What is psoriasis?

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Psoriasis is a common autoimmune condition that affects the skin. The disease causes skin cells to build up over time. This creates scaling on the skin’s surface, often in patches. Psoriasis scales are typically inflamed, red, and brittle-looking. In some cases, they may develop a silvery sheen and a thick texture.

Most types of psoriasis are not considered to be dangerous. However, the lesions can last for weeks and months, making them difficult to deal with. In some cases, they are physically uncomfortable, creating an itching or burning feeling. Additionally, researchers have found that people with psoriasis are at an increased risk for developing certain cancers, like lymphoma, pancreatic cancer, and colon cancer.

If you suspect you have psoriasis, make an appointment with your primary care doctor, dermatologist, or rheumatologist. Receiving a diagnosis can lead to personalized treatment options and an increased quality of life.

What causes psoriasis?

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Psoriasis is an autoimmune condition, which means its symptoms are caused by an outsized immune system reaction. Researchers don’t know the exact cause of this immune reaction, but genetics and past immune responses play a key function. For example, people who have an immediate family member with psoriasis are at an increased risk of developing the condition.

Psoriasis lesions are caused by rapid skin cell turnover. The turnover happens when white blood cells mistakenly attack the skin cells. Over time, this causes skin cell production to increase, which can lead to raised lesions on the skin’s surface.

Some people cite certain stimuli as triggers for psoriasis flares. These triggers are different for every person, but the most common include:

  • Alcohol use
  • High stress
  • Certain medication
  • Viral or bacterial infection
  • Skin injuries, like cuts and scrapes

Unlike other autoimmune conditions, psoriasis affects males and females equally. Most diagnoses happen in people with light skin. This is likely due to how lesions present on darker skin tones, which can lead to misdiagnosis.

What are the symptoms of psoriasis?

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Psoriasis symptoms vary by person and the version of the condition that person has. However, certain symptoms are widespread across the patient population. The most common psoriasis symptoms include:

  • Inflamed and raised patches on the skin, which can be red, purple, brown, and/or gray in color
  • Excessively dry skin
  • Pitted and/or thick finger and toenails
  • Swollen joints
  • Silvery scales or plaques
  • Soreness around patches and plaques

Most people experience psoriasis in cycles of remission and recurrence. Some patients do not experience psoriasis for years at a time, while others have flare-ups that can last for several months. Remember that psoriasis remission does not mean that you are free of the condition. It simply means that you are not actively experiencing symptoms.

Unlike other types of skin conditions, psoriasis is not contagious.

What are the different types of psoriasis?

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There are five types of psoriasis. The psoriasis form with which you are diagnosed will depend on how it manifests on your body. The types of psoriasis are:

  • Plaque psoriasis: This is the most common type of psoriasis. Around 80 to 90 percent of people diagnosed with psoriasis have the plaque variation. Plaque psoriasis causes inflamed patches on the skin, which can range from red to purple in color. The patches are scaly in texture and primarily found on the scalp, knees, and elbows.
  • Pustular psoriasis: This type of psoriasis is characterized by pus-filled blisters, which often occur on the hands and feet. This is more common in adults than in children. The blisters range from red to purple in color.
  • Guttate psoriasis: This type of psoriasis is more common in children. It causes small spots to appear, primarily on the arms, legs, and torso. These lesions range from pink to purple in color, and they often lie flush against the skin. This is in contrast to plaque psoriasis lesions, which are often raised and thick.
  • Inverse psoriasis: In inverse psoriasis, patches develop in skin folds. Lesions commonly appear in the groin, under breasts, around the genitals, and under armpits. The spots are often shiny, inflamed, and red.
  • Erythrodermic psoriasis: This is the most severe type of psoriasis. It is also the rarest form of the condition. People with erythrodermic psoriasis experience large patches of inflammation, which can cover whole sections of the body. The inflammation resembles a sunburn, but scales may develop over time. This type of psoriasis is also known to cause fever and other illness. Erythrodermic psoriasis can be life threatening. The condition affects the body’s fluid balance and temperature. In some cases, it can lead to edema and heart failure. If you suspect you may have this condition, make an appointment with your dermatologist or primary care physician as soon as possible.

Some patients have just one type of the condition, while others develop multiple types over years. Additionally, around one-third of people diagnosed with psoriasis will also experience psoriatic arthritis later in life.

If you are diagnosed with psoriasis, it is important to monitor symptoms. If patches and lesions become more severe over time, schedule an appointment with your medical provider.

How is psoriasis diagnosed?

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Only a doctor can provide a psoriasis diagnosis. They will typically perform two tests to confirm. First, they will perform a physical examination to observe psoriasis scales and plaques. During this part of the visit, be sure to divulge and relevant family history. This may contribute to your diagnosis.

If the doctor believes that your lesions are a result of psoriasis, or if they are unsure, they will perform a biopsy. During this procedure, the doctor will remove a small sample of skin to observe under a microscope. This can both confirm diagnosis and provide information as to what type of psoriasis you have.

What are treatments for psoriasis?

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If you are diagnosed with psoriasis, your doctor will discuss various treatment options. While there is no cure for the condition, treatments can alleviate symptoms and reduce flare-up recurrence. There are three types of psoriasis treatments: topical treatments, oral/injected medications, and non-surgical procedures.

  • Topical treatments: Many people can alleviate psoriasis symptoms with topical creams and ointments, which are applied directly to the skin. Common options include salicylic acid, moisturizers, corticosteroids, retinoids, and anthralin.
  • Oral and injected medications: If your psoriasis is more severe, a doctor may prescribe a systemic medication to address the immune response. Common prescriptions include oral retinoids, biologics, methotrexate, and cyclosporine. Keep in mind that systemic medications can have significant side effects. As a result, they are often prescribed for shorter periods of time.
  • Non-surgical procedures: Light therapy has been shown to reduce and improve psoriasis symptoms. In this procedure, both UVB and UVB light are used to hinder overactive white blood cells.

Most psoriasis patients are prescribed a combination of treatments. Depending on your condition’s severity, you may try treatment options from all three categories. Remember that most psoriasis treatments are not intended for long-term use. They are often prescribed when symptoms begin to flare.

Should I make lifestyle changes if I am diagnosed with psoriasis?

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Some doctors will prescribe diet and lifestyle changes for people with psoriasis. For example, eating a heart-healthy diet and losing excess weight can make treatments more effective. Additionally, some people report having certain trigger foods. This often includes refined sugars, dairy products, and red meat. Psoriasis patients are also counseled to consume less alcohol and to begin taking vitamins every day.

Lifestyle changes can benefit psoriasis flareup. Reducing stress can help ease symptoms. Many people with psoriasis practice yoga and meditation to help manage stress.

What is the outlook for people with psoriasis?

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In most cases, psoriasis is not an exceedingly dangerous condition. People with psoriasis are often able to live normal, healthy lives. But this is a chronic disorder, which means it is lifelong. Receiving a diagnosis enables patients to manage symptoms, which can contribute to a higher quality of life. Remember that erythrodermic psoriasis can be life-threatening because it can disrupt the body’s fluid balance and temperature. However, even this severe form of the condition can be controlled with appropriate treatment.

Around one-third of people diagnosed with psoriasis will also receive a diagnosis of psoriatic arthritis. This is a chronic condition that cycles between flare-ups and remissions. Psoriatic arthritis often affects mobility, especially in the fingers, toes, knees, wrists, and ankles. An early psoriasis diagnosis is key to an efficient psoriatic arthritis diagnosis. If you suspect you may have one or the other, schedule an appointment with your dermatologist or rheumatologist today.