoriasis involving large areas of the body.
• Antineoplastic agents. More rarely, these drugs (which are most often used to treat cancer cells) may be prescribed for severe psoriasis.
• Biologic therapies. Biologics are newer agents used for psoriasis that has not responded to other treatments. Psoriasis is caused, in part, by substances made by the immune system that cause inflammation.  Biologics act against these substances. Biologic treatments tend to be quite expensive.

When To Call a Professional

If you are unsure whether you have psoriasis, contact your doctor. Also contact your doctor if you have psoriasis and are not doing well with over-the-counter treatment.

Prognosis

For most patients, psoriasis is a long-term condition.

There is no cure. But there are many effective treatments.

In some patients, doctors may switch treatments every 12 to 24 months. This prevents the treatments from losing their effectiveness and decreases the risk of side effects.

Learn more about Psoriasis

Associated drugs

IBM Watson Micromedex

Mayo Clinic Reference

Medicine.com Guides (External)

External resources

National Psoriasis Foundation

http://www.psoriasis.org/

American Academy of Dermatology

https://www.aad.org/

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

Psoriasis 101 – Symptoms, Causes, Treatments, & Pictures

Illustration by: Eddie Phan

Table of Contents

Causes | Types | Symptoms | Diagnosis | Treatments | Psoriatic Arthritis

Everybody’s skin gets dry and a little flaky once in a while, and usually, it’s easy to clear up—all it takes is applying lotion more frequently, switching soaps or laundry detergents, or avoiding common skin allergens like nickel and certain preservatives. But what if you’ve developed itchy, painful, rough patches of skin that just won’t go away? You might have psoriasis. Learn more about what causes psoriasis, what it looks and feels like, how it’s diagnosed, and your treatment options.

What is psoriasis?

Psoriasis is a chronic autoimmune disease that causes a buildup of skin cells. This buildup causes rough patches that are often scaly, red, and inflamed. Psoriasis can affect any part of the body, but it most commonly develops behind the elbows and knees, as well as the scalp, back, face, palms, and feet.

Psoriasis affects roughly 7.5 million people in the United States, according to the American Academy of Dermatology. It can strike at any time in your life, but tends to first develop between the ages of 15 and 30 or between the ages of 50 and 60. Most people have mild-to-moderate psoriasis, but 20 percent of people have moderate-to-severe psoriasis, meaning it covers more than 5 percent of the body’s surface.

When someone has psoriasis, skin cells build up about eight times faster than normal, but slough off at the same rate of normal skin. As a result, thick patches of skin called plaques develop.

Illustration by: Eddie Phan

Psoriasis can occur in men and women and in people of all races. There are several types of psoriasis, but the most common type—which affects 80 to 90 percent of psoriasis patients—is called plaque psoriasis.

Let’s bust one common myth right now: Psoriasis is not contagious. So if your rash accidentally rubs on someone else or another person touches it, you don’t have to worry about spreading it. But the rash can be unpleasant to look at and can be embarrassing if it’s on a body part that’s regularly exposed to the public.

What causes psoriasis?

To be frank, we just don’t know yet what, exactly, causes psoriasis. Here’s what we do know: White blood cells in your body called T cells, which you can think of as part of your body’s department of defense, mistakenly think that your body is under attack. So they start to produce proteins that promote inflammation.

“Because of this pro-inflammatory cascade, the skin cells (keratinocytes) then respond by reproducing. But the old skin can’t shed fast enough. So it gets heaped up and forms plaques,” says Bobby Buka, MD, a dermatologist at Bobby Buka MD Dermatology in New York City. “Normally, in someone without psoriasis, the epidermis (the outer layer of skin) will turn over every 28 days. In a psoriatic patient, that turnover happens every seven days.”

Psoriasis triggers to avoid

There are other factors that experts believe may increase your risk for flare-ups. While they’re not precisely causes of psoriasis, many of them are factors that you can try to modify during your treatment to keep your symptoms under control.

• Infections
• Stress
• Certain medications
• Dry skin
• Skin injury or sunburn
• Smoking
• Drinking a lot of alcohol
• Vitamin D deficiency

What are the types of psoriasis?

Plaque Psoriasis

The most common type of psoriasis. Characterized by red or pink skin lesions covered in silvery scales.

Guttate Psoriasis

Causes small, red sores that cover the trunk, arms, and legs. It’s the second most-common type of psoriasis.

Pustular Psoriasis

A rare form of psoriasis that causes tiny blisters filled with pus.

Inverse Psoriasis

Usually occurs in skin folds: under the armpits or behind the knees, under the breasts, or in the butt or groin area.

Erythrodermic psoriasis

Very rare, but very serious. It covers more than 75 percent of the body and causes skin to peel off in sheets.

What are the symptoms of psoriasis?

Psoriasis can occur anywhere on the body, but the most common type—plaque psoriasis—often appears on the elbows, knees, and/or scalp. The telltale symptoms include:

Patches of skin that look pink or red and scaly with a silver coloring on top

They may feel itchy or sore, and it almost looks like the skin has been burned or injured. “If you try to uncover one of the plaques, you’ll get some pinpoint bleeding due to enlarged blood vessels,” says Rhonda Q. Klein, MD, MPH, a dermatologist at Connecticut Dermatology Group. And these patches tend to be symmetrical—in other words, if they show up on one side of the body, you’ll often see a mirror image of the patches on the other side of the body.

Misshapen nails

Believe it or not, there can also be signs of psoriasis on the nails. “There can be misshapen nails, nail pitting or ridging, or oil spots under the nail plate that can cause nail discoloration,” says Dr. Buka.

Oral changes

“You can also get what’s called a geometric tongue, where it almost looks like fractals on the tongue,” says Dr. Buka.

How is psoriasis diagnosed?

Usually, if it’s a classic case of plaque psoriasis, a dermatologist will diagnose you by simply looking at your skin and taking a full medical history. Expect your doc to ask you a lot of questions about your symptoms and how long you’ve been experiencing them, the medications you’ve been taking, your lifestyle (including whether you smoke, how much sleep you get, and how stressed out you’ve been), your family history, and more. Sometimes a biopsy (a tissue sample) may need to be analyzed to confirm your psoriasis diagnosis.

Psoriasis severity

Psoriasis is classified as mild, moderate, or severe. It’s determined based on how much of the body surface is affected.

Mild < 3%, moderate 3-10%, severe > 10%

What is psoriatic arthritis?

As many as four in 10 people who have psoriasis experience a condition called psoriatic arthritis that can cause joint swelling, stiffness, tenderness, and pain. So a doctor might inspect your hands, ankles, and feet and ask you if you’ve noticed any joint discomfort or swollen fingers or toes. “Generally, with psoriatic arthritis, it feels the worst in the morning—as opposed to osteoarthritis, which gets worse as the day goes on,” says Dr. Klein.

Up to 40 percent of people with psoriasis develop psoriatic arthritis.

The association between psoriasis and psoriatic arthritis has been known for a while, but the latest news is that research from the past several years has also discovered that, unfortunately, psoriasis patients are at higher risk of developing other serious (and sometimes life-threatening) conditions such as obesity, depression, and cardiovascular disease (heart attack, stroke).

