Overview of Psoriasis
Psoriasis is a chronic disease that causes skin cells and blood vessels to rapidly generate, resulting in excess layers of cells stacked on the surface of the skin. The extra layers of built up skin often present as itchy, dry or painful red patches and silver-looking scales. Psoriasis is common and can affect anyone at any age. Most often, these patches will appear on the knees, elbows, lower back and groin, but certain forms of psoriasis can manifest anywhere on the body. Risk factors for developing psoriasis include a family history of psoriasis, chronic stress, tobacco use, obesity, and past infections. Additionally, the rash-like symptoms may spread or worsen after certain lifestyle triggers such as periods of high stress, viral or bacterial infections, vitamin D deficiency, or heavy drinking or smoking. According to the National Psoriasis Foundation, between 2 and 3 percent of the global populace is thought to have some form of psoriasis. Many believe this inflammatory skin condition to be linked with autoimmune disorder and inflammation.
There are several types of psoriasis, including plaque psoriasis (also known as psoriasis vulgaris), nail psoriasis, guttate psoriasis, inverse psoriasis, pustular psoriasis, erythrodermic psoriasis, and psoriatic arthritis. Of these, the most common type of psoriasis, by far, is plaque psoriasis, which can develop anywhere on your body. Depending on the type of psoriasis and how pervasive it appears on the body, dermatologists and doctors will classify cases of psoriasis as mild, moderate, or severe. While mild psoriasis can be an irritating cosmetic issue, research has linked moderate and severe cases of psoriasis with increased levels of inflammation in the body, cardiovascular disease, diabetes, and increased risk of death.
If your psoriasis is negatively impacting your appearance, causing you discomfort, or is getting in the way of your daily activities, we recommend booking an appointment at Sanova Dermatology of Baton Rouge to discuss treatment options. During your appointment, your dermatologist will evaluate your skin condition, and determine whether topical treatments, light therapy, systemic medications, or a combination of treatments is right for you.
Types of Psoriasis
There are several categories of psoriasis with symptoms ranging from small, red itchy patches to widespread eruptions to stiff and/or swollen joints. While many types of psoriasis come and go, some forms of psoriasis can be painful or even life-threatening without proper medical care. If you suspect that you may have psoriasis, it’s important to have the affected area evaluated by a board-certified dermatologist. After a skin assessment and review of your medical history, he or she will be able to correctly diagnose your skin condition and recommend the most effective form(s) of treatment to improve your symptoms. In rare cases, your dermatologist may also require a small biopsy of the affected area to confirm diagnosis.
- Plaque psoriasis (psoriasis vulgaris) – Affecting around 90% of all psoriasis patients, plaque psoriasis is, by far, the most common type of psoriasis. Plaque psoriasis is often characterized by dry, raised red patches of skin that could be itchy or painful. It can appear anywhere on the skin.
- Nail psoriasis – This type of psoriasis affects the fingernails and toenails, causing the nail to turn yellow, green, or brown; lift away from the skin; or crumble. Often, the nail will also change in texture, developing ridges, grooves, or pitting on the surface. Nail psoriasis is often found in people with another preexisting form of psoriasis.
- Guttate psoriasis – This type of psoriasis presents as small, droplet-shaped red patches on the arms, legs, trunk and scalp. Typically, guttate psoriasis lesions are often thinner than plaque psoriasis lesions. Most common in children and young adults, guttate psoriasis is often triggered by bacterial infection.
- Inverse psoriasis (intertriginous psoriasis) – Often triggered by fungal infections, inverse psoriasis manifests as a red, shiny, smooth rash. This type of psoriasis affects areas where your skin folds and rubs together, such as the armpits, groin and under the breasts. Sweating, friction, and obesity are thought to contribute to this skin condition.
- Pustular psoriasis – Pustular psoriasis is characterized by small, yellow/white pus-filled blisters surrounded by red skin. If you suspect you may have pustular psoriasis, we recommend seeing a dermatologist immediately to diagnose which type of pustular psoriasis you may have: Von Zumbusch, palmoplantar pustulosis, or acropustulosis. In severe cases, pustular psoriasis can become life-threatening when left untreated.
- Erythrodermic psoriasis – A rare but dangerous form of psoriasis, erythrodermic psoriasis typically impacts a large area of the body and presents as severe redness and shedding of the skin. Those with erythrodermic psoriasis may experience an increased heartrate, severe itching and pain, fluctuations in body temperature, and skin that looks as if it has been burned. If you think you may have erythrodermic psoriasis, we recommend that you see a dermatologist immediately.
Additional Risks for Those with Psoriasis
Those with psoriasis carry a higher risk of developing other diseases and health conditions, including conjunctivitis, type 2 diabetes, high blood pressure, metabolic syndrome, Celiac disease, multiple sclerosis, Crohn’s disease, Parkinson’s disease, kidney disease, and other ailments. Additionally, those with psoriasis are also more likely to develop psoriatic arthritis, a chronic form of arthritis that causes swollen, painful joints as well as inflamed skin. There are five types of psoriatic arthritis: symmetric psoriatic arthritis, asymmetric psoriatic arthritis, distal interphalangeal predominant (DIP), spondylitis, and arthritis mutilans.
How to Treat Psoriasis
While there is not yet a cure for psoriasis, certain treatments and lifestyle measures can help improve and manage the symptoms.
Medical-grade treatments
Psoriasis treatments work to reduce the body’s inflammation and slow skin cell growth. Treatment methods can be split into three categories: topical treatments, light therapy, and systemic medications.
- Topical treatments – Topical creams and ointments can be an effective method for treating mild to moderate forms of psoriasis. For more severe cases of psoriasis, your dermatologist may prescribe a topical treatment in combination with an oral medication or light therapy. Common topical prescription treatments for psoriasis include: topical corticosteroids, vitamin D analogues, anthralin, topical retinoids, calcineurin inhibitors, and salicylic acid. These treatments will slow down skin cell growth, reduce inflammation, and ease your symptoms.
- Light therapy – Light therapy involves exposing the skin to natural sunlight or ultraviolet (UVA and UVB) light as a means of reducing scaling and inflammation from psoriasis. Typically, this type of treatment is most effective when combined with topical treatments or oral medications. In order to prevent the psoriasis from worsening—as well as possible UV damage to the skin—this type of treatment should be overseen and closely monitored by a trained professional. Effective forms of light therapy include: targeted sun exposure, UVB phototherapy, narrow band UVB phototherapy, Goeckerman therapy, and excimer laser therapy.
- Systemic medications – Systemic medications are typically reserved to treat moderate to severe cases of psoriasis and cases that have become resistant to other methods of treatment. They can take the form of either oral or injected medications and are often prescribed in conjunction with other forms of treatment. Because systemic medications can sometimes result in adverse side effects, patients are monitored closely on these medications. Common systemic medications include methotrexate, Apremilast®, and biological medications, such as HUMIRA®, Taltz, Cosentyx®, SILIQ®, Stelara®, and Tremfya®. Other commonly used medications include cyclosporine and acitretin.
Lifestyle measures and other forms of treatment
In addition to following a prescribed psoriasis treatment regimen of topical treatments, light therapy or systemic medications, it can also be helpful to adopt the following lifestyle practices:
- Staying hydrated
- Moisturizing
- Quitting smoking
- Avoiding alcohol
- Epsom salt baths
- Fish oil supplements
- Stress management
Contact Sanova Dermatology
For more information, or to schedule a consultation with one of our experienced dermatologists, please contact Sanova Dermatology today. Need a location closer to you? See our other Louisiana locations.
