Signs, symptoms, and treatment options for Psoriasis

Your skin is more than just a barrier; it shows how healthy and well you are overall. But for people with Psoriasis, their skin hurts, itches, and makes them feel bad emotionally. Psoriasis is more than just a cosmetic issue; it's a chronic autoimmune skin disease that requires accurate diagnosis and ongoing treatment.

This blog is designed to help patients and their families learn about Psoriasis, including what it is, its common signs and symptoms, its causes, and available treatments. It will also inform them when they should consult a dermatologist for professional assistance.

What is Psoriasis?

Psoriasis is an autoimmune disease that lasts a long time (chronic) and makes the immune system speed up the life cycle of skin cells. Usually, skin cells take about a month to grow back, but in Psoriasis, new cells grow back in just a few days. These extra cells accumulate on the surface, forming thick, scaly, and red patches.

The disease is not contagious, meaning it can't be passed from one person to another through direct contact. However, factors in the environment, emotions, or the body can exacerbate or trigger it.

Psoriasis typically follows a cyclical pattern: symptoms worsen for a few weeks or months, then subside or enter remission before recurring.

Typical Signs and Symptoms of Psoriasis

Psoriasis can appear anywhere on the body, but it typically shows up on the scalp, elbows, knees, lower back, and nails. The signs vary for each person, depending on the type and severity of the condition.

1. Skin with red patches and silvery scales

The primary sign of Psoriasis is red, thickened skin with white or silvery scales.

These plaques can break and bleed, especially when they're dry.

2. Skin that is dry, itchy, or sore

Many people feel as though they are constantly itching or experiencing burning sensations.

Scratching can exacerbate inflammation and increase the risk of infection.

3. Nails that are thicker or a different color

Psoriasis can affect the nails in several ways, including the development of pits (minor dents), changes in color, or separation from the nail bed (onycholysis).

4. Pain and stiffness in the joints

Psoriatic arthritis, which affects the joints and tendons, impacts approximately 30% of individuals with Psoriasis.

5. Scales that look like dandruff or flakes on the scalp

Flakes on the scalp with Psoriasis may resemble dandruff, but they are thicker and often accompanied by redness or pain.

6. Bleeding in one place

When scales are removed or scratched, small bleeding spots, known as Auspitz's sign, may appear.

Symptoms can be mild, affecting only small areas, or severe, affecting large areas of the body.

Different kinds of Psoriasis

Dermatologists can recommend the most effective treatment if they identify the specific type of skin condition.

• Psoriasis Vulgaris, also known as Plaque Psoriasis: The most common type is characterized by red patches with silver-white scales on top.
• Guttate Psoriasis looks like small, drop-shaped spots on the skin. Infections like strep throat often cause it.
• Inverse Psoriasis typically occurs in skin folds, such as under the breasts, around the groin, or on the buttocks. It looks like shiny, red patches without scales.
• Pustular Psoriasis: This type of Psoriasis is marked by white, pus-filled blisters that are surrounded by red, inflamed skin.
• Erythrodermic Psoriasis is a rare but serious type that causes widespread redness, scaling, and severe itching. It needs to be treated right away.

What Causes Psoriasis and What Makes It Worse

Scientists don't know precisely what causes Psoriasis, but they do know that it is primarily caused by an immune system that overreacts. People with Psoriasis have immune cells that mistakenly attack healthy skin cells. This causes inflammation and a quick turnover of skin cells.

Some common triggers are:

• Stress: Stressful emotions can exacerbate or worsen flare-ups
• Infections: infections of the throat, lungs, or skin.
• Cold or dry weather can cause the skin to lose moisture, leading to cracking and irritation.
• Some medications, like beta-blockers, lithium, and some antimalarial drugs, can make Psoriasis worse.
• Injury to the skin, also known as the Koebner phenomenon, occurs when scratches, cuts, or burns cause new psoriatic lesions to form.
• Lifestyle Factors: Smoking, drinking, and being overweight may make symptoms worse.

Diagnosis

A dermatologist can usually diagnose Psoriasis by examining the affected areas of your skin, scalp, or nails.

Some of the steps in diagnosis may be:

• Physical examination: Recognizing common lesions and their characteristic distribution patterns.
• Medical history: Knowing what caused the problem, what treatments have been tried, and what family members have had it.
• Skin biopsy: If the diagnosis is unclear, a small sample is examined under a microscope to confirm Psoriasis and rule out other conditions, such as eczema or fungal infections.

