Medical Dermatology 

PSORIASIS

Psoriasis is a skin disease that causes red, itchy scaly patches, most commonly on the knees, elbows, trunk and scalp.

Medical Dermatology  

PSORIASIS

Psoriasis is a skin disease that causes red, itchy scaly patches, most commonly on the knees, elbows, trunk and scalp.

What is Psoriasis?

Psoriasis is a common, long-term (chronic) disease with no cure. It tends to go through cycles, flaring for a few weeks or months, then subsiding for a while or going into remission. Treatments are available to help you manage symptoms. And you can incorporate lifestyle habits and coping strategies to help you live better with psoriasis.

What are the symptoms of Psoriasis?

Psoriasis signs and symptoms can vary from person to person. Common signs and symptoms include:

  • Red patches of skin covered with thick, silvery scales
  • Small scaling spots (commonly seen in children)
  • Dry, cracked skin that may bleed or itch
  • Itching, burning or soreness
  • Thickened, pitted or ridged nails
  • Swollen and stiff joints

 

What are the types of Psoriasis?

 

  • Plaque psoriasis. The most common form, plaque psoriasis causes dry, raised, red skin patches (lesions) covered with silvery scales. The plaques might be itchy or tender, and there may be few or many. They usually appear on elbows, knees, lower back and scalp.
  • Nail psoriasis. Psoriasis can affect fingernails and toenails, causing pitting, abnormal nail growth and discoloration. Psoriatic nails might loosen and separate from the nail bed (onycholysis). Severe cases may cause the nail to crumble.
  • Guttate psoriasis. This type primarily affects young adults and children. It’s usually triggered by a bacterial infection such as strep throat. It’s marked by small, drop-shaped, scaling lesions on the trunk, arms or legs.
  • Inverse psoriasis. This mainly affects the skin folds of the groin, buttocks and breasts. Inverse psoriasis causes smooth patches of red skin that worsen with friction and sweating. Fungal infections may trigger this type of psoriasis.
  • Pustular psoriasis. This rare form of psoriasis causes clearly defined pus-filled lesions that occur in widespread patches (generalized pustular psoriasis) or in smaller areas on the palms of the hands or the soles of the feet.
  • Erythrodermic psoriasis. The least common type of psoriasis, erythrodermic psoriasis can cover your entire body with a red, peeling rash that can itch or burn intensely.
  • Psoriatic arthritis. Psoriatic arthritis causes swollen, painful joints that are typical of arthritis. Sometimes the joint symptoms are the first or only symptom or sign of psoriasis. And at times only nail changes are seen. Symptoms range from mild to severe, and psoriatic arthritis can affect any joint. It can cause stiffness and progressive joint damage that in the most serious cases may lead to permanent joint damage.

 

What are the types of Psoriasis?

  • Corticosteroids. These drugs are the most frequently prescribed medications for treating mild to moderate psoriasis. They are available as ointments, creams, lotions, gels, foams, sprays and shampoos. Mild corticosteroid ointments (hydrocortisone) are usually recommended for sensitive areas, such as your face or skin folds, and for treating widespread patches. Topical corticosteroids might be applied once a day during flares, and on alternate days or weekends only to maintain remission.

    Your doctor may prescribe a stronger corticosteroid cream or ointment— triamcinolone (Acetonide, Trianex), clobetasol (Temovate) for smaller, less-sensitive or tougher-to-treat areas.

    Long-term use or overuse of strong corticosteroids can thin the skin. Over time, topical corticosteroids may stop working.

  • Vitamin D analogues. Synthetic forms of vitamin D, such as calcipotriene and calcitriol (Vectical) slow skin cell growth. This type of drug may be used alone or with topical corticosteroids. Calcitriol may cause less irritation in sensitive areas. Calcipotriene and calcitriol are usually more expensive than topical corticosteroids.
  • Retinoids. Tazarotene (Tazorac, Avage) is available as a gel and cream and applied once or twice daily. The most common side effects are skin irritation and increased sensitivity to light.

    Tazarotene isn’t recommended when you’re pregnant or breast-feeding or if you intend to become pregnant.

  • Calcineurin inhibitors. Calcineurin inhibitors — such as tacrolimus (Protopic) and pimecrolimus (Elidel) — reduce inflammation and plaque buildup. They can be especially helpful in areas of thin skin, such as around the eyes, where steroid creams or retinoids are too irritating or may cause harmful effects.

    Calcineurin inhibitors are not recommended when you’re pregnant or breast-feeding or if you intend to become pregnant. This drug is also not intended for long-term use because of a potential increased risk of skin cancer and lymphoma.

  • Salicylic acid. Salicylic acid shampoos and scalp solutions reduce the scaling of scalp psoriasis. It may be used alone, or to enhance the ability of other medications to more easily penetrate the skin.
  • Coal tar. Coal tar reduces scaling, itching and inflammation. It’s available over-the-counter or by prescription in various forms, such as shampoo, cream and oil. These products can irritate the skin. They’re also messy, stain clothing and bedding, and can have a strong odor.

    Coal tar treatment isn’t recommended for women who are pregnant or breast-feeding.

  • Goeckerman therapy. Some doctors combine coal tar treatment with light therapy, which is known as Goeckerman therapy. The two therapies together are more effective than either alone because coal tar makes skin more receptive to UVB light.
  • Anthralin. Anthralin (another tar product) is a cream used to slow skin cell growth. It can also remove scales and make skin smoother. It should not be used on the face or genitals. Anthralin can irritate skin, and it stains almost anything it touches. It’s usually applied for a short time and then washed off.

