Psoriasis, which is mostly chronic, is a common dermatological disease with different appearances in different people. The disease is not an infectious one and it can occur in people of all ages, even if it is generally seen in people 15 to 30 years old. Although the reason for its emergence is not completely known, it is thought that it occurs as a result of an interaction of the immune system, genetics and environmental factors.
A frequently asked question is, "How do you understand whether a skin rash is actually psoriasis or not?" This article examines the description of psoriasis, its types and treatment alternatives.
The disease takes its name from some of the most common symptoms which are white, bright and dry dandruff on a red skin eruption. It can appear with the hardening of the soles of the feet and palms, and cracks in the skin. It can occur with a rash-like appearance in the folding parts of the body, such as the armpits or belly button. In patients with psoriasis, small pits on nails, yellow-red stains like oil drops, hollow and thickening nails, bleeding under nails and disorder on the surface of nails can be observed. The disease can occur on the skin with hair, knees and elbows, sacrum and hips. Sometimes, it can be mistaken for eczema or allergic skin diseases.
Types and symptoms
Plaque psoriasis: Plaque psoriasis, the most common one, is red lesions covered by blotchy, inflammatory, white and nacred flakes. These plaques, which can be itchy and painful, can be seen anywhere in the body. However, the most common areas are the elbows, knees, waist and scalp. Eighty percent of patients with psoriasis have this type.
Guttate Psoriasis: Guttate psoriasis is the second most common disease after plaque psoriasis and mostly appears in childhood or young adulthood. Its frequency among all psoriasis types is 10 percent. It is seen on the skin of the chest, arms, legs and other parts of the body as small, red, separate spots. These spots are generally not as thick as plaque lesions.
Pustular psoriasis: Pustular is a rare type of psoriasis seen mostly in adults. It is usually observed on a small area on the hands and feet as white blisters filled with non-inflammatory liquid but it can spread to other areas.
Inverse Psoriasis: This is seen on the armpits, groin, inframammary fold, backs of the knees, sexual organs and other skinfolds on the hips. This type appears as nacred, smooth, bright and red inflammatory lesions.
Erythrodermic Psoriasis: This is an inflammatory type of psoriasis which is seen frequently. This disease is the most severe as it covers a great part of the body, more than 75 percent, with itching and redness on the skin and painful, exanthematous flaking.
Psoriatic arthritis: Along with typical psoriasis symptoms on the skin, there can be rheumatic problems. Swelling, pain, redness and mobility restriction can be seen among its symptoms that affect the joints. In many patients, effects such as heel spur, elbow pain, waist and back pain, can also be observed. In some cases, psoriasis negatively affects the fingernails and toenails. Nails generally thicken and the disease causes some effects such as dents on the nails and nail separation from their bed.
As psoriasis can be mistaken for other skin diseases, consulting your doctor can help with getting a proper diagnosis and the best treatment plan for you.
The treatment of psoriasis should be planned, considering the general health, age and lifestyle of the patient and the type of psoriasis. The first thing that should be done while struggling against the illness is to prefer soaps that do not dry the skin, and moisturizing creams and lotions should be applied in order to clear up the dryness and to stop the flaking. The itch should be taken under control in this way as well.
Psoriasis is treated with various methods, such as steroid medicines, light therapy and edible medicine.
Topical medicines that are among the treatment methods that are applied to the skin directly, i.e., creams and sprays. Some of them contain a steroid, some have an analog of vitamin D, some have both a steroid and vitamin D and some contain retinoid.
More naturally, honey is applied to the skin and is accepted as a treatment option.
If topical medicines don't provide adequate relief, your dermatologist can prescribe oral medicines that you take two times a week or a day. One of the recommended medicines that is generally prescribed is Apremilast. For some people, Acitretin, which is a derivative of vitamin A, is also recommended as an alternative, but you should inform your doctor about any medicine, like vitamins, food supplements and et cetera, which you use. You should also let him/her know about any allergies, health problems that you have or had, like pregnancy and surgery, before using this medicine.
If you use another medicine, the effects of Acitretin can change. This situation can both increase side effect risks and also prevent the medicine from working the way it should. Acitretin cannot be taken with some chemotherapy medicines, like Methotrexate and Tetracyclines. As a result, serious side effects can be observed. The treatment can be practiced by natural (solar) rays and artificial UV rays. In this practice, treatment can be done together with other medicines.
UVB phototherapy: UVB phototherapy can increase the symptoms of light and moderate psoriasis while it can treat spots, common psoriasis and problems that are resistant against the topical treatments. Its side effects can be itching, redness and skin dehydration.
Psoralen plus UVA: UVA rays can penetrate into deeper regions than UVB rays. Its short-term side effects are nausea, headache, burning and itching while long-term effects can be dry skin, increased sun sensitivity and skin cancer risk.
Atomic laser: This is used for light and moderate illnesses and applied to only the problematic skin area.
Injections: You can bid farewell to psoriasis with biological treatment - the success rate of which is between 80 and 90 percent - which is a much safer alternative that has fewer side effects. Injections are given every other week or once every three months to treat the illness.
However, medicines are expensive so be sure to consult with your doctor before deciding on a treatment plan.
If you're suffering from this disease, you should definitely see a dermatologist instead of thinking that there is no cure.
Triggering factors for psoriasis
Mechanic trauma, such as sunburn, bath-glove or wax, that cause skin injury
Smoking and alcohol
Vitamin D deficiency
Stress, emotional trauma
Strong painkillers, some heart and malaria medicines
Infection and hormonal changes like pregnancy and menopause