“The thought is: All this inflammation that we’re seeing in the dermis is inflammation that’s probably happening on a low, basal layer throughout many organs,” says Dr. Buka. If you have psoriasis, your doctor may also talk to you about ways to optimize your health in those particular areas mentioned above. This might include eating more nutritious foods and exercising more, seeing a mental health professional, or taking steps to lower your blood pressure or cholesterol.

What are the most common treatments for psoriasis? And what’s the prognosis?

The bad news is that psoriasis is chronic, so if you’re diagnosed with it, it’s likely a condition that you’ll have for life. And there is currently no cure. But there’s some very good news to keep in mind, too. Symptoms can come and go over time, and there are a variety of treatment options that are more effective than ever and can help you find significant symptom relief.

Common psoriasis treatments include:

Topical medications

These can include steroid creams, a vitamin D analog, or a combination.

Oral medications

They may include Apremilast, Acitretin, methotrexate, and cyclosporine.

Laser or light therapy

Narrow-band UVB phototherapy feels a lot like going to a tanning salon—you step into a vertical box that’s filled with lights.

Biologics

An injection or infusion that can be done weekly, every other week, every six weeks, or every three months, depending on the medication.

Remember: If you think that you might have psoriasis, you don’t have to suffer in silence. It’s nothing to be ashamed of. Go get an evaluation from a dermatologist so you can get treated right away, get rid of the rash, and live your life with confidence.

Jane Bianchi
Jane Bianchi is a writer and editor with more 13 years of experience specializing in health; she formerly worked as a health editor at Family Circle, and her work has appeared in Men’s Health, Women’s Health, Esquire, and more.

Questions and answers about psoriasis

Psoriasis is a chronic (long-lasting) skin disease of scaling and inflammation that affects more than three percent of the U.S. population.

Although the disease occurs in all ages, it mostly affects adults. It appears about equally in males and females.

Psoriasis occurs when skin cells quickly rise from below the surface of the skin and pile up on the surface before they can mature. Usually this process (also called turnover) takes about a month, but in psoriasis it may occur in only a few days.

In its typical form, psoriasis results in patches of thick, red (inflamed) skin covered with silvery scales. These patches, which are sometimes referred to as plaques, are usually itchy or sore. Plaques often occur on the elbows, knees, other parts of the legs, scalp, lower back, face, palms, and soles of the feet. But they can occur on skin anywhere on the body.

How does psoriasis affect quality of life?

People with psoriasis may experience significant physical discomfort and some disability. Itching and pain can interfere with basic functions, such as caring for oneself, walking, and sleeping. Plaques on hands and feet can make it difficult to work in certain physical occupations, play some sports, and care for family members. People with moderate to severe psoriasis may also feel self-conscious about their appearance.

How is psoriasis diagnosed?

Because psoriasis can resemble other skin diseases, doctors sometimes find it difficult to diagnose it. Health care providers may need to use a microscope to examine a small skin sample before confirming a diagnosis.

In many cases, there is a family history of psoriasis. Researchers who have studied a large number of families affected by psoriasis have identified genes linked to the disease.

People with psoriasis may notice times when their skin worsens, called flares, before improving. Infections, stress, and weather changes can cause flares. Also, certain medicines may trigger an outbreak or worsen the disease.

How is psoriasis treated?

Doctors generally treat psoriasis in steps based on the severity of the disease, size of the areas involved, type of psoriasis, and where the psoriasis is located. Options can include:

• Medicines applied to the skin (topical treatment)
• Light treatment (phototherapy)
• Medicines by mouth or injection (systemic therapy)

Over time, affected skin can become resistant to treatment, especially when topical corticosteroids are used. Also, a treatment that works well in one person may have little effect in another. Thus, doctors often use a trial-and-error approach to find an option that works.

Topical Treatment

Treatments applied directly to the skin may improve the condition. Doctors find that some patients respond well to ointment or cream forms of corticosteroids, vitamin D3, retinoids, coal tar, or anthralin. Bath solutions and lubricants may be soothing, but they are seldom strong enough to improve the condition of the skin. Therefore, they usually are combined with stronger remedies.

Light Therapy

Natural ultraviolet (UV) light from the sun and controlled delivery of artificial UV light are used to treat psoriasis. It is important that a doctor administers light therapy. Spending too much time in the sun or a tanning bed can cause skin damage, increase the risk of skin cancer, and worsen symptoms.

Systemic Treatment

For more severe forms of psoriasis, doctors sometimes prescribe medicines that are taken by pill or injection.

• Cyclosporine. Taken orally, cyclosporine acts by suppressing the immune system to slow the rapid turnover of skin cells. It may provide a quick relief of symptoms, but the improvement stops when treatment is discontinued. Cyclosporine may impair kidney function or cause high blood pressure (hypertension). Therefore, a doctor’s supervision is important.
• Methotrexate. Like cyclosporine, methotrexate suppresses the immune system to slow cell turnover. It can be taken by pill or injection. Patients taking methotrexate must be closely monitored because it can cause liver damage and decrease the production of oxygen-carrying red blood cells, infection-fighting white blood cells, and clot-enhancing platelets.
• Retinoids. Oral retinoids are compounds with vitamin A-like properties that may be prescribed for severe cases of psoriasis that do not respond to other therapies. Because these medications may cause birth defects, women must consult with their health-care provider if they plan to become pregnant.
• Biologics. Biologics are made from proteins produced by living cells instead of chemicals. They interfere with specific immune system processes, which cause the overproduction of skin cells and inflammation. These drugs are injected (sometimes by the patient). Patients need their doctors to carefully monitor these treatments.
• PDE4 inhibitors. Taken orally, phosphodiesterase 4 (PDE4) inhibitors target molecules inside immune cells to suppress the rapid turnover of skin cells and inflammation.

Combination Therapy

Combining various topical, light, and systemic treatments often permits lower doses of each and can result in greater improvements.

There are many approaches for treating psoriasis. Ask your doctor about the best options for you.

Image credit: Adobe Stock

April 24, 2017

Psoriasis Vulgaris – an overview

Plaque Psoriasis

Etanercept for plaque psoriasis has been studied in four large trials. After two smaller studies demonstrated efficacy, two larger, Phase III studies continued to show the clinical efficacy of etanercept. In the first study, etanercept monotherapy was used in patients with moderate-to-severe psoriasis, with a mean Psoriasis Area Severity Index (PASI) score of 18. However, alternative dosing schedules were also evaluated. For the first 12 weeks of therapy, enrolled subjects were treated with placebo, etanercept 25 mg once weekly, etanercept 25 mg twice weekly, or etanercept 50 mg twice weekly. The PASI-75 for 12 weeks of therapy was 4% for placebo, 14% in the lowest dose, 34% in the 25 mg twice-weekly group, and 49% in the 50 mg twice-weekly group. Subjects were continued on their therapy for another 12 weeks, with PASI-75 response rates increasing to 25% in the low-dose, 44% in the middle-dose, and 59% in the high-dose groups.²⁸

Another large trial with 580 patients showed similar results. In this study, the first 12 weeks had a placebo arm, plus a 25 mg twice-weekly group and a 50 mg twice-weekly group. After 12 weeks all patients were changed to 25 mg twice weekly. Q26.4 The patients on the high dose initially showed a PASI-75 of 49%; even after the decrease in dose to etanercept, 25 mg twice weekly, some patients continued to improve with a PASI-75 of 54% at 24 weeks. Further, 77% of those patients who achieved a PASI-75 in the first 12 weeks maintained their PASI-75 at the end of 24 weeks despite the decreased dose. In addition, 33% of patients who did not reach their PASI-75 initially were able to finally reach the PASI-75 level, while on the ‘maintenance’ dose of etanercept. Overall, this study demonstrated that about 20% of patients required etanercept 50 mg twice weekly to maintain clearance of their psoriasis. The net result is that many patients can be given this higher ‘induction’ dose of etanercept, and after 3 months can maintain their clearance with only 25 mg twice weekly of etanercept.²⁹

