Psoriasis

What is psoriasis?

Psoriasis, an autoimmune disorder, is a chronic skin condition. It is characterized by inflamed, red, raised areas that often develop into silvery scales on the scalp, elbows, knees, and lower back. Psoriasis can also be associated with arthritis. It is estimated to affect 7.5 million people in the U.S.

What causes psoriasis?

The cause of psoriasis is unknown; however, it is thought to be caused by abnormally fast-growing and shedding skin cells. The skin cells multiply quickly. This causes the skin to shed every 3 to 4 days. This may be caused by a trigger, such as injury, sunburn, certain classes of medicines, infection, stress, alcohol, or tobacco. Though not contagious, the condition is hereditary. Psoriasis often returns and can be more severe one time than another. 

What are the symptoms of psoriasis?

The following are the most common symptoms of psoriasis. Psoriasis comes in several forms and severities. Symptoms may include:

  • Plaque psoriasis. This type of psoriasis is the most common. Symptoms may include patches of red, raised skin on the trunk, arms, legs, knees, elbows, genitals, and scalp. Nails may also thicken, become pitted, and separate from the nail beds.

  • Guttate psoriasis. This type of psoriasis affects mostly children. Symptoms may include many small spots of red, raised skin. A sore throat usually proceeds the onset of this type of psoriasis.

  • Pustular psoriasis. Symptoms may include small pustules (pus-containing blisters) all over the body or just on the palms, soles, and other small areas.

The symptoms of psoriasis may look like other skin conditions. Always talk with your healthcare provider for a diagnosis.

How is psoriasis diagnosed?

When the condition progresses to the development of silvery scales, the healthcare provider can usually diagnose psoriasis with a medical exam of the nails and skin. Confirmation of diagnosis may be done with a skin biopsy (taking a small skin specimen to examine under a microscope).

Treatment for psoriasis

Specific treatment for psoriasis will be discussed with you by your healthcare provider based on:

  • Your age, overall health, and medical history

  • Severity of the condition

  • Your tolerance of specific medicines, procedures, or therapies

  • Expectations for the course of the condition

  • Your opinion or preference

The goal of treatment is to reduce inflammation and slow down the rapid growth and shedding of skin cells. At the present time, there is no cure for psoriasis. Treatment may include:

  • Ointments and creams (to moisturize the skin)

  • Sunlight or ultraviolet light exposure (under a healthcare provider's supervision)

  • Laser treatments

  • Topical steroid creams

  • Vitamin D cream

  • Creams containing salicylic acid or coal tar

  • Anthralin. An anti-inflammatory drug that treats the thicker, hard-to-treat patches of psoriasis.

  • Oral or topical retinoids

  • Immunosuppressive medicines (such as cyclosporine or methotrexate)

  • Newer injectable biologic medicines 

Outlook

There is no known way to prevent psoriasis. Although it is a lifelong condition, it often can be controlled with appropriate treatment. Keeping the skin clean and moist, and avoiding person-specific psoriasis triggers (excessive stress, for example) may help decrease flare-ups.