Psoriasis is a common, long-term skin disease that causes red, itchy, and scaly patches on the skin. Psoriasis can flare up for a few weeks or months before going into remission. There is no known cause of psoriasis, but it is thought to be the result of an immune system problem that causes the skin to regenerate at faster than normal rates, creating scaly patches. These patches may present as a few affected spots, or can cover much larger areas, typically around the knees, elbows, trunk, and scalp. There is also a link between genetics and psoriasis; while we still don’t clearly understand what causes a psoriasis outbreak, new findings in genetic research have provided important insights to indicate that certain gene mutations may be associated with psoriasis.
There are five official different types of psoriasis: plaque, guttate, inverse, pustular, and erythrodermic. The symptoms of your psoriasis will vary based on its type.
Plaque psoriasis, which affects about 6.7 million adults in the United States, is the most common form of psoriasis. It causes dry, raised, red skin patches that are covered with silvery scales. The plaques may be either itchy or tender, and can range in number. They usually appear on the elbows, knees, lower back and scalp.
Guttate psoriasis appears in small red drop-shaped, scaling spots on the skin, usually found on the trunk, arms, or legs. It primarily affects young adults and children. Most of the time, guttate psoriasis is triggered by a bacterial infection like strep throat. Remission between flare-ups tends to be longer than other varieties of psoriasis, and can last years.Unlike plaque psoriasis, however, guttate psoriasis is much more rare; only about 4 percent of people in the United States who have psoriasis have the guttate form.
Flexural or inverse psoriasis often appears in skinfolds, such as under the breasts, in the armpits, buttocks, or groin area. Inverse psoriasis causes red patches that are often shiny and smooth and worsen with friction and sweating. Most people with inverse psoriasis also have a different form of psoriasis in other places on the body.
Pustular psoriasis is a rare but severe form of psoriasis that causes multiple white pustules surrounded by red skin. These clearly defined pus-filled lesions occur in widespread patches or in smaller areas on the palms of the hands or the soles of the feet.
Erythrodermic psoriasis, or exfoliative psoriasis, is the least common type of psoriasis. It can cover your entire body with a red, peeling rash that can itch or burn intensely. Erythrodermic psoriasis can be a medical emergency; in fact, you may need hospitalization because your body may not be able to control body temperature.
Psoriatic arthritis is a condition with no cure that causes swollen, painful joints that are typical of arthritis. Sometimes, the joint symptoms are the first or only symptom or sign, and at other times only nail changes are seen. There are five types of psoriatic arthritis, all with varying symptoms that range from mild to severe. According to most estimates, between 5 and 10 percent of people with psoriasis develop psoriatic arthritis, though some studies suggest a figure as high as 30 percent.
Psoriasis signs and symptoms can vary from person to person, ranging from a few spots of dandruff-like scaling to major eruptions that cover large areas. The most commonly affected areas include the lower back, elbows, knees, legs, soles of the feet, scalp, face and palms.
Common signs and symptoms include:
To diagnose your psoriasis, your doctor will ask questions about your health and examine your skin, scalp and nails. For the most part, the diagnosis of psoriasis is primarily clinical, which means that a skin biopsy is rarely required.
While there is no cure for psoriasis, there are many different treatments available that can help manage your symptoms. Most treatments either aim to stop skin cells from growing so quickly, or remove the symptomatic scales. Your doctor will consider how severe your psoriasis is, and how responsive it has been to previous treatment when deciding which treatment option is right for you.
Psoriasis treatments fall into three main categories: topical treatments, oral or injected medications, and light therapy.
Topical psoriasis treatments include:
Oral and injected medications are usually only prescribed if you have moderate to severe psoriasis, or if you didn’t respond well to other treatment types. Because many of these medications have severe side effects, you will usually only be prescribed to use them for short periods of time.
These medications include:
Light therapy is a first-line treatment for moderate to severe psoriasis, either alone or in combination with other medications. By repeatedly exposing the skin to controlled amounts of natural or artificial light, the overactive white blood cells that are attacking healthy skin cells and causing the rapid cell growth are killed. Both UVA and UVB light may be helpful in reducing symptoms of mild to moderate psoriasis.
Consulting with your doctor or dermatologist is an essential part of the process when deciding upon a treatment plant for your psoriasis. They will consider the type and severity of the psoriasis you suffer from, as well as the area of skin affected. Most physicians treat using a traditional approach, starting with the mildest treatments (such as topical creams), and progressing to stronger treatments only if necessary. Essentially, your doctor will work with you to choose a treatment option that most successfully slows cell turnover with the least side effects.
There are a number of self-care measures you can take to reduce flare-ups and live a healthy life.