For those that do respond with a PASI-75, there have been additional studies to evaluate withdrawal and rechallenge with etanercept. The mean time to relapse (defined as a reduction of the maximal improvement from baseline by 50%) of plaque psoriasis after discontinuation of etanercept was 84 days. There were no reports of a change of morphology of the patients’ psoriasis (no transition to pustular or erythrodermic psoriasis) during treatment or after withdrawal. There were no reports of rebound flare (defined as worsening of the PASI to 125% of the patient’s baseline) or tachyphylaxis after restarting etanercept. Also, no patients demonstrated neutralizing antibodies to the drug.^61,62

Long-term safety in combined Phase III trials in a 72-week open-label extension showed no difference in the adverse effect (AE) profile between the 50 mg twice weekly and the 25 mg twice weekly dosing patterns. Patients who stopped and then restarted medication continued to show improvement.⁶³ This was also seen in post-hoc analysis of 226 patients who had received 50 mg twice weekly, until clinical response was achieved, and then paused treatment until relapse. Patients were then restarted on 25 mg twice weekly of etanercept, and 83% of those patients achieved a Physician Global Analysis (PGA) of 2 or less (2 = mild, 1 = almost clear, 0 = clear) without any new safety concerns during retreatment.⁶⁴

One unique aspect of etanercept is that it is approved for treatment in pediatric populations. A 48-week study of 211 patients (ages 4–17 years) underwent weekly dosing of 0.8 mg/kg (up to 50 mg) for 12 weeks. Patients were then entered into an open-label portion of the study. Q26.4 At week 12, 57% of patients achieved a PASI-75, compared with 11% of patients on placebo, and at week 36 (after 24 weeks of open-label treatment), about 65% of patients had achieved a PASI-75.⁶⁵

The long-term extension portion of this trial followed 182 patients, 140 of whom completed the week-96 follow-up and 69 completed 264 week follow-up. PASI responses were similar at the end of the trial compared with the 12-week data, and 40% to 50% of patients maintained a clear/almost clear PGA. ^66,67

90,000 Psoriasis: causes, symptoms, treatment methods

Psoriasis is a multifactorial chronic inflammatory non-infectious immune-mediated disease, predominantly of the skin, with the appearance of characteristic bright red or pink plaques, raised above the surface of the skin and randomly scattered over the skin.

Types of psoriasis
– Plaque psoriasis. Also known as psoriasis vulgaris and psoriasis vulgaris. It is diagnosed in more than 80% of patients.Plaque psoriasis is often found on the head.

– “Reverse psoriasis”. Another name for the disease is flexor surface psoriasis. This form of psoriasis is characterized by smooth, non-flaky red, inflamed spots. The main sites of localization are folds of skin, for example, in the folds of the elbow, under the breast, the inner surface of the thigh and in other places in the absence or with minimally affected areas of smooth skin.

– Guttate psoriasis. It is accompanied by the presence of small, dry papules, shaped like drops.The color of the papules is red. Sometimes lilac and purple papules are found. Guttate psoriasis can appear all over the body: on the neck, head, limbs, and other places.

– Pustular (exudative) psoriasis. In this form of psoriasis, the affected skin not only peels off, but transparent blisters also form. The skin around the papules turns red, and a yellowish crust may form on the papules themselves.

– Psoriasis of nails. This form of psoriasis is characterized by deformation of the nail layer.

– Psoriatic erythroderma. A severe form of psoriasis, possibly generalized, accompanied by inflammation and peeling of the upper skin of the skin and affecting a large area of ​​the body.

– Psoriatic arthritis. A chronic disease characterized by a strong inflammatory process in the joints.

Prevalence
Men and women equally suffer from psoriasis [1], the course of the disease is approximately the same, it causes similar symptoms. The disease develops at any age.Debuts more often in the period from fifteen to twenty-five years [2]. However, there are cases of psoriasis in people aged 50-60. In this age group, the disease may be less pronounced. In the world, psoriasis occurs in 2-4% of patients [3]. In Russia, the percentage of cases is from 0.72 to 11.8% [4]. It is important for patients with psoriasis to find the right treatment.

Causes of psoriasis
Psoriasis, the causes of which are often associated with heredity, stress, intercurrent infections, is caused by many factors.The main causes of the disease can be:
– allergic reactions, for example, associated with the use of household chemicals, soap and detergents, alcohol-containing solutions;
– Injury or irritation of skin cells caused by friction or pressure;
– genetic predisposition to the disease;
– viral, fungal and other types of infections;
– disruption of the pituitary gland and thyroid gland;
– depression and constant stress;
– diseases of the liver, stomach and intestines

Symptoms
If the symptoms described below appear, you should consult a doctor to prevent exacerbation and complications of the disease.
The main symptom of psoriasis is a scaly, pale, gray or silvery papule that coalesces to form a psoriatic plaque on the skin. When diascopy (viewing with pressure) of the plaque, it turns pale, which characterizes the growth of new vessels during inflammation.
All symptoms can be divided into:
• Affection of smooth skin
• Affection of folds
• Affection of nails
• Affection of the scalp
• Affection of joints

Psoriasis of nails is characterized by the appearance of yellowish spots under the nails, the appearance of depressions, points, transverse lines, thickening or delamination of the nail.

The most dangerous form of psoriasis is psoriatic erythroderma, which is often fatal. This is due to the fact that during the course of the disease the body loses its ability to regulate body temperature, the barrier function of the skin decreases, which leads to various complications, including secondary infection.

Psoriasis worsens the quality and lifestyle, affects social adaptation. At the same time, in patients with psoriasis, there is concern about their appearance, up to the appearance of signs of dysmorphophobia and low self-esteem.
Diagnostics
Diagnosis and treatment are determined at the consultation with a dermatologist, after a non-invasive skin test. When diagnosing psoriatic arthritis, you will need to consult a rheumatologist.

Prevention
The following preventive measures are designed to prevent and prevent the progression of psoriasis:
– Stress avoidance. It is necessary to monitor your psycho-emotional background, minimize the negative impact on the psyche from the outside and “listen” to the signals of your body, since stress can become a catalyst for a disease that is “dormant”.
– Diet food. For people prone to psoriasis, the Pegano diet is recommended, in which the consumption of harmful foods that impair the functioning of the digestive tract is contraindicated, for example, fried, spicy, salty and pickled foods, sweets, convenience foods, as well as citrus fruits and some other types of foods.
– Skin Care. It is recommended to follow a number of rules to prevent the development of psoriasis: taking regular water treatments, using hypoallergenic and hygienic products, maintaining humidity in the room at 50-60%, and more.
– Choosing the right clothes.
– Taking vitamins. Especially vitamins A, E, D and group B.
– Preventive use of certain drugs prescribed by the doctor. Be careful, some medications can make the disease worse.
– Do not injure your skin and watch the condition of your nails.
Also, prevention measures include giving up bad habits (smoking, drinking alcohol-containing products), visiting sanatoriums and dispensaries, massage.
Treatment of psoriasis
Psoriasis, the treatment of which is mainly aimed at alleviating the symptoms of the disease, is still an incurable disease. Treatment of psoriasis is prescribed by a dermatologist. There are two areas of treatment: local and systemic. Research on psoriasis over the past 10 years has led to the emergence of new and highly targeted agents and treatments for severe psoriasis, which have already proven their effectiveness. For the treatment of local manifestations, as well as to alleviate the symptoms, ointments are used that effectively treat the manifestations of psoriasis, for example, flaking and itching.In some cases of therapy, drug treatment of psoriasis is carried out to reduce the severity of inflammatory processes, but this method often contributes to the occurrence of side effects such as fatigue, loss of appetite, and others. In some situations, it is possible to use injections for treatment, which improve the parameters of the immune system.

