Psoriasis

Overview

Psoriasis is a common, long-term skin disease characterized by patches of itchy, scaly rashes on various parts of the body, including the knees, elbows, trunk, and scalp. It is a chronic condition with no known cure, and its severity and duration can vary. Psoriasis is believed to be an immune system problem, where infection-fighting cells mistakenly attack healthy skin cells. Triggers for psoriasis can include infections, injuries to the skin, certain medications, weather conditions, smoking, alcohol consumption, and rapid withdrawal of oral or injected corticosteroids. There are several types of psoriasis, each with different symptoms, and it is not contagious. If you suspect you have psoriasis or experience worsening symptoms, it is important to consult a healthcare provider.

Understanding the disease

Symptoms

Symptoms of psoriasis include a patchy rash with itchy, scaly patches on the knees, elbows, trunk, and scalp. The rash can vary in appearance, with shades of purple, gray, pink, or red, and may involve small scaling spots or dry, cracked skin that bleeds. Psoriasis can also cause itching, burning, or soreness, and the condition tends to go through cycles of flaring up for a few weeks or months before subsiding. There are several types of psoriasis, each with distinct signs and symptoms, such as plaque psoriasis, nail psoriasis, guttate psoriasis, inverse psoriasis, and pustular psoriasis. Risk factors for developing psoriasis include family history, smoking, and certain medications. Psoriasis can also lead to complications such as psoriatic arthritis, eye conditions, obesity, type 2 diabetes, high blood pressure, and cardiovascular disease.

Risk Factors

Risk factors for developing psoriasis include:

1. Family history: Having one or both parents with psoriasis increases your risk of getting the disease.
2. Smoking: Smoking tobacco not only increases the risk of psoriasis but may also worsen the severity of the disease.
3. Age: About a third of psoriasis cases begin in childhood. These factors can contribute to the development of psoriasis, but it's important to remember that anyone can develop the condition. Psoriasis is not contagious, and its cause is not fully understood. Researchers believe that both genetics and environmental factors play a role in the development of psoriasis.

Development

Psoriasis develops when the immune system mistakenly attacks healthy skin cells, causing rapid cell growth and the formation of silvery scales on the skin's surface. The condition can occur due to a combination of genetic predisposition and environmental factors. Triggers such as infections, injuries, weather changes, smoking, alcohol consumption, certain medications, and rapid withdrawal of oral or injected corticosteroids can activate psoriasis in individuals with a genetic susceptibility. There are several types of psoriasis, including plaque psoriasis, guttate psoriasis, inverse psoriasis, pustular psoriasis, and psoriatic arthritis, each with distinct signs and symptoms.

Assessment and Diagnosis

Triage

You should see a doctor if psoriasis is suspected when the itching:

• Lasts more than two weeks and doesn't improve with self-care measures
• Is severe and distracts you from your daily routines or prevents you from sleeping
• Comes on suddenly and can't be easily explained
• Affects your whole body
• Comes with other symptoms, such as weight loss, fever, or night sweats Additionally, if the condition persists for three months despite treatment, it is recommended to see a dermatologist to be evaluated for skin disease. You may also need to see a doctor who specializes in internal medicine (internist) to check for other diseases.

Diagnosis

To diagnose psoriasis, a healthcare provider will typically examine your skin, scalp, and nails, ask questions about your health and medical history, and possibly perform a skin biopsy. A skin biopsy involves taking a small sample of skin for examination under a microscope to determine the type of psoriasis and rule out other disorders. The healthcare provider may also recommend laboratory tests, such as a rheumatoid factor (RF) test, to differentiate psoriatic arthritis from rheumatoid arthritis or a joint fluid test to rule out gout.

Management and Treatment

Complications

Potential complications of psoriasis include psoriatic arthritis, temporary skin color changes, eye conditions such as conjunctivitis and uveitis, obesity, type 2 diabetes, high blood pressure, and cardiovascular disease.

Home Remedies

Home remedies for managing psoriasis symptoms include:

1. Moisturizers: Applying a fragrance-free moisturizer to your skin regularly can help lock in moisture and reduce dryness. Look for moisturizers containing ingredients like ceramides, which can help repair the skin's natural barrier.
2. Bath solutions: Soaking in a warm bath with Epsom salt or oatmeal can help soothe the skin and relieve itching. Be sure to pat your skin dry afterward, as excess moisture can worsen psoriasis symptoms.
3. Sun exposure: Exposure to natural sunlight can help improve psoriasis symptoms for some people. However, be cautious not to sunburn, as this can trigger a flare-up.
4. Stress reduction: Practice relaxation techniques such as deep breathing exercises, meditation, or yoga to help manage stress, which can worsen psoriasis symptoms.
5. Diet: Maintaining a healthy diet rich in fruits, vegetables, and whole grains, and avoiding triggers like alcohol and smoking, can help improve overall health and potentially reduce psoriasis symptoms. While these home remedies may provide some relief, it's essential to consult with a healthcare professional for proper treatment and management of psoriasis.

Treatment

There are various treatments available for managing psoriasis symptoms. Treatments may include topical medications, light therapy, systemic medications, and biologic drugs. Topical treatments involve applying creams or ointments directly to the affected skin. Light therapy, also known as phototherapy, involves exposing the skin to ultraviolet light under medical supervision. Systemic medications are taken orally or by injection and work throughout the body, while biologic drugs are a newer class of medications that target specific immune system proteins associated with psoriasis. It's essential to consult a healthcare professional to determine the most appropriate treatment plan based on the severity and type of psoriasis, as well as individual health factors. Lifestyle modifications, such as maintaining a healthy weight, avoiding triggers, and managing stress, can also help in managing psoriasis symptoms. Please note that the above answer is a general overview, and it's important to consult a healthcare professional for personalized advice and recommendations.

Preparing for medical consultation

To prepare for an appointment for psoriasis, you should:

1. Make a list of your symptoms, including when they began and how long they've lasted.
2. List all medications, vitamins, and supplements you take, including doses.
3. Take along the original bottles and a list of dosages and directions for any creams or lotions you're using.
4. Bring a friend or family member with you to your appointment to help you remember the information.
5. Prepare a list of questions to ask your healthcare provider, such as:
   • What is likely causing my symptoms?
   • Are tests needed to confirm the diagnosis?
   • What is the best course of action?
   • How can I manage other health problems alongside psoriasis?
   • What are the alternatives to the primary approach you're suggesting?
   • Do I need prescription medication, or can I use nonprescription products to treat the condition?
   • What results can I expect?
   • Can I wait to see if the condition goes away without treatment? By being well prepared for your appointment and asking relevant questions, you can help your healthcare provider understand your concerns and develop an appropriate treatment plan for your psoriasis.