About Psoriasis

" Psoriasis (psoriasis vulgaris) is a chronic skin condition characterized by dry, red plaques of thick skin that affects 1.5% to 2% of the population. There may be dry flakes and scales commonly found on the skin of the scalp, face, back, elbows, palms, knees, and feet. Psoriasis may occur as a mild condition that may not be noticeable, while in others, it may be a severe condition that affects the whole body. The condition can be treated, but not cured. The condition is thought to be triggered by environmental factors, stress, skin rubbing and scratching, stress, medications and alcohol use. Most children with the condition start at age 8 while adults start to see signs at age 22. In addition to the skin lesions, most patients experience skin itch (pruritis).  This is a non-contagious but long-term skin condition that is non-curable. It follows a variable course, which can periodically improve or worsen. In some people, the condition spontaneously clears for years and stays in remission."

psoriasis symptoms
Psoriasis Symptoms on Leg
Source: Meisenheimer Clinic

 

This skin condition is a common disease worldwide, affecting both sexes in all races. Although it occurs in people of any age, most patients are first diagnosed in early on in their adult years.



Causes

The cause is unknown but factors associated with it include genetic predisposition, immune system dysfunction, and environmental influence. The condition runs in families and it may be triggered by environmental factors such as intake of certain medications and cold weather. Other factors include stress, dry skin, infections, and skin injury.

The specific cause of any symptoms are skin cells that rapidly divide resulting in scaling and thickening skin.

psoriasis photos
Psoriasis Photos on Different Body Locations and for Different Types
Source: Journal of Pediatric Dermatology



Pictures

The condition can occur on any part of the body as shown in the following psoriasis pictures.

psoriasis picture

Symptoms on Women’s Torso
Source: CDC


psoriasis on back
Symptoms on Back and Buttocks
Source: CDC/Dr. Gavin Hart


psoriasis abdomen

On the Abdomen and Legs
Source: CDC/Susan Lindsley


psoriasis picture arm
 
The Condition on an Arm
Source: CDC/N.J. Fiumara



Foot Psoriasis Pictures

psoriasis pictures
Foot Psoriasis Picture of Parent and Child
Source: Journal of Pediatric Dermatology


Scalp Psoriasis Pictures

Scalp symptoms are characterized by thick skin scales accompanied by itch. The condition does not cause hair loss.

scalp psoriasis picture
Scalp Psoriasis Picture
Source: Journal of Pediatric Dermatology

scalp psoriasis
Psoriasis on Scalp
Source: JPD



Diagnosis

A doctor can diagnose the condition based on medical history and physical examination. A skin biopsy may help confirm the diagnosis. Other laboratory tests can help exclude other conditions or determine the severity of the disease.


Symptoms

People can have one or more types with the following symptoms:

Plaque psoriasis: patches of red skin, silvery scales, itchy thick skin and crumbly nails 

Guttate psoriasis: small red or salmon colored spots which may appear all over the skin, especially after a respiratory infection but may disappear without treatment


gluttate psoriasis
Guttate Psoriasis Appears as Salmon-pink papules with or without skin scales
Source: Journal of Pediatric Dermatology

• Pustular Psoriasis: skin bumps filled with pus appear on palms and soles and may be accompanied by pain or soreness

pustular psoriasis
Pustular Psoriasis on Foot
Source: Journal of Pediatric Dermatology

Inverse psoriasis: patches of raw, red skin in areas where skin touches skin, such as armpits, groin, buttocks, genitals, and under breasts.

Erythrodermic psoriasis: skin looks badly burned, may be accompanied by intense itching, pain and inability to maintain normal body temperature.

erythridermic psoriasis
Erythrodermic Psoriasis on Leg
Source: Journal of Pediatric Dermatology

Many people experience worsening of symptoms during the winter months. Severe psoriasis can lead to social embarrassment, emotional distress, job stress, and other personal issues.

nail psoriasis
Psoriasis on the Nails Causes Pitting
Source: Meisenheimer Clinic

This is a life-long condition that has no permanent cure. However, it can be managed to reduce severity and prevent progression of the disease. The patients age, type, area of involvement and reaction to previous treatment will determine the optimal treatment approach.

For mild problems that affects less than ten percent of the total skin surface, one can apply topical corticosteroids and moisturizers containing salicylic acid, urea, lactic acid, and glycolic acid.

When more than 20% of the skin is affected (moderate to severe psoriasis), ultra-violet light treatments, oral medications or injections may be needed. Systemic medications are also more effective for psoriatic arthritis.


Treatment (see below specific types)

The treatment of skin bumps will depend on the cause and accompanying symptoms which need immediate or long-term relief. Many skin bumps are harmless and may go away on their own, while others may need medical treatment involving topical medications, oral drugs or even surgery. Treatment may be directed at curing an infection, relieving itchiness or inflammation, treating a systemic disease (like a viral infection) or improving one’s appearance (cosmetic reasons).

One may need to call a doctor if skin bumps are accompanied by symptoms that indicate severe inflammation or widespread infection, such as fever, severe pain, and weakness. Immediate medical help is needed in cases of anaphylactic or severe allergic reactions causing difficulty in breathing and swallowing, swelling of the tongue, hoarseness, dizziness, and loss of consciousness.

laser psoriasis treatment
Results Achieved by the XTRAC Excimer PsoriasisTreatment
Source: Meisenheimer Clinic

Other topical treatments include immunomodulators creams like pimecrolimus and tacrolimus, bath salts, coal tar (an ingredient in bath solutions, shampoos, and creams), anthralin cream or ointment, and calcitriol, a vitamin D analogue cream.

Scalp Treatment

Mild scalp conditions calls for the use of Tar or ketoconazole shampoos followed by a topical lotion (betamethasone valerate 1%). For more chronic scalppsoriasis, the skin plaque is removed with a topical that contains 10% salicylic acid suspended in a mineral oil solution. After scales are shed, a cream or lotion that contains fluocinolone is left on the scalp overnight (covered by a plastic shower cap). Once under control, other lotions (clobetasol propionate) or calcipotriene lotion is used.

Palm (hands) and Sole (foot) Treatment

Topical glucocorticoids are used to treat the skin as well as phototherapy (PUVA).

Inverse Psoriasis

Topical glucocorticoids are applied for limited periods in some patients depending on skin condition. Others receive a vitamin D based topical such as atacrolimus. Tar baths or Castellani paint can be of help.

Nail Treatment

Topicals are used to treatpsoriasis in nails. The condition may go away on its own with no treatment. Phototherapy can be effective using high-intensity UVA light. Topical retinoids are effective as well. If the nail cannot be cured, then removal and regrowth is used.

Guttate Treatment

Any infection is treated with antibiotics. For localized conditions (in one area), phototherapy and UVB irradiation therapy can be effective.

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References

AAD

Cole, G. MedicineNet.

 






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