Used literature:
1. Kupetsky E.A., Keller M. Psoriasis vulgaris: an evidence-based guide for primary care (English) // Journal of the American Board of Family Medicine: journal.- Vol. 26, no. 6. – P. 787-801. – doi: 10.3122 / jabfm.2013.06.130055. – PMID 24204077.
2. Benoit S., Hamm H. Childhood Psoriasis (English) // Clinics in Dermatology (English) Russian .. – Elsevier, 2007. – Vol. 25, no. 6. – P. 555-562. – doi: 10.1016 / j.clindermatol.2007.08.009. PMID 18021892
3. Parisi R., Symmons D. P., Griffiths C. E., Ashcroft DM; Identification and Management of Psoriasis and Associated ComorbidiTy (IMPACT) project team. Global epidemiology of psoriasis: a systematic review of incidence and prevalence (eng.) // Journal of Investigative Dermatology: journal. – 2013. – February (vol. 133, no. 2). – P. 377-385. – doi: 10.1038 / jid.2012.339. – PMID 23014338.
4. Molochkov V. A., Badokin V. V., Albanova V. I., Volnukhin V. A. Psoriasis and psoriatic arthritis. – M., 2007.

90,000 Psoriasis: description of the disease, causes, symptoms, cost of treatment in Moscow

Psoriasis is a common chronic skin disorder. With this disease, a monomorphic rash appears, or pink-red nodules, which are distinguished by a loose silvery-white scaly surface.This disease can last for more than one year with alternating relapse and remission. In most cases of psoriasis, dryish red patches appear that rise above the skin. But there are cases when a person has no visible skin lesion. The formation of psoriatic plaques is localized in the place that is affected by pressure and friction. This place can be the buttocks, knee and elbow folds.

Spots, in addition to such places, may appear on another area of ​​the skin.This includes the palms, scalp, genitals, feet. In most cases, psoriasis has an undulating course. The patient can feel both an improvement, which was caused by a therapeutic effect, and an exacerbation, which was provoked by unfavorable external factors. Such factors include stress, excessive drinking.

The severity of the disease during relapses or remissions varies from a localized small area of ​​the body that has undergone damage, or a complete coverage of the body with red spots.If there are no therapeutic measures, the disease will progress, as a result of which the area of ​​the affected areas will increase. Over time, such an exacerbation will become more frequent and heavier. Medical practice knows cases when the disease proceeds without remission.

Stages of the disease

Since psoriasis is a chronic disease, it is important to clearly distinguish between its stages. In this case, you can easily assess how the disease is progressing, determine the sensitivity to certain methods of therapy, and also choose the subsequent scheme of actions.There are three stages of psoriasis.

The onset of the progressive stage indicates the onset of another exacerbation of the disease, which, in turn, has an undulating development. To recognize the progression of psoriasis, the following signs must be remembered:

• New papules appear on the surface of the extensor areas of the skin.

• They merge, forming a kind of plaques that have a whitish tint compared to the reddened skin.

• Newly formed psoriatic elements are formed, which are similar in appearance to small scales.

The onset of the stationary stage of the disease is an indicator that inflammatory changes on the skin are decreasing. In addition, this testifies to effective treatment measures that need to be replaced by an aggressive method. In the stationary stage of psoriasis, the following symptoms are characteristic:

• New red papules stop appearing.

• The existing psoriatic plaques stop growing.

• All psoriatic skin plaque is covered with scales.

• The reddened rim near the flaking element disappears.

The onset of the regressive stage of the disease refers to the most pleasant moment during treatment, both for the patient and for the attending physician.The presence of such a stage indicates that the exacerbation of the disease is almost over, and further actions will be aimed at preventing another exacerbation. The regressive stage has its own characteristics:

• The appearance of light small folds and radial lines.

• Near the psoriatic plaque, peeling gradually decreases, and then completely disappears.

• In the place where the plaque was previously located, whitish hypopigmented or dark hyperpigmentation spots form.

If we talk about the classic symptoms of psoriasis, we can distinguish the presence of a convex area of ​​the skin, which is distinguished by a red tint, and is covered with a crust that has a silvery tint. In most cases, the localization of the affected areas is the elbows and knees. There are some types of disease, the symptoms of which differ in intensity. The most common symptoms of psoriasis include:

• The presence of bright red psoriatic plaques that are covered with a flaky, silvery crust.

• If flaky skin breaks, a small bleeding area may form in this area.

• The condition of the nails is impaired. This is the most common symptom, especially for severe disease. There is the formation of small dimples on the nails, as well as the separation of the nails, their acquisition of a yellowish color.

• Itching.This symptom is typical for a spontaneous outbreak of the disease, or if the plaques are located under the breast or buttocks.

• The appearance of painful sensations in the joints, increased sensitivity.

Given the above symptoms of psoriasis, the patient’s body remains unchanged. In addition, the disease is not able to affect the way of life. a person does not need to find special conditions.However, psoriasis is a serious and aesthetically unattractive condition. In the absence of control of the developing process, inconveniences and limitations appear. This includes the rejection of tanning and clothing that has a short sleeve.

Since psoriasis is characterized by itching, a scratching wound may form, which will take a long time to heal. If left untreated, the disease can spread to the joints, resulting in psoriatic arthritis.This concomitant disease is characterized by painful sensations or swelling of the articular part of the bone.

Why does the disease appear

Psoriasis can worsen, develop or develop due to a regular stressful condition. The disease can provoke emotional upheavals, which differ in severity. Currently, there are no reliable reasons for the appearance of this disease. A possible reason for the development of psoriasis is the impaired functioning of the endocrine organs, changes in the functioning of the immune system, a strong shock, a hereditary factor.The only thing that can be said with certainty is the mechanism of psoriatic plaque formation. The basis is the presence of an immune imbalance. This means that the immune system has ceased to function normally. As a result, there is aggression from the cells and antibodies of the body in relation to its own tissues. The skin is a mirror image of the general condition of the body, therefore, in most cases, it gives a reaction to any autoimmune disorder.

Such a strong immune imbalance can be provoked by:

• The presence of a genetic predisposition.

• Severe stressful condition.

• If a person is constantly in a neuropsychic strain.

• The presence of a disease of the endocrine organs.

• Metabolic processes are disturbed.

• Vitamins and trace elements do not enter the body in sufficient quantities.

• The presence of intestinal parasites.

• Viral infection.

