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Dermatology

What Is Psoriasis – Ultimate Guide

If you are suffering from a red patch of skin that is covered with white scales, then you may have psoriasis. A proper diagnosis for this autoimmune condition is important, so a treatment plan can be started. 

In this guide we will discuss:

  1. What is psoriasis?
  2. What are the main causes of psoriasis?
  3. What are the different psoriasis types?
  4. Psoriasis symptoms
  5. What is the best treatment for psoriasis?
  6. Alternative treatments
  7. Can psoriasis go away?
  8. How to get diagnosed
  9. Psoriasis statistics
  10. Is psoriasis contagious?
  11. What is psoriatic arthritis?
  12. What causes psoriatic arthritis?

What is Psoriasis?

Psoriasis is an autoimmune condition that causes skin cells to grow rapidly. The rapid growth causes the skin to build-up resulting in red bumpy patches that are covered with white scales. 

Most commonly found on:

  • Scalp
  • Elbows
  • Knees
  • Lower back

Psoriasis is not contagious but can be hereditary. Typically appears in early adulthood, and usually only affects a few areas. In some severe cases of psoriasis, large areas of the body may be affected. Patches will eventually heal but may return throughout a patient’s life. 

What are the Main Causes of Psoriasis?

The exact cause of psoriasis is unknown. However, research has proven that a combination of factors contributes to psoriasis. One major cause is an issue with the immune system. This results in inflammation, which then causes the skin cells to grow too quickly. 

Typically, skin cells grow every 10 to 30 days. Psoriasis causes new skin cells to grow every 3 to 4 days. This results in a buildup of the old cells which causes white scales to form. While psoriasis is hereditary, it can skip generations. Outbreaks can occur at any time but can be triggered by certain elements. 

Psoriasis on Body Dermatology Treatment

Psoriasis Triggers: 

  1. Trauma to skin – cuts, scrapes or surgery
  2. Emotional stress
  3. Strep infections
  4. Medications – lithium, antimalarial drugs, Inderal, quinidine, indomethacin
  5. Infections
  6. Allergies
  7. Diet
  8. Weather

What are the Different Psoriasis Types?

Pustular Psoriasis

It appears as red and scaly skin that has small pustules. Pustules can form together and cause scaling. There are 3 different kinds of Pustular psoriasis, which includes von Zumbusch, palmoplantar pustulosis (PPP), and acropustulosis.

  • Body Parts: Palms of the hands and soles of the feet
  • Treatment: Corticosteroid creams, oral medications, and light therapy

Guttate Psoriasis

This type of skin condition typically begins in childhood or early adulthood. It appears as small red spots. It can be triggered by respiratory infections, strep throat, tonsillitis, stress, injuries to the skin and certain types of medication. 

  • Body Parts: Torso and limbs
  • Treatment: Steroid creams, light therapy, and oral medications

Inverse Psoriasis

Appears as bright red and shiny lesions. Often misdiagnosed as a fungal or bacterial infection because it appears in skin folds. 

  • Body Parts: Skin folds, including the armpits, groin and under the breasts
  • Treatment: Topical steroid creams, light therapy, and oral medications.

Erythrodermic Psoriasis

Will present as fiery red skin that contains shedding scales. It can be triggered by sunburn, infections, and medications. Must be treated immediately as it can lead to severe illness.

  • Body Parts: Can spread over large parts of the body
  • Treatment: Could possibly need hospitalizations where medicated wet dressings, topical steroid applications, and prescription oral medications are given until symptoms subside. 

Plaque Psoriasis

This is the most common form of psoriasis. It is known to cause thick red patches of skin which may have silver or white scales. 

  • Body Parts: Elbows, knees, lower back, and scalp
  • Treatment: Cortisone cream, ointment-based moisturizer, vitamin D creams, topical retinoids, tazarotene, coal tar, or light therapy.

Nail Psoriasis

This has not been deemed an official type of psoriasis and is often misdiagnosed as a fungal infection. 

