Psoriasis

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Psoriasis
Synonyms
Pronounce	N/A
Specialty	N/A
Symptoms	Red, itchy, scaly patches of skin
Complications	Psoriatic arthritis, cardiovascular disease, depression
Onset	Typically adulthood
Duration	Long term
Types	N/A
Causes	Genetic and environmental factors
Risks	Family history, stress, smoking, obesity
Diagnosis	Based on symptoms and skin biopsy
Differential diagnosis	Eczema, seborrheic dermatitis, lichen planus
Prevention	N/A
Treatment	Topical corticosteroids, phototherapy, immunosuppressants
Medication	Methotrexate, cyclosporine, biologics
Prognosis	N/A
Frequency	~2-4% of the population
Deaths

Pustular psoriasis

Psoriasis is a chronic autoimmune disease that causes skin cells to reproduce faster than normal, resulting in patches of skin that are scaly and inflamed. Psoriasis is chronic, meaning it is a long-lasting disease, but certain treatments can improve the skin and help prevent flares. Over time, the skin can become resistant to treatments, necessitating periodic changes in treatment methods. People with psoriasis have an increased risk of developing other conditions, including:

• Psoriatic arthritis, a condition that causes joint pain and swelling
• Cardiovascular problems, which affect the heart and blood circulation system
• Obesity
• High blood pressure
• Diabetes

Who Gets Psoriasis?

Psoriasis is more common in adults, but anyone can develop it. Certain genes have been linked to the disease, so individuals with a family history of psoriasis are more likely to develop it themselves.

Types of Psoriasis

There are several different types of psoriasis, including:

• Plaque psoriasis, which causes patches of skin that are red at the base and covered by silvery scales
• Guttate psoriasis, which causes small, drop-shaped lesions on the trunk, limbs, and scalp, often triggered by upper respiratory infections like strep throat
• Pustular psoriasis, which causes pus-filled blisters; flares can be caused by medications, infections, stress, or certain chemicals
• Inverse psoriasis, which causes smooth, red patches in skin folds near the genitals, under the breasts, or in the armpits; rubbing and sweating can exacerbate this type of psoriasis
• Erythrodermic psoriasis, which causes red and scaly skin over much of the body and can result from a bad sunburn, certain medications (e.g., corticosteroids), or poorly controlled psoriasis; this type can be very serious and requires immediate medical attention.

Symptoms of Psoriasis

Psoriasis typically causes patches of thick, red skin with silvery scales that itch or feel sore. These patches can appear anywhere on the body but are most common on the elbows, knees, legs, scalp, lower back, face, palms, soles of feet, fingernails, toenails, genitals, and inside the mouth. Flares, or periods when the skin worsens, can occur and are followed by periods of improvement.

Causes of Psoriasis

Psoriasis is an autoimmune disease, meaning the body's immune system overreacts and causes problems. In individuals with psoriasis, a type of white blood cell called T cells become overactive, triggering other immune system responses, including swelling and rapid skin cell turnover. Psoriasis is also linked to certain genes, and many people with the condition have a family history of it. Flares may be caused by infections, stress, weather changes that dry out the skin, certain medications, or trauma to the skin (e.g., cuts, scratches, sunburns).

Diagnosis of Psoriasis

Psoriasis can be difficult to diagnose because it often resembles other skin diseases. Doctors may take a small skin sample to examine under a microscope for a more accurate diagnosis.

Treatment of Psoriasis

Treatment for psoriasis varies and can include topical treatments (creams or ointments), light therapy (phototherapy), and systemic treatments (prescription medicines or injections). People respond differently to treatments, so several types may need to be tried before finding an effective one. Over time, the skin may become resistant to treatment, especially corticosteroids, necessitating a change in treatment methods.

Who Treats Psoriasis?

Diagnosing and treating psoriasis involves a team effort between the patient and various healthcare professionals, which may include:

• Dermatologists, who treat skin problems
• Internists, who specialize in the diagnosis and medical treatment of adults

Living With Psoriasis

Psoriasis can cause significant discomfort and interfere with basic functions such as work and sleep. Medical care can be expensive, and the scaly patches of skin may cause some individuals to feel self-conscious about their appearance, potentially leading to depression. However, treatment can help reduce the symptoms of psoriasis. In addition to regular doctor visits, the following strategies may help manage symptoms:

• Keeping skin well moisturized; some bath solutions and lubricants may help soothe the skin
• Maintaining overall health
• Participating in support groups or counseling to realize you are not alone in dealing with psoriasis and to share ideas for coping with the condition

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