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Dermatology Information and Resources

Psoriasis

Psoriasis is a common skin condition that results from an overactive immune system. When the immune system accelerates the life cycle of skin cells, this causes a rapid build up of these cells on the outer layer of skin. Several forms of psoriasis exist:

  • Plaque psoriasis is the most common, causing dry, raised, red skin lesions (plaques) covered with silvery scales. The plaques might be itchy or painful and can appear anywhere on the body.
  • Nail psoriasis. Psoriasis commonly affects fingernails and toenails. This type of psoriasis can lead to abnormal nail growth, discoloration, or dislodging of the nail from the nail bed.
  • Guttate psoriasis. This stems from bacterial infections, most commonly strep throat. Small lesions might be present rather than large red areas.
  • Psoriatic arthritis. This type affects both the joints and skin, causing painful symptoms similar to arthritis.[1]

Common Symptoms: Psoriasis is characterized by medium to large red patches on the skin with silver or white-like scales in and around the patches. Itchiness and pain are common. These red patches or lesions can spread over specific areas of the body, becoming dry and can sometimes lead to cracking or peeling of the skin. A psoriasis sufferer may also experience burning sensations, as well as soreness and stiffness in affected area(s). Psoriasis flare ups tend to recur for a few weeks or months, then go back into remission.[2] Outbreaks can occur just about anywhere on the body (including the genitals) but is commonly seen on the scalp, hands, nails, chest, stomach, arms, and feet.

Causes: Researchers have not been able to pin down exactly why psoriasis occurs, but strong links to the immune system, T cells and white blood cells have been found. T cells specifically, defend the body against viruses and bacteria. An overactive T cell condition may either attack healthy skin cells or overproduce skin cells, resulting in an abundance of cells that begin to appear on the epidermis, causing redness and scaliness.

Overactive cell production may have several contributing factors such as genetics, fungal infections, bacterial infections, skin wounds or injuries, drug and alcohol addiction, allergies, stress, hormonal changes, or even certain medications.[3]

Treatment: Treatment for psoriasis is often more reactive than preventative. Dietary changes that properly address inflammation have been shown to have some reductive effect on flare ups. Topical corticosteroids and retinoids can reduce inflammation and irritation. Salicylic acid, another OTC product reduces scaling and can help to remove dead skin cells. Slowing skin cell growth is one of the main goals of targeting psoriasis, so apart from treating discomfort, a doctor may prescribe synthetic Vitamin D such as Calcipotriene (Dovonex) or Calcitriol (Vectical) can treat mild to moderate cases of psoriasis by reducing skin cell growth.[4] In severe cases, a skin biopsy may be ordered by a doctor to determine whether there are underlying conditions that should be addressed.

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References

[1] https://www.psoriasis.org/about-psoriasis
[2] https://www.psoriasis.org/about-psoriasis
[3] https://www.webmd.com/skin-problems-and-treatments/psoriasis/psoriasis-causes-triggers#1
[4] https://www.mayoclinic.org/diseases-conditions/psoriasis/diagnosis-treatment/drc-20355845