Diagnostic measures

The diagnosis of psoriasis is carried out by a dermatologist or therapist, taking into account external signs. Such a disease is not difficult to recognize. It is characterized by the location of multiple lesions on the patient’s body. In most cases, an accurate diagnosis is limited to clinical examination.This is explained by the presence of altered areas of the skin, which are characteristic only of psoriasis.

As for the picture of the disease that has occurred in children, the doctor may prescribe additional studies. Such studies include skin biopsy. The basis of such an analysis is the collection of a small piece of the damaged area of ​​the skin, after which the sample taken is examined. Based on this analysis, the doctor makes an accurate diagnosis. In the presence of painful sensations and swelling of the joints, the patient should be examined for the presence of psoriatic arthritis.The clinic is attended by qualified and experienced specialists in diseases of the skeletal system. The performed X-ray and blood test are fundamental factors before prescribing the correct treatment.

Preventive measures

It must be remembered that when symptoms of psoriasis occur, it is forbidden to self-medicate. This can lead to a worsening of the disease. In addition, constant monitoring of the condition of the skin is required. The patient should not comb the itchy areas, drink alcohol.You should balance your diet. He should exclude the use of refined foods, spicy foods, sweets. If possible, avoid colds so that the immune system does not weaken. Impaired immunity can negatively affect the course of the disease.

The appointment of psoriasis treatment is carried out in the clinic on an individual basis. Therapeutic tactics are based on the patient’s age, general condition of the body, professional activity, gender and personal characteristics of the person.Before prescribing treatment, the doctor determines the nature of the disease, the stage. In addition, it is necessary to eliminate provoking factors. You should stop drinking alcohol, drugs that can cause an allergic reaction in the body.

It is necessary to pay attention to the psychological and physical condition of the patient. It is necessary to normalize the environment, provide adequate rest, if necessary, hospitalize for a short period of time, or change the mode of work.

The complex of treatment measures is divided into:

Systemic therapy. It is necessary if the disease is severe, or there is no effect from other methods of treatment. The use of systemic therapy is based on the use of cytostatics, glucocorticoids, antihistamines, hepatoprotectors, enterosorbents.

Local therapy. It is necessary at any stage of the disease, and consists in the use of moisturizing ointments, creams, local glucocorticoids, herbal remedies, cytostatics.

Instrumental method. It is characterized by the use of ultraviolet irradiation of the inflamed surface, laser therapy, photo and chemotherapy, selective phototherapy, plasmapheresis, hemodialysis.

Psoriasis, what is it? – Bratsk regional dermatovenerologic dispensary

Psoriasis, what is it?

This is a common chronic skin disease, psoriasis was previously known as lepra, psora.In France, the incidence is about 4%, in Germany – about 4%, in Denmark – 6%, in the USA – 3.28%, in the Russian Federation – from 3% to 6%. Psoriasis (psoriasis) – from the Greek psoriasis-itching, scabies. Women and men get psoriasis equally often. Psoriasis usually begins during puberty (adolescence). Psoriasis is often a familial disorder. Psoriasis occurs due to changes in immunity, metabolic disorders, neuroses and stress. Psoriasis in humans, the most common dermatological disease in the world, suffered from such famous people as Dzhugashvili Joseph Vissarionovich, Benjamin Franklin (inventor, politician, journalist, publisher, scientist), Henry Ford (industrialist, owner of car factories, inventor ), John Rockefeller (entrepreneur, philanthropist, first dollar billionaire), etc.e. Rockefeller promised a Nobel Prize to anyone who finds a cure for psoriasis. Despite the fact that the disease has been studied for many years, the exact causes of this disease have not yet been identified. Psoriasis occurs at any age, sometimes even congenital. The disease is psoriasis, characterized by the appearance on the skin of rounded spots of red or pink dry – scaly plaque, usually on the flexion areas (elbows, knees, etc.). These spots are usually itchy and itchy. The disease psoriasis is not contagious and is not transmitted, it usually proceeds in waves, then, exacerbating, then remission occurs.Remission may depend on the time of year and what you eat.

Why is psoriasis dangerous?

The main inconvenience of psoriasis diseases are: the presence of inflammatory red spots on the skin, which sometimes peel off very strongly. And of course itching with psoriasis in most people, psoriasis itches very much, comb the plaques until they bleed. A certain percentage of people with psoriasis may develop psoriatic arthritis (PA). It affects various joints: the hip, shoulder, knee joints, small joints of the hands and feet, the spine, which can lead to disability (but this is rare, do not worry).Each person with psoriasis has a different course of the disease. Plus, almost all nail plates are affected, often people with psoriasis have hepatitis, psoriasis and the liver are strongly interconnected.

Diagnosis of psoriasis
To make a correct diagnosis of psoriasis, in fact, is not a problem for a good doctor. Since psoriasis is diagnosed mainly visually, in exceptional cases, a skin biopsy may be required (Cut off a small piece of psoriatic plaque and examine it under a microscope).A biopsy is an accurate test for psoriasis. The symptoms by which a dermatologist diagnoses psoriasis are the psoriatic triad – a stearin spot (white or yellow crust) and drip bleeding when the scales are removed. Plus, there may be depressed dots on the nails. There are no other tests to determine psoriasis. The rest of the tests are taken to determine if there are any deviations in the body, rheumatic tests, sugar, etc. So the diagnosis of psoriasis is not difficult and there is no problem to make the correct diagnosis.

Advantages of psoriasis

People with psoriasis usually look several years younger than their peers, due to the rapid renewal of cells. Rapid healing of wounds, including internal ones. Most often, people with psoriasis are creative people (dermatologists say this), men have excellent potency and intelligence. If you have a psoriatic crown on your head, then it is not necessary to wear a hat in winter, as psoriasis protects against wind and cold.If you often lie in a hospital, then naturally you make many different acquaintances and friends. Someone finds their soul mate there. People with psoriasis are forced to constantly struggle with their complexes about their appearance, to prove to everyone that they are not worse than others. This forced struggle makes us psychologically stronger and allows us to get rid of various complexes and become socially adapted.

Is it possible to work with psoriasis?

And so many psoriasis patients are worried about whether it is possible to work with psoriasis? Let’s try to figure it out.Psoriasis is, first of all, moral and ethical suffering for the patient, as psoriasis is expressed outside the person, and not inside like other sores. During an exacerbation of psoriasis, many of us are forced to temporarily or permanently give up certain types of work (life-activity, rest). When we have plaques (spots) on our hands, scalp and face, we are not always able to work, where work is related to communicating with people and to occupy social and social positions. Since the spots on the hands and face do not look aesthetically pleasing and scare off squeamish people.Being of working age, we are forced to limit ourselves in choosing a profession. Some people are still dismissed from work due to psoriasis (due to disgust), but this is far from everywhere and not always the case, it all depends on the specific case, the boss. You shouldn’t quit your job because of psoriasis, our people mostly understand. You can always excuse yourself that it is an allergy. If people start asking what and how, answer as broadly as possible that it is not contagious, bring light to the masses, like many of us.And often in such cases, many remember that friends and relatives also had this or have this. We really drive into our heads more about our sores, it is stupid to hide the disease – it just drives the problem inside and creates unnecessary stress. So, is it possible to work with psoriasis? Yes, of course you can (this is not a contagious disease), but there are some restrictions in employment with psoriasis, for some types of work and professions. Work and psoriasis are quite compatible. It is forbidden to work in the food industry (for example, as a cook) with skin diseases.With psoriasis, they will also not be taken to the Ministry of Internal Affairs, VV. Why are they not hired with psoriasis? If you work in a trade and psoriasis on a prominent area of ​​the skin, the employer may not allow communication with buyers from an aesthetic point of view. I hope psoriasis, after reading, ceased to be an unknown disease for you, about which you knew little. Do not let yourself be discouraged, your loved ones and friends! Depression only worsens psoriasis, rejoice and have positive emotions. Any active lifestyle will help in all troubles.Usually when a person has psoriasis, he hides from society, waiting for the skin condition to improve at least a little and will not be ashamed to appear in front of people. You should not do this or allow your loved ones to such a state, since any complexes aggravate the course of the disease. As they say, keep it simple and people will be drawn to you. Make acquaintances with the same sore when you visit KVD, in social networks we must support each other, help with advice and experience. Communication with each other will help get rid of our complexes.

