What is psoriasis and how to treat it

31 October 2023

Psoriasis affecting the skin, the treatment of which includes the use of ointments

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

Depending on the type of psoriasis, it 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 build up and form inflamed red patches. Psoriasis symptoms can vary depending on the type, stage, and cause. Common symptoms of psoriasis:

inflamed skin areas;
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, ridged nails.

Psoriasis in children usually first affects the scalp and nails, then spreads to the elbows, knees and trunk. In children with nail psoriasis, depending on the type of psoriasis, nails are thick, without pits or with small ridges, as well as yellowing of the nails or separation from the bed.

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 reddish spots or silvery scales appear on the skin in children, a pediatrician should be consulted.

How does psoriasis start?

Psoriasis begins with the formation of small red bumps that rise a few millimeters above the skin (outwardly they resemble a regular rash). As their size increases, white or silver scales may appear. The scales on top may fall off. The remaining scales stick together and start to hurt and itch. When the resulting rash is scratched, the scales detach from the skin, causing bleeding.

What does psoriasis look like?

Psoriasis causes red spots on light skin and brown or purple spots on dark skin. In the early stages of scalp psoriasis, the spots resemble dandruff (due to the 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 limbs);
moderate form of psoriasis (the rash covers 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).

The treatment of psoriasis is selected by the dermatologist depending on the form and type of psoriasis, the symptoms and the location of the rash. If the treatment is incorrect or untimely, extensive lesions appear on the skin.

Where can psoriasis occur?

The localization of psoriasis spots depends on the type. Types of psoriasis:

plaque (vulgar) psoriasis. Plaque psoriasis causes dry, raised patches of skin covered with silvery scales. Psoriasis appears on the elbows, knees, lower back and scalp;
erythrodermic psoriasis. The skin looks burnt, chills appear and the temperature rises;
guttate psoriasis. On the arms, legs and trunk, scaly, flesh-colored spots similar to water droplets are formed;
pustular psoriasis. In the case of pustular psoriasis, white blisters filled with pus and large inflamed skin areas form on the skin. It is localized in small areas 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 appears in skin folds (armpits, buttocks, genitals).

In nail psoriasis, the skin under the nails builds up, causing them to rise and form indentations ("nail pits"). The skin under the nail plate will be white, yellow or brown. Nails become rough, crumble and break quickly.

Dermatologists also distinguish between palmoplantar psoriasis. The skin of the palms and feet with psoriasis 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 come off and stick to the eyelashes;
pain when moving the eye;
irritation of the skin of the eyelids, accompanied by pain and itching.

The edges of the eyelids can 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. Psoriasis sometimes affects the mouth, causing reddening and burning of the lips, gums, tongue, and cheeks. Oral psoriasis can cause difficulty chewing and swallowing food.

The manifestation of psoriasis depends on its type, symptoms and stage. Psoriasis can be seen in the photo.

Manifestations of psoriasis on the knees

Causes of psoriasis

Psoriasis is caused by a malfunction of the immune system, in which white blood cells mistakenly attack skin cells. Thanks to the effect of leukocytes, the process of producing new skin cells is reduced 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.

Genetic predisposition (family history of psoriasis) or triggering factors (environmental factors that increase the risk of psoriasis) can lead to a malfunction of the immune system. Factors that trigger the development of psoriasis:

infections (tonsillitis, herpes, lichen);
skin injury (sunburn, insect bites, scratches, cuts);
smoking or drinking alcohol;
uncontrolled use of drugs;
regular stressful situations (lead to the development of stress psoriasis);
weather (dry and cold weather);
sudden discontinuation of systemic or oral corticosteroids.

These factors can lead to the development of psoriasis in people who are prone to it, or cause it to get worse. Aggravation of psoriasis can be avoided by identifying and eliminating factors that contribute to its development.

Exacerbation of psoriasis

Psoriasis on the face, limbs and head is characterized by periods of exacerbation (the symptoms appear intensively) and periods of remission (the size of the rash decreases, the pain disappears). Remission periods last from one month to one year. Stages of psoriasis:

progressive stage(beginning of psoriasis). Small nodular rashes appear on the skin, which are accompanied by itching. Areas of redness grow, forming plaques;
standing stage. New nodules (papules) do not appear, the inflammation goes away after the formation of scales or crusts on the plaques;
regressive stage. Plaques are reduced, itching and peeling disappear.

A dermatologist helps alleviate the worsening of psoriasis, identifies the root causes and prescribes treatment. Following the doctor's recommendations will help reduce the period of exacerbations and increase the periods of remission.

How do we treat psoriasis?

Before starting the treatment of psoriasis, the dermatologist collects an anamnesis (asks about the symptoms, the time of their appearance and whether psoriasis has occurred in the family) and visually examines the rash. After establishing the diagnosis, the doctor selects a comprehensive treatment for psoriasis. Psoriasis treatment includes:

ointments, shampoos, creams and gels based on extracts of algae and Dead Sea minerals;
light therapy (by exposing the skin affected by the rash to ultraviolet radiation, the growth of skin cells decreases, which leads to the normalization of the condition).

For psoriasis, the dermatologist recommends taking vitamins. Your doctor will prescribe vitamins A, D, E, K, B, and C to help produce healthy skin cells and reduce inflammation and symptoms.

Diet for psoriasis

In case of psoriasis, the dermatologist recommends dietary changes. Anti-inflammatory foods:

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

Following a psoriasis diet helps reduce symptoms and prevent complications (high blood pressure, diabetes, heart disease). If you have psoriasis on your legs, arms, or face, you should limit your alcohol consumption.

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

Psoriasis prevention

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

dietary changes (abstaining from alcohol, simple carbohydrates and saturated fats, eating foods containing fatty acids);
head and body protection from the sun (use of sunscreen and hat);
give up smoking;
reducing the risk of skin injuries (use of insect repellant spray, gloves, long sleeves);
skin hydration (dry skin is prone to damage).

Extreme temperatures should be avoided to reduce the likelihood of psoriasis flare-ups. If you are exposed to temperatures that are too cold or too hot, your skin can become dry or damaged. Reducing stressful situations to a minimum helps prevent the appearance of psoriasis due to nervousness.

How can psoriasis be distinguished from dermatitis?

Psoriasis of the scalp (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, on which greasy white or yellow scales form (when pressed, sebum - tallow - may be released);
dandruff (flakes) that accumulate near the hair shaft.

Psoriasis can be distinguished from dermatitis by the location of the rash. Unlike seborrheic dermatitis, psoriasis develops not only on the head, but also spreads beyond the hairline and appears on other parts of the body (extremities, lower back, nails). In the case of psoriasis, the skin areas affected by the rash are sore and itchy, and in the case of dermatitis, you may feel a slight itch on the scalp.