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 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, which accumulate and form inflamed red patches. Symptoms of psoriasis may vary depending on its type, stage, and cause. General signs of psoriasis:

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

Psoriasis in children usually first affects the scalp and nails, 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 may 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 reddened spots on the skin or silvery scales appear in children, you should 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 resembling a regular rash). As they increase in size, white or silver scales may appear. The scales that are on top may fall off. The remaining scales stick together and begin to hurt and itch. When scratching the resulting rash, the scales may come 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. At 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 of the feet, 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 localization of psoriasis spots depends on its 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 burned, chills appear, and the temperature rises;
guttate psoriasis. Small scaly flesh-colored spots, similar to drops of water, form on the arms, legs, and torso;
pustular psoriasis. With pustular psoriasis, white blisters filled with pus and large inflamed areas of 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. The rash occurs in folds of skin (armpits, buttocks, genitals).

In nail psoriasis, skin accumulates 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 quickly break.

Dermatologists also distinguish palmoplantar psoriasis. The skin with psoriasis of the palms and feet is dry and prone to cracks.

Eyelid psoriasis causes redness, flaking, 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 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 spots, which leads to friction between the eyelashes and the eyeball. Possible consequences of eyelid psoriasis include uveitis (inflammation of the eyes) 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 may 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 begin to attack skin cells. Due to the action of leukocytes, the process of producing new skin cells is reduced from a month to several days. Cells formed ahead of time are pushed by the body to the surface of the skin, where they accumulate and transform 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 in the immune system. Factors that provoke the development of psoriasis:

infections (tonsillitis, herpes, lichen);
skin trauma (sunburn, insect bite, scratches, cuts);
smoking or alcohol abuse;
uncontrolled use of medications;
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 an exacerbation. 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, pain goes away). Periods of remission last from one month to a year. Stages of psoriasis:

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

A dermatologist will help relieve an exacerbation of psoriasis, who will identify 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 collects an anamnesis (asks about symptoms, when they appeared, and whether there is a family history of psoriasis) and conducts a visual examination of the rash. After making a diagnosis, the doctor selects a comprehensive treatment for psoriasis. Treatment for psoriasis includes:

ointments, shampoos, creams and gels based on extracts of algae and Dead Sea minerals;
phototherapy (by exposing rash-affected skin 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;
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 consumption of foods that contain fatty acids (sardines, salmon, shrimp, flax seeds). 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:

dietary changes (abstinence from alcohol, simple carbohydrates and saturated fats, consumption of foods containing fatty acids);
protecting your head and body from the sun (using sunscreen and a hat);
to give up smoking;
reducing the risk of skin injury (use of insect repellent sprays, gloves, long sleeves);
moisturizing 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 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:

redness of the skin, on which greasy white or yellow scales form (when pressed, sebum - sebum - can be released);
dandruff (flakes of skin) 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). With psoriasis, the areas of the skin affected by the rash are sore and itchy, and with dermatitis, you may feel a slight itching of the scalp.