90,000 features of the disease in childhood

Psoriasis in children: features of the disease in childhood.

When it comes to psoriasis, most often the patient seems to us to be an adult, but this is not always the case.In recent decades, psoriasis has become somewhat younger: more and more cases of the disease are registered in children, and psoriasis symptoms are found even in infants and newborn babies.

Causes of the disease in children.

Heredity remains the main factor. If both parents have psoriasis, then the probability that the child will also develop this disease is 50-70%. Includes a hereditary predisposition to one or more provoking factors: stress or severe fear; infectious diseases: flu, pneumonia; impaired liver and kidney function; skin damage, etc.Often, the symptoms of psoriasis in children are initially mistaken for an allergy. It has been noticed that girls get sick more often than boys.

Peculiarities of pediatric psoriasis.

In small patients, the disease proceeds somewhat differently than in adults, and the treatment of psoriasis requires a different approach. Symptoms of the disease can also vary. For example, in children, the winter form is more common, while in adults the summer form of the disease predominates. The localization of the first manifestations of the disease is also different.Plaques and papules can appear on the genitals of the child, on the face, in deep folds of the skin. Psoriatic arthritis is almost non-existent, although some children sometimes complain of joint pain. When establishing a diagnosis, it is necessary to differentiate psoriasis from other diseases: congenital ichthyosis: Leiner’s desquamative erythroderma; trichophytosis and seborrheic dermatitis; keratoderma of a hereditary nature and other diseases.

Treatment of psoriasis in children.

Features of the course of the disease in childhood require a thoughtful and strictly individual approach to treatment. Usually doctors are guided by the principle of gradualness: first, they prescribe the simplest remedies, and only if there is no result, more potent drugs are used. Therapy must necessarily be accompanied by medical nutrition, taking sedatives, antiallergic drugs and enterosorbents, local treatment of psoriatic plaques. Prescribe a course of vitamin therapy.In the absence of the expected effect, doctors may decide to prescribe hormonal drugs from the group of glucocorticosteroids. Possible use of phototherapy: irradiation of the skin with ultraviolet B.

Causes and symptoms of psoriasis on the skin in adults and children

Diagnostics and methods of treatment of psoriasis in Ukraine

Psoriasis (squamous lichen) is a chronic multisystem disease with predominantly skin lesions, affecting about 2% of the population.Pathology occurs at any age, but there are two peaks of the onset of the disease: at 20-30 and 50-60 years. Is psoriasis contagious? No, it is not contagious. The disease has a serious impact on the health and quality of life of patients, but is absolutely not dangerous to others.

Causes and symptoms of psoriasis on the skin

The cause of the disease remains unclear. Despite a sufficient number of hypotheses put forward, none of them is generally accepted. The role of the genetic component is clearly established: about 30% of patients with psoriasis have relatives suffering from this disease.The family indicator of patients with squamous lichen is several times higher than the population indicator. There is information about the relationship of psoriasis with antigens of the HLA system. The main pathogenetic link responsible for the appearance of skin rashes is recognized as increased mitotic activity and accelerated proliferation of epidermal cells. In this case, the cells of the lower layers of the skin, as it were, push out the overlying ones. The described process is called parakeratosis and is accompanied by profuse desquamation.

Psoriasis can be caused by infections.The initial stage of pustular psoriasis on the hands and large skin lesions on the trunk in young people is often preceded by streptococcal pharyngitis. Local immunopathological processes play an important role in the development and progression of psoriatic lesions. Stress is a common trigger for psoriasis. Other triggers include trauma to the skin or taking certain medications.

The main symptoms of scaly lichen

Psoriasis is a chronic recurrent pathology.During the course of the disease, spontaneous remissions are observed. The periods of exacerbation are more often in autumn / winter.

The main symptom of the disease is scaly reddish psoriatic plaques. The main localization of spots is the knee and elbow folds, the lower back, skin folds. There is a lesion of the scalp. The first signs of seborrheic psoriasis are peeling of the skin, so patients often mistake the onset of psoriasis for ordinary seborrhea and try to get rid of “dandruff” with the help of advertised shampoos.In 25% of patients, damage to the nail plates is observed.

What causes genital psoriasis? With the spread of the process, the rash can go to the external genital organs. In women, this manifestation of the disease is often associated with abrupt hormonal changes (menopause, pregnancy).

The causes and symptoms of psoriasis on the skin depend on the type of disease. The classification is based on the nature of the lesions.

Classification of psoriasis

Main types of scaly lichen:

1. Vulgar (normal).Flat pinkish-red papules are delimited from healthy skin and are covered with loose white scales. What vulgar psoriasis on the elbows looks like depends on the stage of the disease: at the onset of the disease, these are individual scaly plaques. How plaque psoriasis begins: Psoriatic papules grow and merge into plaques of different sizes and shapes. With the progression of the process and the absence of rational treatment, plaques merge and psoriatic erythroderma develops – a severe form of psoriasis.At the same time, the skin becomes edematous, acquires a bright red color, and peels off profusely. Patients suffer from severe itching.
2. Pustular (exudative) psoriasis is manifested by rashes (pustules) filled with uninfected exudate. The main localization is the skin of the palms and soles. How to treat patients with palmoplantar psoriasis depends on the stage of the disease. Usually they start with the appointment of topical drugs. In terms of effectiveness, they are, of course, inferior to systemic therapy, but less often have side effects.
3. Guttate psoriasis usually develops in children and presents with sudden rashes. Red spots of teardrop-shaped psoriasis on the body in children are small papular elements (1-10 mm) in the form of drops.
4. Inverse, or flexor psoriasis: red spots are located in the folds of the skin.
5. Nail psoriasis. It is characterized by various changes in the nail plate: spots, point depressions (like a thimble), thickening, yellowing, brittleness.

Effective drugs for the treatment of psoriasis on the face and other parts of the body

Scaly lichen requires a differentiated approach to treatment: therapy for psoriasis is prescribed taking into account the stage of the disease, its form, the degree of prevalence of rashes. The general condition of the body plays an important role.

How to get rid of psoriasis on the legs? Treatment is complex, involving a combination of external and systemic drugs. Creams, lotions, gels, shampoos, non-hormonal ointments for psoriasis are used at the initial stage of the disease.Preparations of Naftalan oil, Tambukan mud, xamiol gel have proven themselves well.

It is difficult to determine the best drug for nail psoriasis. The choice of drug depends on the stage of the disease. At the first signs of nail psoriasis, drugs for local use are prescribed: glucocorticosteroids, salicylic acid, retinoids for external use, vitamin D preparations.

