What is psoriasis and how to treat it

31 October 2023

Psoriasis affecting the skin, the treatment of which involves the use of ointments

Psoriasis is a dermatological disease in which red spots 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 can vary depending on the type, stage and cause. Common signs of psoriasis:

inflamed areas of the 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 claws.

Psoriasis in children usually first affects the scalp and nails, then spreads to the elbows, knees and torso. In nail psoriasis in a child, depending on the type of psoriasis, thick nails without pits or with small ridges can 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. The dermatologist deals with the diagnosis and treatment of psoriasis in adults. If red spots on the skin or silvery scales appear in children, you should consult a pediatrician.

How does psoriasis start?

Psoriasis begins with the formation of small red bumps that rise a few millimeters above the skin (externally they look like a simple rash). White or silver scales may appear as they increase in size. The scales that are on top may fall off. The remaining scales stick together and start to hurt and itch. When scratching the resulting rash, the scales can peel off the skin, causing bleeding.

What does psoriasis look like?

In psoriasis, red patches appear on fair skin and brown or purple patches on dark skin. In the initial stage of scalp psoriasis, the spots look like dandruff (due to white flakes). Forms of psoriasis:

mild form of psoriasis (less than three percent of the body is affected, rashes are localized on the scalp or limbs);
a moderate form of psoriasis (the rash covers three to ten percent of the body, affecting the scalp, hands, feet, and torso);
severe form of psoriasis (more than ten percent of the body is affected, rashes appear on the palms, soles and face).

The treatment of psoriasis is chosen by a dermatologist depending on the form and type of psoriasis, the symptoms and the location of the rash. If the 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 occurs on the elbows, knees, lower back and scalp;
erythrodermic psoriasis. The skin looks burnt, chills appear and the temperature rises;
guttate psoriasis. On the arms, legs and torso, small, flesh-colored, scaly spots similar to drops of water form;
pustular psoriasis. In 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;
reverse psoriasis. Smooth red spots appear on the skin. The rash appears in skin folds (armpits, buttocks, genitals).

In nail psoriasis, skin builds up under the nails, causing them to lift and form depressions ("pits"). The skin under the nail plate turns white, yellow, or brown. Nails become rough, brittle, and break easily.

Dermatologists also distinguish palmoplantar psoriasis. The skin in psoriasis on the hands and feet is dry and prone to cracking.

Psoriasis of the eyelids causes redness, flaking and crusting around the eyelids. Other symptoms of eyelid psoriasis:

the formation of flakes that peel off and stick to the eyelashes;
pain with eye movement;
irritation of the skin of the eyelids, accompanied by pain and itching.

The edges of the eyelids can turn up or down depending on the location of the spots, resulting in 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 can cause difficulty chewing and swallowing food.

The manifestations of psoriasis depend on its type, symptoms and stage. Psoriasis is visible in the photo.

Manifestations of psoriasis on the knees

Reasons for the development of psoriasis

Psoriasis is caused by a malfunctioning immune system in which white blood cells mistakenly start attacking skin cells. Thanks to the action of leukocytes, the process of producing new skin cells is reduced from a month to a few days. Cells formed before time are pushed from the body to the surface of the skin, where they accumulate and transform into spots or plaques.

A genetic predisposition (family history of psoriasis) or triggers (environmental factors that increase the risk of psoriasis) can cause the immune system to malfunction. Factors provoking the development of psoriasis:

infections (tonsillitis, herpes, lichen);
skin trauma (sunburn, insect bites, scratches, cuts);
smoking or alcohol abuse;
uncontrolled use of drugs;
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 factors that contribute to it.

Exacerbation of psoriasis

Psoriasis on the face, limbs and head is characterized by periods of exacerbation (symptoms are intense) and remission (rash decreases in size, pain disappears). Remission periods last from one month to one 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. No new nodules (papules) appear, the inflammation subsides after the formation of scales or crusts on the plaques;
regressive stage. Plaques decrease, itching and flaking disappear.

A dermatologist will help alleviate psoriasis flare-ups, who will identify the causes and prescribe treatment. Following your doctor's recommendations will help reduce periods of exacerbation and increase periods of remission.

How is psoriasis treated?

Before starting treatment for psoriasis, the dermatologist takes a history (asking about the symptoms, when they appeared and whether there is a family history of psoriasis) and conducts a visual examination of the rash. After making the diagnosis, the doctor chooses a comprehensive treatment for psoriasis. Treatment for psoriasis includes:

ointments, shampoos, creams and gels based on extracts of algae and minerals from the Dead Sea;
phototherapy (by exposing the skin affected by the rash to ultraviolet rays, the growth of skin cells is reduced, which leads to the 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, the dermatologist recommends dietary changes. Foods that reduce inflammation:

fatty fish (tuna, salmon);
flax and pumpkin seeds;
nuts (walnuts, almonds);
cabbage, spinach.

Following a psoriasis diet helps reduce symptoms and prevent the development of complications (high blood pressure, diabetes, heart disease). If you have psoriasis on your feet, hands or face, you should limit your alcohol intake.

Your diet should also include eating foods that contain fatty acids (sardines, salmon, shrimp, flaxseeds). 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 hands, feet and head. Psoriasis prevention includes:

dietary changes (abstinence from alcohol, simple carbohydrates and saturated fats, consumption of foods containing fatty acids);
protection of the head and body from the sun (use of sunscreen products 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 psoriasis flare-ups, extreme temperatures should be avoided. Exposure to temperatures that are too cold or too hot can dry out or damage your skin. 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 differentiated 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 (sebum may be released under pressure);
dandruff (flakes) that accumulate near the hairline.

You can tell psoriasis from dermatitis by the location of the rash. Unlike seborrheic dermatitis, psoriasis does not form only on the head, but also spreads beyond the hairline and appears on other parts of the body (extremities, back, nails). In psoriasis, the areas of skin affected by the rash are painful and itchy, and in dermatitis, you may feel a slight itch on the scalp.