  • Body Parts: Nails
  • Treatment: light therapy, oral medications, and biologics

Scalp Psoriasis

Most common for those who have plaque psoriasis. It can lead to severe cases of dandruff that is painful, itchy and noticeable. 

  • Body Parts: Scalp, and may extend to the neck, face, and ears 
  • Treatment: medicated shampoos, steroid-containing lotions, tar preparations, topical application of vitamin D, Light therapy and oral medications 

Psoriasis Symptoms

It will highly depend on what type of psoriasis you have as to what symptoms you may exemplify. 

Common symptoms include:

  • Skin with red patches covered in white scales
  • Small spots of scaling
  • Skin that may bleed as a result of it being dry and cracked
  • Itching
  • Soreness
  • Thick nails that are pitted or ridged
  • Swelling in joints

In addition, those who suffer from psoriasis may develop a type of arthritis called psoriatic arthritis. According to a study conducted by the National Psoriasis Foundation, they estimated between 10% to 30% of those with psoriasis will also develop psoriatic arthritis. 

What is the Best Treatment for Psoriasis?

Treatments help slow down the growth of skin cells, as well as ease itching and dry skin. There are a lot of different treatment options. Your doctor will base your plan on the size of your rash, what body parts are affected, your age, and overall health. 

what is psoriasis

Topical Medications

  • Corticosteroids
  • Vitamin D
  • Anthralin
  • Topical retinoids
  • Calcineurin inhibitors
  • Salicylic acid
  • Coal tar
  • Moisturizers

Light Therapy

  • Sunlight
  • UVB phototherapy
  • Narrowband UVB phototherapy
  • Goeckerman therapy
  • Psoralen plus ultraviolet A (PUVA)
  • Excimer laser

Oral and Injected Medications

  • Retinoids
  • Methotrexate
  • Cyclosporine
  • Drugs that alter the immune system (biologics): etanercept (Enbrel), infliximab (Remicade) and adalimumab (Humira)
  • Other medications: Thioguanine (Tabloid) and hydroxyurea (Droxia, Hydrea)

Alternative Treatment Options

There are many alternative treatment options that help ease symptoms.

  • Special diets
  • Creams
  • Dietary supplements 
  • Herbs

However, there is no supportive evidence that these treatments work for psoriasis. 

Patients have commented that these alternative therapies have helped decrease signs and symptoms, including itching and scaling. These alternatives are best for milder cases and not recommended for pustules, erythroderma or arthritis psoriasis.

  • Aloe Vera – An extract taken from the plant’s leaves. It may help decrease redness, scaling, itching, and inflammation. 
  • Fish Oil – This capsule contains omega-3 fatty acids and is known to help with inflammation. 
  • Oregon Grape – Applied topically, this agent is known to help decrease inflammation and relieve some symptoms associated with psoriasis. 

It is always best to consult your physician before taking any type of alternative therapy. They will be able to help you understand the pros and cons of these types of treatments. 

Can Psoriasis Go Away?

Psoriasis may go away on its own, but it is likely for patients to have flare-ups throughout their lives. It is a chronic skin condition, so it is not completely curable. Treatment can help with symptoms and make flare-ups occur for shorter periods of time. 

This condition varies from one person to the next. Some may have a milder case than others. Therefore, there is no textbook explanation as to how long flares could last and how often patients may experience a breakout. 

How to Get Diagnosed

When visiting a dermatologist, they will conduct a physical exam to check for signs of psoriasis. During this exam they will check:

  • Scalp
  • Ears
  • Elbows
  • Knees
  • Belly button
  • Nails

Your physician will also ask if anyone in your family has been diagnosed with psoriasis, as it is a hereditary condition.  

In addition, your dermatologist may conduct lab tests or do a biopsy to ensure the correct diagnosis is given. They will want to rule out any type of skin infection.