Hormonal ointments are considered effective drugs for the treatment of psoriasis on the face.Irradiation of the skin with ultraviolet rays is shown: UV therapy and PUVA therapy (combination of ultraviolet irradiation with the appointment of photosensitizers). Diet and vitamins for psoriasis of the scalp are recommended in addition to the medication prescribed by the doctor. This approach allows you to extend the period of remission.

Diagnostics and methods of treatment of psoriasis in Ukraine are based on international standards. The Dobrobut clinic successfully uses special equipment – a camera for the diagnosis and treatment of psoriasis.Read more about this on our website https://www.dobrobut.com/

Why is self-medication dangerous?

About 20% of patients with psoriasis suffer from psoriatic arthritis, which can lead to joint destruction. Patients diagnosed with lichen scaly have an increased risk of developing cardiovascular pathologies. This should be remembered. Therefore, to the question of what to do in case of exacerbation of psoriasis, we will answer: contact a doctor who will conduct an examination and prescribe a complex therapy.

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Dermatovenereology

It is not contagious! Dermatologist dispels myths about psoriasis

October 29 is the International Day of Psoriasis, a disease that affects approximately 250 million people worldwide. Despite its prevalence, many do not know what kind of disease it is, what factors lead to it and whether it can be cured of it.

The history of psoriasis begins in ancient times.The first mentions of the disease can be found in Hippocrates, in the Old Testament, and in the Book of Leviticus.

– The difficulty of searching for historical descriptions of the disease lies in the fact that earlier psoriasis was often called leprosy, leprosy – explains Daria Troshina, assistant of the Department of Dermatovenereology and Cosmetology of Omsk State Medical University. – Therefore, it is impossible to unequivocally answer the question of when psoriasis was first diagnosed. Also confusion was added by the ancient Roman physician Cornelius Celsus, who in his writings called him “impetigo” (literally – “scabs”).It was only in 1809 that the English physician Robert Villan gave the first classical description of this disease. The very term “psoriasis” (from the ancient Greek “psoriasis” – itching condition) was introduced in 1841 by the Austrian dermatologist Ferdinand Gebra, finally separating it from leprosy.

Many famous people suffered from psoriasis. So, Winston Churchill promised to cast a monument of pure gold to someone who can create an effective cure for psoriasis, and John Rockefeller offered for this a prize equal in size to the Nobel Prize.But, as we know, the monument has not yet been erected to anyone, and the prize has not been awarded. Now there are many methods of treating psoriasis that allow you to control the disease and achieve remission, but unfortunately, there is no universal method that would completely cure psoriasis.

– Every person suffering from this ailment should remember that psoriasis is a multifactorial disease that largely depends on lifestyle and concomitant diseases, and therefore requires daily work on oneself, giving up bad habits and striving for a healthy lifestyle – comments the doctor. – Indeed, in this case and subject to the individual recommendations of the attending physician, you can defeat psoriasis. Let not forever, but for many years.

Tatiana Repina, Candidate of Medical Sciences, dermatovenerologist, told the Omsk Here correspondent about the main myths associated with psoriasis, and dispelled some of them.

Tatiana Repina

– I want to dispel this myth. Psoriasis cannot be contracted; there is a genetic predisposition to it.A person is born already with a certain set of genes that were passed on to him from relatives who were sick or also had a predisposition to this skin disease. From each other, using common household items, people cannot get infected in any way.

– Unfortunately, this is a myth. Despite the best efforts of scientists, psoriasis remains an incurable disease. There are many treatments available that can alleviate the suffering of a patient and can prolong periods of remission.The goal of treatment is to improve the quality of life of a person with psoriasis, reduce the frequency of exacerbations and increase the time of remission. The cause of psoriasis has been elucidated, but it is still impossible to influence it, since there is a “breakdown” in the genetic apparatus.

– Quite the opposite. Psoriasis is inherited. But again: even if a person’s relatives, both mom and dad, are sick, then the probability that their child will get sick does not exceed 50%. For this, the influence of the so-called trigger factors must occur.For example: stress, a sharp change in climate, a previous infection, hormonal changes, alcohol and smoking.

– It’s true. Stress is one of the main provoking factors of this skin disease, which triggers the manifestation of rashes in a person with a predisposition. The more unfavorable the living conditions of a person, including in psychological terms, the higher the risks of psoriasis.

– This is a myth.Such procedures are reasonably permitted. The only irritating factor when visiting the pool can be chlorinated water. After the pool, you need to take a shower and use products that soften the skin.

You can sunbathe in the morning and evening hours. The exception is patients with the summer form of psoriasis, their minority, but their exposure to the sun provokes an exacerbation of psoriasis.

One of the methods of psoriasis treatment is phototherapy – treatment with various types of ultraviolet radiation.In our dispensary there are installations that look like solariums, but special lamps are installed in them, with which we can act on the entire surface of the human skin or on individual areas, with different types of ultraviolet radiation, depending on the clinical form that we are faced with. This is the strong point of our region, because beyond the Urals, phototherapy in such a modern kit is available only in Omsk.

– Any allergic diseases do not turn into psoriasis.Psoriasis is an independent chronic skin disease. At the same time, it can spread and grow on the skin, and it is impossible to predict the sites of localization and the course of the disease. We can predict that if the patient leads an unhealthy lifestyle, if he has chronic diseases and does not monitor them, then all this will aggravate psoriasis.

– This is not entirely true. The diet for psoriasis is not hypoallergenic, it is more gentle on the gastrointestinal tract. Spicy, smoked, salty, fried foods, alcoholic and fizzy drinks are limited.

– It can occur at any age, starting at 4-5 months and even at the age of 50-60. Also, depending on this, two types of psoriasis are distinguished: one is difficult and occurs at an earlier age; the second, which manifests itself in adulthood, is usually easier.

– This question cannot be answered unequivocally. There is a typical psoriasis, which is easy to identify without serious diagnostic tricks.But psoriasis can proceed under the guise of other diseases: it can be similar to eczema, seborrheic dermatitis and other allergic processes, and it is not always easy for a doctor to diagnose it initially. In difficult cases, a histological examination is performed – a skin biopsy.

– This is both a myth and a truth. We recommend limiting physical activity associated with contact irritation of the skin, activities associated with contact with the skin of harmful substances.It is worth remembering that psoriasis can cause a more serious condition. About 25-35% of people with psoriasis have joint lesions. Sometimes arthritis is very severe and leads to disability: a person is limited in movement, cannot serve himself. Now there are drugs for treatment, they can curb the development of psoriatic arthritis. In such cases, the dermatologist works in conjunction with a rheumatologist to work successfully.

“It all started with one speck on the knee”

Anna learned that she had psoriasis as a teenager, just when complexes associated with appearance most often appear.

– At first there was one spot on my knee, which I did not attach any importance to and did not tell my parents about it. A little later, spots appeared on the elbows, but, knowing nothing about this disease, I thought it was just dry skin. Once I woke up, and everything was sprinkled with such specks, from head to heels. Of course, I was scared, my parents got scared, and we turned to a dermatologist. The doctor was unable to make a diagnosis right away. I had a lot of tests, it took two months, until we left for another city, where the doctor from the doorway said that it was psoriasis, and that it was not being treated.I remember then I was very upset, cried, because I thought that all my life I would walk with these spots on my body.

