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 characterized by the appearance of red spots with silver scales 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, accumulating and forming inflamed red patches. Symptoms of psoriasis can vary depending on the type, stage and cause. General signs of psoriasis:

inflamed areas of the skin;
whitish-silver scales or plaques on red spots;
pain and burning of the skin;
dry, chapped skin (may itch and bleed);
stiff and swollen joints;
thickened and ribbed nails.

Psoriasis in children usually affects the scalp and nails first, then spreads to the elbows, knees and torso. With child nail psoriasis, depending on the type of psoriasis, thick nails without dimples 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 see a doctor. A dermatologist deals with the diagnosis and treatment of psoriasis in adults. If red spots on the skin or silvery scales appear in children, it is necessary to consult a pediatrician.

How does psoriasis begin?

Psoriasis begins with the formation of small red bumps that rise a few millimeters above the skin (outwardly they resemble 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 start to hurt and itch. When you scratch the resulting rash, the scales can peel 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 stage of scalp psoriasis, the patches resemble dandruff (due to the white flakes). Forms of psoriasis:

mild form of psoriasis (less than three percent of the body is affected, the rashes are localized on the scalp or extremities);
moderate form of psoriasis (rash covers 3 to 10 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 of the hands, soles of the feet and face).

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

Where can psoriasis occur?

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

plaque psoriasis (vulgaris).. 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 spots, similar to drops of water, form on the arms, legs and torso;
pustular psoriasis. In pustular psoriasis, white pus-filled blisters and large inflamed areas 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. 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 turns 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, scaling, and crusting around the eyelids. Other symptoms of psoriasis on 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 rise or fall 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.

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 of the immune system, in which white blood cells mistakenly begin to attack skin cells. Due to the action of leukocytes, the process of production of new skin cells is shortened 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 (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, lichens);
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);
abrupt discontinuation of systemic or oral corticosteroids.

These factors can lead to the development of psoriasis in people predisposed to it or cause a flare-up. Exacerbation of psoriasis can be avoided 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). Remission periods last from a month to a year. Stages of psoriasis:

progressive phase(beginning of psoriasis). Small nodular rashes appear on the skin accompanied by itching. The reddened areas increase, forming plaques;
stationary phase. No new nodules (papules) appear, the inflammation disappears after the formation of scales or crusts on the plaques;
regressive phase. The plaques decrease, itching and scaling disappear.

A dermatologist will help relieve a psoriasis flare-up, identify triggers and prescribe treatment. Following your doctor's recommendations will help reduce periods of flare-ups and increase periods of remission.

How to treat psoriasis?

Before starting treatment for psoriasis, the dermatologist takes a medical history (asks about 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 algae extracts and Dead Sea minerals;
phototherapy (by exposing the skin affected by the rash to ultraviolet rays, the growth of skin cells is reduced, leading to 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;
dried fruit (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 that contain fatty acids (sardines, salmon, shrimp, flaxseed). It is recommended to minimize the consumption of foods that contain saturated fats (fatty meats, confectionery) and simple carbohydrates (dairy products, grapes, baked goods).

Prevention of psoriasis

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

changes in diet (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;
reduce the risk of skin lesions (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 temperatures that are too cold or too hot can dry or damage your skin. Minimizing stressful situations 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 distinguished from scalp psoriasis with the help of a dermatologist. Symptoms of seborrheic dermatitis:

redness of the skin, on which white or yellow greasy scales form (if pressed, sebum - sebum can be released);
dandruff (skin flakes) that accumulates 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 areas of skin affected by the rash are sore and itchy, while with dermatitis you may feel a mild itch on the scalp.