Different Ways to Treat Psoriasis

Psoriasis can't be completely cured, but treatments that work can keep symptoms under control, lower inflammation, and stop flare-ups.

The type of Psoriasis, its severity, and the patient's response to treatment all contribute to determining the appropriate treatment.

1. Topical Treatments (for Psoriasis that isn't too bad)

You put these directly on the skin that is affected:

• Corticosteroid creams: Stop itching and swelling.
• Calcipotriol, a vitamin D analog, slows the growth of excessive skin cells.
• Coal tar products can help with scaling, itching, and redness.
• Salicylic acid: breaks down and softens scales
• Moisturizers help keep skin moist and reduce dryness.
• Topical therapy is often the first line of treatment that doctors try, and it can be more effective when used in conjunction with other therapies.

2. Phototherapy (Light Therapy) means putting the skin under medical supervision and exposing it to ultraviolet (UV) light.

UVB therapy: Slows down the growth of skin cells.

PUVA (Psoralen + UVA): A light-sensitizing drug is used before UVA exposure.

Phototherapy is effective for moderate to severe Psoriasis and can induce long-term remission with consistent application.

3. Medications that work throughout the body (for moderate to severe Psoriasis)

When topical treatments are ineffective, these are administered to work throughout the body.

• Methotrexate: stops the immune system from working too hard.
• Cyclosporine: Controls immune cells to lower inflammation.
• Acitretin is a vitamin A derivative that helps skin cells grow normally.

These drugs need to be watched closely because they can cause problems, especially with the liver, kidneys, and blood pressure.

4. Therapies that use living things

• Biologics are a new way to treat Psoriasis. They work by targeting specific proteins in the immune system that cause inflammation.
• Adalimumab, Etanercept, and Infliximab are examples of biologics that target tumor necrosis factor-alpha (TNF-α).
• Ustekinumab, Secukinumab, and Ixekizumab stop other pathways that cause inflammation.
• Biologics are usually injected and can help people control their symptoms for a long time with fewer side effects than regular medicines.

5. Changes to your lifestyle and care at home

• Along with medical care, daily care can help control Psoriasis:
• Keep your skin moist: Staying hydrated helps keep your skin from drying out and reduces the amount of shedding.
• Avoid using harsh soaps; instead, opt for gentle, scent-free ones.
• Meditation, yoga, or counseling can help you deal with stress and stop flare-ups.
• Eat a balanced diet. Foods rich in omega-3 fatty acids, such as fish and flaxseeds, can help reduce inflammation.
• Don't drink or smoke, as both can set off an episode.
• Get enough sunlight: A little bit of safe exposure to sunlight can help, but you should always talk to your doctor first.

When to Go to the Doctor

• If you see red or scaly patches that don't go away with over-the-counter treatments, you should see a doctor.
• Your nails or joints are sore.
• Psoriasis can cause you pain, discomfort, or distress.
• You suddenly worsen, experience excessive redness, or exhibit signs of infection (such as swelling, fever, or pus).
• Dermatologists at advanced hospitals can make accurate diagnoses, customize treatments, and keep an eye on long-term care.

Questions and Answers About Psoriasis

1. Can you catch Psoriasis?

No. Psoriasis is an autoimmune disease, so it cannot be contracted by touching someone or sharing items with them.

2. Can Psoriasis be cured completely?

There is no permanent cure, but with the proper treatment, symptoms can be managed and long-term remission can be reached.

3. Can Psoriasis be affected by what you eat?

Yes. Fruits, vegetables, nuts, and fish are all anti-inflammatory foods that can help. Stay away from alcohol, red meat, and processed foods.

4. Can stress make Psoriasis worse?

Stress doesn't cause Psoriasis, but it can make flare-ups happen or get worse. Managing stress is an integral part of treatment.

5. Can Psoriasis have an effect on internal organs?

In severe or untreated cases, psoriasis-related inflammation can impact joints

and elevate the risk of cardiovascular disease or diabetes.

Conclusion

Psoriasis can be challenging to manage, but with the proper medical care, lifestyle adjustments, and emotional support, most people can effectively manage it and live comfortably. To keep flare-ups and complications from happening, it's essential to get an early diagnosis, stick to your treatment plan, and see a dermatologist regularly.

Specialists at hospitals with advanced dermatology departments provide patients with personalized care, including topical treatments, biologics, counseling, and guidance on maintaining healthy skin.

Keep in mind that Psoriasis can affect your skin, but it doesn't define who you are. You can maintain healthy skin and boost your confidence with the proper care and treatment.