What is psoriasis and how is it treated?

31 October 2023

Psoriasis, which affects the skin and whose treatment involves the use of ointments

Psoriasis is a dermatological disease in which red patches with silvery scales appear on the skin.

Depending on the type, psoriasis affects the knees, elbows, trunk, nails, face or scalp.

What is Psoriasis?

Psoriasis is an autoimmune disease that causes skin cells to grow too quickly, build up, and form inflamed red patches. Symptoms of psoriasis can vary depending on the type, stage and cause. General signs of psoriasis:

inflamed areas of skin;
whitish-silver scales or plaques on red spots;
pain and burning of the skin;
dry, cracked skin (may itch and bleed);
stiff and swollen joints;
thickened, ribbed nails.

Psoriasis in children usually first affects the scalp and nails and then spreads to the elbows, knees and trunk. With nail psoriasis in a child, depending on the type of psoriasis, thick nails without pits or with small grooves, as well as yellowing of the nails or their detachment from the nail bed, can be observed.

If you notice the first signs of psoriasis, you should see a doctor. A dermatologist deals with the diagnosis and treatment of psoriasis in adults. If red spots on the skin or silvery scales appear in children, you should consult a pediatrician.

How does psoriasis begin?

Psoriasis begins with the formation of small red bumps that rise a few millimeters above the skin (outwardly resembling a normal rash). As the size increases, white or silver scales may appear. The scales on it may fall off. The remaining scales stick together and begin to hurt and itch. If you scratch the resulting rash, the scales can detach from the skin and cause bleeding.

What does psoriasis look like?

With psoriasis, red patches appear on light skin and brown or purple patches on dark skin. In the initial stages of scalp psoriasis, the spots resemble scales (due to white scales). Forms of psoriasis:

mild form of psoriasis (less than three percent of the body is affected, rashes are localized on the scalp or extremities);
moderate form of psoriasis (the rash covers three to ten percent of the body and affects the scalp, arms, legs and trunk);
Severe form of psoriasis (more than ten percent of the body is affected, rashes appear on the palms of the hands, soles of the feet and on the face).

Treatment for psoriasis is selected by a dermatologist depending on the form and type of psoriasis, symptoms and location of the rash. Incorrect or delayed treatment results in large lesions on the skin.

Where can psoriasis occur?

The location of psoriatic spots depends on the type. Types of Psoriasis:

Plaque (vulgar) psoriasis. Plaque psoriasis causes dry, raised patches of skin covered in silvery scales. Psoriasis occurs on the elbows, knees, lower back, and scalp;
erythrodermic psoriasis. The skin looks burned, chills appear and the temperature rises;
Guttate psoriasis. Small, scaly, flesh-colored spots, similar to water droplets, form on the arms, legs, and torso.
pustular psoriasis. In pustular psoriasis, white, pus-filled blisters and large inflamed areas of skin form on the skin. Localized in small areas of skin affecting legs or arms;
exudative psoriasis. Spots covered with yellow crusts appear on the skin;
inverse psoriasis. Smooth red spots appear on the skin. The rash appears in skin folds (armpits, buttocks, genitals).

In nail psoriasis, skin builds up under the nails, causing them to lift and form depressions ("nail pits"). The skin under the nail plate turns white, yellow, or brown. Nails become rough, crumble, and break easily.

Dermatologists also differentiate between palmoplantar psoriasis. The skin in psoriasis on the palms and feet is dry and prone to cracking.

Eyelid psoriasis causes redness, scaling, and crusting around the eyelids. Other symptoms of psoriasis on the eyelids:

the formation of scales that peel off and stick to the eyelashes;
pain when moving eyes;
Irritation of the skin of the eyelids, accompanied by pain and itching.

The edges of the eyelids can go up or down depending on the location of the spots, causing friction between the eyelashes and the eyeball. Possible consequences of eyelid psoriasis include uveitis (inflammation of the eye) and loss of vision.

Psoriasis can occur on the eyebrows, behind and around the ears, and in the ear canal. Sometimes psoriasis affects the mouth and causes redness and burning of the lips, gums, tongue, and cheeks. Oral psoriasis can cause difficulty chewing and swallowing food.

The manifestations of psoriasis depend on the type, symptoms and stage. Psoriasis can be seen in the photo.

Manifestations of psoriasis on the knees

Reasons for the development of psoriasis

Psoriasis is caused by a malfunction of the immune system in which white blood cells mistakenly begin attacking skin cells. Due to the action of leukocytes, the process of forming new skin cells shortens from a month to several days. Prematurely formed cells are pushed by the body to the surface of the skin, where they accumulate and turn into spots or plaques.

