What is psoriasis and how to treat it

31 October 2023

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

Psoriasis is a dermatological disease in which red spots 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, which clump together and form red, inflamed patches. Symptoms of psoriasis can vary depending on the type, stage and cause. General signs of psoriasis:

inflamed skin areas;
silver-white scales or plates on red dots;
pain and burning of the skin;
dry, cracked skin (may itch and bleed);
stiff and swollen joints;
nails thick, ribbed.

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

If you notice the first signs of psoriasis, you should consult a doctor. A dermatologist deals with the diagnosis and treatment of psoriasis in adults. If red spots on the skin or silver 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 (from the outside it resembles a common rash). As they grow in size, white or silver scales may appear. The scales that are above may fall. The remaining scales stick together and start to hurt and itch. When you scratch the resulting rash, the scales can come off the skin, causing bleeding.

What does psoriasis look like?

With psoriasis, red patches appear on fair skin and brown or purple patches on dark skin. In the initial stage of scalp psoriasis, the spots resemble dandruff (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, affecting the scalp, arms, legs and torso);
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 the treatment is incorrect or premature, large areas of lesions appear on the skin.

Where can psoriasis occur?

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

plaque psoriasis (vulgar).. 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. Small, flesh-colored, scaly spots, similar to drops of water, form on the arms, legs, and torso;
pustular psoriasis. With pustular psoriasis, white pus-filled blisters and large areas of inflamed skin form on the skin. Localized in small areas of the skin, affecting the legs or arms;
exudative psoriasis. Spots covered with yellow crusts appear on the skin;
inverse psoriasis. Smooth red spots appear on the skin. Redness appears in skin folds (armpits, buttocks, genitals).

In nail psoriasis, the 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. The skin with psoriasis of the palms and soles is dry and prone to cracking.

Psoriasis of the eyelids causes reddening, redness 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 during eye movement;
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. 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.

Manifestations of psoriasis depend on its 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 start attacking skin cells. Due to the action of leukocytes, the production process of new skin cells is reduced from a month to a few days. Prematurely formed cells are pushed from the body to the surface of the skin, where they accumulate and turn into spots or plaques.

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

infections (tonsillitis, herpes, lichen);
skin trauma (sunburn, insect bites, scratches, cuts);
smoking or alcohol abuse;
uncontrolled use of drugs;
regular stressful situations (lead to the development of stress psoriasis);
weather (dry and cold conditions);
immediate 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 avoided by identifying and eliminating factors that contribute to it.

Worsening of psoriasis

Psoriasis on the face, extremities and head is characterized by periods of exacerbation (symptoms appear intensively) and remission (redness decreases in size, pain goes away). Grace periods last from one month to one year. Stages of psoriasis:

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

A dermatologist will help alleviate a worsening of psoriasis, who will identify the causes and prescribe treatment. Following the 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 collects an anamnesis (asks about the symptoms, when they appeared and if there is a family history of psoriasis) and performs a visual examination of the rash. After making a diagnosis, the doctor chooses a comprehensive treatment for psoriasis. Treatment for psoriasis includes:

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, 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 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 the consumption of foods containing fatty acids (sardines, salmon, shrimp, flax seeds). It is recommended to minimize the consumption of foods containing saturated fats (fatty meat, sweets) and simple carbohydrates (dairy products, grapes, bakery products).

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);
protecting the head and body from the sun (using sunscreen and a hat);
to quit smoking;
reducing the risk of skin damage (use of bug sprays, gloves, long sleeves);
skin moisturizer (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 your skin to dry out or become 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:

skin rash, in which white or yellow greasy scales form (when pressed, sebum - sebum - can be released);
dandruff (skin flakes) that accumulates near the hair shaft.

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