“I always wore long sleeved sweaters”

– At first, the treatment was simple: moisturizers and hormonal ointments. Then it helped, the skin almost cleared after a couple of weeks, only spots remained on the knees and elbows. From time to time, spots appeared on my hands, so at school I always wore long-sleeved sweaters.It seemed to me that everyone was looking at these spots and thinking that I was contagious. I was afraid to say the word “psoriasis” to someone, because the children would not understand it. Although later, when I grew older, I told my close friends about the disease, and they said: “We thought you were just allergic and didn’t pay much attention to it.”

Before leaving school, I had a whole complex because of these few spots. Then, in the senior courses of the medical university, I am a dermatovenerologist, I no longer had skin manifestations.

I tried many methods of treatment, I tried to cure even these small spots: these were just moisturizers and very powerful hormonal preparations, but personally for myself I noted that the sea climate, sun and lack of stress help me best. And now, of course, nutrition is already affecting: you cannot eat fatty, sweet, drink alcohol. You can’t smoke yet.

“One of the factors in the development of the disease is stress”

– For a long time I had these single spots, which did not bother me much, until about a year ago I had an exacerbation again, and it looked like one solid red spot.I was no longer ashamed of my skin manifestations, and calmly wore T-shirts, tops, T-shirts. I realized that only a few begin to look at you, look askance. For the most part, people don’t care. At the same time, during the period of exacerbations, I do not go to pools, saunas, where you need to undress, where people can really think that this is a contagious disease.

Now I realized that in childhood one of the main factors in the development of the disease was stress, moreover, the stress caused by psoriasis itself.The debut of the disease took place, I was sprinkled, I was very worried, upset, complexed about my appearance.

It is important that I did not pay attention to this small speck. If my parents and I had consulted a doctor earlier, probably such a serious and large exacerbation could have been avoided.

Now I do not feel discomfort with public opinion, because there are many doctors around, and I explain to other people what kind of disease it is.By the way, when you say that you have such a skin disease, many say: “Yes, my relative / friend / acquaintance also has an allergy.” Everyone is calm and understanding.

Since the disease debuts in adolescence, parents should provide the child with psychological support and explain that psoriasis is not as scary as it might seem at first glance. “Omsk Here” turned to psychotherapist Mark Greenberg , who spoke about ways to support themselves and loved ones who were diagnosed with such a disease.

– The skin, intestines and nervous system are formed from one “germinal petal” – says the doctor. – Therefore, often skin problems are closely related to the internal, psychological state of a person. And therefore, the attitude to yourself, to your body, to the world around you, in one way or another, affects the course and prognosis of recovery. If the world is perceived as threatening, as unsafe, then, among other things, the skin will try to protect a person from the world, create a “shell”. If one’s own body is perceived as someone else’s, then the body will defend itself from its own body, including through an “allergy” to its own body.

The most important thing, perhaps, is to help a teenager, and an adult too. It is necessary to separate “I”, “my life” and “disease”. Often, the disease becomes everything for both the patient and his loved ones. All thoughts, conversations, communication, actions revolve around the disease. It becomes the center of the universe, on the edge of which a lonely teenager “hangs out”. But no. It should be the other way around. There is a clear formula: “Yes, psoriasis is a part of my life, but my life is bigger and more varied than psoriasis.”

Psoriasis is like a mangy dog ​​that tries to bite your arms and legs, and sometimes he succeeds.But the more you are afraid of him, the more often he will bite you. You cannot tame him until you stop being afraid of him. You cannot train him as long as you close your eyes to him. But by becoming a “caring owner” of yourself and your skin, you can help this “dog” become calm, get a smooth coat and a healthy look. And then not “My Psoriasis and I” will enter the class, but “Me and my psoriasis, which is learning to be smooth and beautiful skin.” You are not on a leash with psoriasis, but psoriasis on a leash is with you.

And it is important for parents to help the child pay attention to what he is doing, to those interests and desires that are beyond the boundaries of the disease. Help and maintain the child’s confidence in their abilities and capabilities, demonstrate, voice confidence in him. Help in accepting the characteristics of your skin, your body. Pay attention to yourself and the child to what helps to reduce the manifestations of the disease. Teach the child how to increase his confidence, stress resistance – autogenous training, simple techniques of self-hypnosis.Support sports, creativity, and other forms of self-expression. And, of course, maintain an atmosphere of acceptance and support for each other at home.

90,000 Psoriasis: Causes, Symptoms and Treatment

Psoriasis is a common skin disease that affects up to 12% of the population of Russia. In this article we will tell you what are the causes of psoriasis, its first symptoms and how to treat this disease.

What is psoriasis?

Psoriasis is a chronic non-infectious skin disease with the development of pathological processes in the skin, nails and joints.

Why does psoriasis occur?

Today, the exact cause of psoriasis has not been established. However, scientists suggest that this is an autoimmune disease. This means that the cells of the human immune system attack the epidermis, while releasing special substances that provoke inflammation (the so-called inflammatory mediators). At the same time, skin cells enter into regeneration processes, their maturation processes are disrupted, excessive growth and reproduction of these cells is observed.

Suspected of being hereditary in nature.

Factors that can provoke the development of psoriasis:

• neuropsychic trauma
• endocrine diseases (diabetes mellitus, thyroid diseases)
• streptococcal infection (especially chronic)
• immunodeficiency

Psoriasis symptoms

The most common form of psoriasis is psoriasis vulgaris.

• Occurs more often symmetrically on the extensor surfaces of the upper and lower extremities
• Has the appearance of pink papules that grow on the periphery, become large and turn into plaques. In this case, large papules and plaques are covered with silvery, easily detachable scales.
• Large papules and plaques during growth can merge, forming large spots or occupy almost the entire skin
• Fresh rashes may appear at the site of damage to the skin
• Lesions can be located in large folds (inguinal-femoral, axillary, folds under the mammary glands)
• The lesion of the feet and palms can be either in the form of papules and plaques, or more resembling ordinary calluses
• Nail damage can be in two forms: 1) multiple punctate depressions in the nail plate (like a thimble) 2) the upper edge of the nail plate becomes yellow and brittle
• Scalp psoriasis usually extends beyond the scalp, but no hair loss occurs

Psoriasis vulgaris has periods of course:

• Progressive: appearance of fresh papules and their growth, desquamation in the central part of papules and plaques
• Stationary period: no symptoms of the progressive period, scaling over the entire surface of papules and plaques
• Period of regression: resorption of papules and plaques with the formation of spots with a reduced or increased pigment content

Psoriasis can have seasonal exacerbations either in the autumn-winter period, or in the spring-summer period.

There are other variants of the course of psoriasis vulgaris. They have special symptoms:

• Symmetrical eruptions of many small papules resembling spots and not showing a tendency to significant peripheral growth
• Psoriatic papules and plaques may be covered with yellowish crusts or scales. Such a picture arises as a result of the fact that exudate (fluid released during inflammation) soaks ordinary scales. In this case, there may be itching.
• Scales can be impregnated with sebum, stick together and firmly adhere to the surface of papules and plaques, simulating a picture of seborrheic dermatitis
• When an irritating external therapy is carried out in a progressive period, papules may have a cherry red color with a rim around them
• Plaques can become bluish and wart-like. Such foci exist for a long time and are difficult to treat

How to treat psoriasis?

Consult a dermatologist.Only after the examination, the doctor will be able to start the competent and most effective treatment.