Psoriasis Statistics

  • 8 million Americans have psoriasis.
  • More than 125 million people worldwide are diagnosed with psoriasis. 
  • 10% to 30% of those who have psoriasis also develop psoriatic arthritis. 
  • Psoriasis often begins between the ages of 15 and 25.
  • Psoriatic arthritis usually occurs between the ages of 30 to 50. 
  • 1 out of 3 people reported that they have a relative that has psoriasis. 
  • Parents who have psoriasis have a 10% chance of having a child who develops psoriasis. 

Is Psoriasis Contagious?

Psoriasis is an autoimmune disease. This means that the body becomes overactive and can affect the body inside and out. While psoriasis is hereditary, it is not contagious. 

When Should I See a Dermatologist?

If you have persistent signs and symptoms that do not go away with over-the-counter treatments, then you need to seek the help of a dermatologist. They will be able to properly diagnose you, and get you on a treatment plan to help your symptoms. 

Follow up with your dermatologist any time:

  • Your psoriasis is flaring up
  • Symptoms are worsening 
  • Your treatment plan is not working
  • If you are interested in trying a new type of treatment plan

What is Psoriatic Arthritis?

This type of arthritis can lead to pain, stiffness, and swelling in and around the joints, as well as areas where tendons and ligaments connect to bone. If left untreated, psoriatic arthritis can be debilitating. 

Symptoms of Psoriatic Arthritis

  • Swollen and painful joints
  • Swollen and painful entheses (the area where the muscle or ligament joins to the bone)
  • Back pain
  • Nail changes
  • Stiffness 
  • Generalized fatigue
  • A decrease in range of motion
  • Redness and pain surrounding the eyes

What Causes Psoriatic Arthritis?

Psoriatic arthritis can be caused by both genetics and environmental factors. This arthritis is directly linked to psoriasis of the skin. The immune system plays a role in this condition. 

5 different Types of Psoriatic Arthritis:

  • Symmetric – Can affect several pairs of joints. Will occur on both sides of the body in the same joints. 
  • Oligoarticular – A milder form of arthritis and asymmetrically affects joints. 
  • Distal interphalangeal (DIP) – Affects the distal joints in the fingers and toes.
  • Spondylitis – Primarily in the spinal cord from the neck to the lower back.
  • Arthritis mutilans – Primarily in the small joints of the hands and feed, but can be found in other joints as well. It is rare and a severe form of arthritis. 

Treatment Options Include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Disease-modifying antirheumatic drugs (DMARDs) 
  • Biologics – Enbrel, Humira, and Remicade 

3 replies on “What Is Psoriasis – Ultimate Guide”

I have been suffering from psoriasis for years. This blog is very informative and helped me understand some of the triggers that could be causing my flare-ups. I often use topical medications but have also had to take oral medications to help with really bad flare-ups. My doctor consulted with me about trying light therapy, but I want to do a little more research before agreeing to it. I have tried special diets and different herbs but did not have much success. Oral steroids and corticosteroid creams seem to be my go-to when flare-ups occur. Thanks for the great information, and I hope others get out of this what I have. There are tons of options out there when it comes to treatment, but you have to find the one that works best for you!

I am newly diagnosed with pustular psoriasis. I have had it for many years but my family physician kept treating it as a fungal type of infection. When I was not getting any type of relief, I asked to be referred to a dermatologist. Right away they took a biopsy and it came back that I had psoriasis. I am glad to finally know what we are dealing with. I mainly have it on the palms of my hands and I have seen success with corticosteroid creams. This is great information, especially about the triggers. I was not aware that so many things could trigger a flare-up.

My son has psoriasis and we have tried all different types of oral medication and creams without any success. The dermatologist we are seeing recommended trying light therapy and it is doing wonders. My son is finally getting some relief and has not had a flare-up in a few months. This article was very informative and I did not realize there were so many different types of psoriasis. I have a few other friends who have children with psoriasis and I sent them the link to this article. I am hoping they can find some treatment options that will work for their children too! Thanks for the great information!

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