What is psoriasis and how to treat it

31 October 2023

Psoriasis that affects the skin, the 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, torso, nails, face or scalp.

What is psoriasis?

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

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

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

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

How does psoriasis start?

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

What does psoriasis look like?

In psoriasis, red patches appear on fair skin and brown or purple patches appear on dark skin. In the early stages of scalp psoriasis, the patches 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 extremities);
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).

Treatment for psoriasis is selected by a dermatologist depending on the form and type of psoriasis, symptoms and location of the rash. If treatment is incorrect or untimely, large areas of lesions appear on the skin.

Where can psoriasis occur?

The location of psoriasis patches depends on their type. Types of psoriasis:

Plaque psoriasis (common). Plaque psoriasis causes dry, raised patches of skin covered in silvery scales. Psoriasis appears on the elbows, knees, lower back and scalp;
erythrodermic psoriasis. The skin appears burned, chills appear and the temperature rises;
guttate psoriasis. Small, flesh-colored, scaly patches resembling water drops 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. Located in small areas of the skin, affecting legs or arms;
exudative psoriasis. Spots covered with yellow crusts appear on the skin;
inverse psoriasis. Soft red spots appear on the skin. The rash occurs in the folds of the skin (armpits, buttocks, genitals).

In nail psoriasis, skin builds up 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 on the palms and feet is dry and prone to cracking.

Eyelid psoriasis 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 eyes;
irritation of the skin of the eyelids, accompanied by pain and itching.

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

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 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 in the immune system, in which white blood cells begin to mistakenly attack skin cells. Due to the action of leukocytes, the process of producing new skin cells is reduced from a month to several days. The cells formed in advance are pushed by the body to the surface of the skin, where they accumulate and become patches or plaques.

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

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

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

Exacerbation of psoriasis

Psoriasis on the face, extremities and head is characterized by periods of exacerbation (symptoms appear intensely) and remission (the rash decreases in size, the pain disappears). Periods of remission last from a month to a year. Stages of psoriasis:

progressive stage(onset of psoriasis). Small nodular rashes appear on the skin, accompanied by itching. Areas of redness increase, forming 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 peeling disappear.

A dermatologist will help alleviate an exacerbation of psoriasis, who will identify the triggers and prescribe treatment. Following your doctor's recommendations will help reduce periods of exacerbations and increase periods of remission.

How to treat psoriasis?

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

ointments, shampoos, creams and gels based on extracts of algae and minerals from the Dead Sea;
phototherapy (by exposing the skin affected by the rash to ultraviolet rays, the growth of skin cells is reduced, leading to the 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

For psoriasis, a dermatologist recommends dietary changes. Foods that reduce inflammation:

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

Following a psoriasis diet 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 the consumption of foods containing fatty acids (sardines, salmon, shrimp, flaxseeds). It is recommended to minimize the consumption of foods containing saturated fats (fatty meats, confectionery) and simple carbohydrates (dairy products, grapes, baked goods).

Psoriasis prevention

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 (using sunscreen and a hat);
stop smoking;
reducing the risk of skin injuries (use of insect repellent sprays, gloves, long sleeves);
moisturize the skin (dry skin is prone to damage).

To reduce the likelihood of a psoriasis flare-up, extreme temperatures should be avoided. Exposure to very cold or very hot temperatures can cause dryness or damage to the skin. Reducing stressful situations to a minimum will help prevent the onset of psoriasis due to nervousness.

How to distinguish psoriasis from dermatitis?

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

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