A genetic predisposition (a family history of psoriasis) or triggers (environmental factors that increase the risk of psoriasis) can cause the immune system to malfunction. Factors triggering the development of psoriasis:

Infections (tonsillitis, herpes, lichen);
skin trauma (sunburn, insect bite, scratches, cuts);
smoking or alcohol abuse;
uncontrolled taking of medications;
regular stressful situations (lead to the development of stress psoriasis);
weather (dry and cold conditions);
abrupt discontinuation of systemic or oral corticosteroids.

These factors can lead to the development or exacerbation of psoriasis in people who are predisposed to it. Exacerbation of psoriasis can be avoided by identifying and eliminating the factors that contribute to it.

Worsening of psoriasis

Psoriasis of the face, extremities and head is characterized by periods of exacerbation (symptoms become more intense) and remission (the rash decreases in size, pain disappears). Remission periods last between a month and a year. Stages of Psoriasis:

progressive stage(Onset of psoriasis). Small nodular rashes form on the skin, which are accompanied by itching. redness increases and forms plaques;
stationary stage. No new nodules (papules) appear, the inflammation subsides after the formation of scales or crusts on the plaques;
regressive stage. Plaques decrease, itching and flaking disappear.

A dermatologist will help relieve an exacerbation of psoriasis, identify the triggers and prescribe treatment. Following your doctor's recommendations will help shorten exacerbation periods and lengthen remission periods.

How do you treat psoriasis?

Before starting psoriasis treatment, the dermatologist takes a medical history (asks about symptoms, when they appeared and whether there is a family history of psoriasis) and performs a visual examination of the rash. After the diagnosis, the doctor selects a comprehensive treatment for psoriasis. Treatment for psoriasis includes:

Ointments, shampoos, creams and gels based on seaweed extracts and Dead Sea minerals;
Phototherapy (by exposing the skin affected by the rash to ultraviolet rays, the growth of skin cells is reduced, leading to normalization of the condition).

For psoriasis, a dermatologist recommends taking vitamins. To produce healthy skin cells and reduce inflammation and symptoms, your doctor will prescribe vitamins A, D, E, K, B, and C.

Diet for psoriasis

If you have psoriasis, a dermatologist will recommend changing your diet. Foods that reduce inflammation:

fatty fish (tuna, salmon);
linseed and pumpkin seeds;
nuts (walnuts, almonds);
Cabbage, spinach.

A diet for psoriasis helps relieve symptoms and prevent the development of complications (high blood pressure, diabetes, heart disease). If you have psoriasis on your legs, arms, or face, you should limit your alcohol consumption.

Your diet should also include foods containing fatty acids (sardines, salmon, shrimp, flaxseed). It is recommended to minimize the consumption of foods containing saturated fats (fatty meats, confectionery) and simple carbohydrates (dairy products, grapes, baked goods).

Prevention of psoriasis

Preventive measures help prevent the development and progression of psoriasis on the arms, legs and head. Preventing psoriasis includes:

Change in diet (abstinence from alcohol, simple carbohydrates and saturated fats, consumption of foods containing fatty acids);
Protect your head and body from the sun (with sunscreen and a hat);
stop smoking;
Reducing the risk of skin injuries (use of insect repellent sprays, gloves, long sleeves);
Moisturizing the skin (dry skin is prone to damage).

To reduce the likelihood of a psoriasis outbreak, extreme temperatures should be avoided. Temperatures that are too cold or too hot can cause your skin to dry out or become damaged. Reducing stressful situations to a minimum will help prevent the onset of psoriasis due to nervousness.

How to distinguish psoriasis from dermatitis?

Psoriasis of the scalp (seborrheic psoriasis) is similar to seborrheic dermatitis. With the help of a dermatologist, dermatitis can be differentiated from scalp psoriasis. Symptoms of seborrheic dermatitis:

Redness of the skin, on which greasy white or yellow scales form (when pressed, sebum - sebum - can be released);
Scales (skin flakes) that accumulate near the hair shaft.

You can distinguish psoriasis from dermatitis by the location of the rash. Unlike seborrheic dermatitis, psoriasis does not only arise on the head, but also spreads beyond the hairline and appears on other parts of the body (limbs, lower back, nails). With psoriasis, the areas of skin affected by the rash are sore and itchy; with dermatitis, you may feel a slight itch on the scalp.