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What is Psoriasis?

Psoriasis is a common, long-term (chronic) disease with no cure. It tends to go through cycles, flaring for a few weeks or months, then subsiding for a while or going into remission. Treatments are available to help you manage symptoms. And you can incorporate lifestyle habits and coping strategies to help you live better with psoriasis.

What are the symptoms of Psoriasis

Psoriasis signs and symptoms can vary from person to person. Common signs and symptoms include:

  • Red patches of skin covered with thick, silvery scales
  • Small scaling spots (commonly seen in children)
  • Dry, cracked skin that may bleed or itch
  • Itching, burning or soreness
  • Thickened, pitted or ridged nails
  • Swollen and stiff joints

 

What are the types of Psoriasis?

  • Plaque psoriasis. The most common form, plaque psoriasis causes dry, raised, red skin patches (lesions) covered with silvery scales. The plaques might be itchy or tender, and there may be few or many. They usually appear on elbows, knees, lower back and scalp.
  • Nail psoriasis. Psoriasis can affect fingernails and toenails, causing pitting, abnormal nail growth and discoloration. Psoriatic nails might loosen and separate from the nail bed (onycholysis). Severe cases may cause the nail to crumble.
  • Guttate psoriasis. This type primarily affects young adults and children. It’s usually triggered by a bacterial infection such as strep throat. It’s marked by small, drop-shaped, scaling lesions on the trunk, arms or legs.
  • Inverse psoriasis. This mainly affects the skin folds of the groin, buttocks and breasts. Inverse psoriasis causes smooth patches of red skin that worsen with friction and sweating. Fungal infections may trigger this type of psoriasis.
  • Pustular psoriasis. This rare form of psoriasis causes clearly defined pus-filled lesions that occur in widespread patches (generalized pustular psoriasis) or in smaller areas on the palms of the hands or the soles of the feet.
  • Erythrodermic psoriasis. The least common type of psoriasis, erythrodermic psoriasis can cover your entire body with a red, peeling rash that can itch or burn intensely.
  • Psoriatic arthritis. Psoriatic arthritis causes swollen, painful joints that are typical of arthritis. Sometimes the joint symptoms are the first or only symptom or sign of psoriasis. And at times only nail changes are seen. Symptoms range from mild to severe, and psoriatic arthritis can affect any joint. It can cause stiffness and progressive joint damage that in the most serious cases may lead to permanent joint damage.

 

What are the types of Psoriasis?

  • Corticosteroids. These drugs are the most frequently prescribed medications for treating mild to moderate psoriasis. They are available as ointments, creams, lotions, gels, foams, sprays and shampoos. Mild corticosteroid ointments (hydrocortisone) are usually recommended for sensitive areas, such as your face or skin folds, and for treating widespread patches. Topical corticosteroids might be applied once a day during flares, and on alternate days or weekends only to maintain remission.

    Your doctor may prescribe a stronger corticosteroid cream or ointment— triamcinolone (Acetonide, Trianex), clobetasol (Temovate) for smaller, less-sensitive or tougher-to-treat areas.

    Long-term use or overuse of strong corticosteroids can thin the skin. Over time, topical corticosteroids may stop working.

  • Vitamin D analogues. Synthetic forms of vitamin D, such as calcipotriene and calcitriol (Vectical) slow skin cell growth. This type of drug may be used alone or with topical corticosteroids. Calcitriol may cause less irritation in sensitive areas. Calcipotriene and calcitriol are usually more expensive than topical corticosteroids.
  • Retinoids. Tazarotene (Tazorac, Avage) is available as a gel and cream and applied once or twice daily. The most common side effects are skin irritation and increased sensitivity to light.

    Tazarotene isn’t recommended when you’re pregnant or breast-feeding or if you intend to become pregnant.

  • Calcineurin inhibitors. Calcineurin inhibitors — such as tacrolimus (Protopic) and pimecrolimus (Elidel) — reduce inflammation and plaque buildup. They can be especially helpful in areas of thin skin, such as around the eyes, where steroid creams or retinoids are too irritating or may cause harmful effects.

    Calcineurin inhibitors are not recommended when you’re pregnant or breast-feeding or if you intend to become pregnant. This drug is also not intended for long-term use because of a potential increased risk of skin cancer and lymphoma.

  • Salicylic acid. Salicylic acid shampoos and scalp solutions reduce the scaling of scalp psoriasis. It may be used alone, or to enhance the ability of other medications to more easily penetrate the skin.
  • Coal tar. Coal tar reduces scaling, itching and inflammation. It’s available over-the-counter or by prescription in various forms, such as shampoo, cream and oil. These products can irritate the skin. They’re also messy, stain clothing and bedding, and can have a strong odor.

    Coal tar treatment isn’t recommended for women who are pregnant or breast-feeding.

  • Goeckerman therapy. Some doctors combine coal tar treatment with light therapy, which is known as Goeckerman therapy. The two therapies together are more effective than either alone because coal tar makes skin more receptive to UVB light.
  • Anthralin. Anthralin (another tar product) is a cream used to slow skin cell growth. It can also remove scales and make skin smoother. It should not be used on the face or genitals. Anthralin can irritate skin, and it stains almost anything it touches. It’s usually applied for a short time and then washed off.

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