What is psoriasis and how to treat it

31 October 2023

Psoriasis affecting the skin, treatment of which includes 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, which accumulate and form red, inflamed patches. Symptoms of psoriasis may vary depending on the type, stage and cause. Common symptoms of psoriasis:

inflamed skin area;
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 nails, ribs.

Psoriasis in children usually first affects the scalp and nails, and then spreads to the elbows, knees and body. With nail psoriasis in children, depending on the type of psoriasis, thick nails without holes or with small ridges may be observed, as well as yellow nails or their separation from the bed.

If you notice the early signs of psoriasis, you should see a doctor. Dermatologists deal 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 start?

Psoriasis begins with the formation of small red bumps that rise a few millimeters above the skin (the outside resembles a normal rash). As they increase in size, white or silver scales may appear. The scales that are on top may fall off. The remaining scales stick together and start to hurt and itch. When scratching the resulting rash, scales may come off the skin, causing bleeding.

What does psoriasis look like?

With psoriasis, red spots appear on light skin and brown or purple spots on dark skin. In the early stages of scalp psoriasis, the spots resemble dandruff (caused by white scales). Forms of psoriasis:

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

Treatment for psoriasis is chosen by a dermatologist depending on the form and type of psoriasis, symptoms and location of the rash. If the treatment is not correct or not on time, large areas of lesions appear on the skin.

Where can psoriasis occur?

Localization of psoriasis spots depends on the type. Types of psoriasis:

plaque psoriasis (abusive).. Plaque psoriasis causes dry, raised patches of skin covered with silvery scales. Psoriasis appears on elbows, knees, lower back and scalp;
erythrodermic psoriasis. The skin appears to burn, chills appear, and the temperature rises;
guttate psoriasis. Small, flesh-colored, scaly spots, similar to drops of water, formed on the arms, legs, and body;
pustular psoriasis. With pustular psoriasis, white blisters filled with pus and large inflamed skin areas form on the skin. Localized in a small area of the skin, affecting the legs or arms;
exudative psoriasis. Spots covered with a yellow crust appear on the skin;
inverse psoriasis. Smooth red spots appear on the skin. The rash occurs in skin folds (armpits, buttocks, genitals).

In nail psoriasis, skin collects under the nails, causing them to lift and form indentations ("nail pits"). The skin under the nail plate becomes white, yellow or brown. Nails become rough, crumble and break quickly.

Dermatologists also distinguish palmoplantar psoriasis. Skin with psoriasis of the hands and feet is dry and prone to cracking.

Psoriasis of the eyelids causes redness, peeling, 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 the eyes;
eyelid skin irritation, accompanied by pain and itching.

The edge of the eyelid may turn up or down depending on the location of the spots, which leads to friction between the eyelashes and the eyeball. Possible consequences of eyelid psoriasis include uveitis (inflammation of the eye) and vision loss.

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

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, where white blood cells mistakenly start attacking skin cells. Due to the action of leukocytes, the process of producing new skin cells is reduced from a month to a few days. Cells formed prematurely are pushed by the body to the surface of the skin, where they accumulate and turn into spots or plaques.

Genetic predisposition (family history of psoriasis) or triggers (environmental factors that increase the risk of psoriasis) can cause damage in the immune system. Factors that trigger the development of psoriasis:

infections (tonsillitis, herpes, lichen);
skin trauma (sunburn, insect bites, scratches, wounds);
smoking or alcohol abuse;
uncontrolled drug use;
frequent stressful situations (leading 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 of psoriasis in people who are prone to it, or cause exacerbation. The severity of psoriasis can be avoided by identifying and eliminating factors that contribute to it.

Severity of psoriasis

Psoriasis on the face, legs and head is characterized by periods of exacerbation (symptoms appear intensively) and remission (rash decreases in size, pain disappears). The period of remission lasts from one month to a year. Stages of psoriasis:

progressive stage(beginning of psoriasis). A small nodular rash appears on the skin, which is accompanied by itching. Areas of redness increase, forming plaques;
stationary stage. New nodules (papules) do not appear, inflammation decreases after the formation of scales or crusts on the plaque;
regressive stage. Plaque decreases, itching and peeling disappear.

A dermatologist will help relieve the severity of psoriasis, who will identify the trigger and prescribe treatment. Following your doctor's recommendations will help reduce the duration of exacerbations and increase the duration of remission.

How to treat psoriasis?

Before starting treatment for psoriasis, dermatologists collect anamnesis (asking about symptoms, when they appeared, and whether there is a family history of psoriasis) and conduct a visual examination of the rash. After making a diagnosis, the doctor chooses a comprehensive treatment for psoriasis. Treatments for psoriasis include:

ointments, shampoos, creams and gels based on Dead Sea algae and mineral extracts;
phototherapy (by exposing the skin affected by the rash to ultraviolet rays, the growth of skin cells decreases, leading to the normalization of the condition).

For psoriasis, dermatologists recommend 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

For psoriasis, dermatologists recommend dietary changes. Foods that reduce inflammation:

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

Following a diet for psoriasis helps reduce 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 intake.

Your diet should also include foods that contain fatty acids (sardines, salmon, shrimp, flaxseed). It is recommended to minimize the consumption of foods containing saturated fat (fatty meat, sweets) and simple carbohydrates (dairy products, wine, baked goods).

Prevention of psoriasis

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

dietary changes (abstinence from alcohol, simple carbohydrates and saturated fats, consumption of foods containing fatty acids);
protect your head and body from the sun (use sunscreen and a hat);
to quit smoking;
reduce the risk of skin injury (use of insect repellent spray, gloves, long sleeves);
moisturizes the skin (dry skin is easily damaged).

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

How to distinguish psoriasis from dermatitis?

Scalp psoriasis (seborrheic psoriasis) is similar to seborrheic dermatitis. Dermatitis can be distinguished from scalp psoriasis with the help of a dermatologist. Symptoms of seborrheic dermatitis:

redness of the skin, where white or yellow oily scales form (when pressed, sebum - sebum - can be released);
dandruff (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 form on the head, but also spreads beyond the hairline and appears on other parts of the body (limbs, lower back, nails). With psoriasis, the area of skin affected by the rash is sore and itchy, and with dermatitis, you may feel a slight itch on the scalp.