Psoriasis is a chronic skin disorder affecting more than 4.5 million men and women. Psoriasis is a long-lasting disease that develops when a person’s immune system sends faulty signals that tell skin cells to grow too quickly. When you have psoriasis, your new skin cells form in days instead of weeks and your body cannot shed these excess cells. The rapid cell reproduction piles up on the surface of your skin, resulting in red, dry, and silvery patches or thickened plaques. The dry patches are a result of the rapid buildup of cells and psoriasis commonly affects the skin of the elbows, knees, and scalp but it can be found anywhere on the body.
Types of Psoriasis
Red or pink areas of thickened, raised, and dry skin typically characterize psoriasis. It normally affects the areas on the elbows, knees, and scalp but psoriasis can involve any body area. It does tend to be more common in areas of repeated rubbing and constant use, however. Psoriasis can have many different appearances such as flattened bumps, large thick plaques of raised skin, mildly pink dry skin, red patches, and dry skin with big flakes. Pulling one of these flakes of skin can cause a blood spot on the skin and this is medically referred to as a special diagnostic sign in psoriasis called the Auspitz sign.
There are several different types of psoriasis and some people get more than one type or their type of psoriasis changes.
If you have psoriasis, you will have one or more of these types:
- Plaque or Psoriasis Vulgaris—The most common type of psoriasis. Thick, red patches of skin are covered by flaky, silver-white scales.
- Guttate Psoriasis—Small, pink-red spots appear on the skin.
- Inverse Psoriasis–Also known as Flexural Psoriasis or Intertriginous Psoriasis. Skin redness and irritation occurs in the armpits, groin, navel, buttocks, and in between overlapping skin.
- Pustular Psoriasis—White blisters are surrounded by red, irritated skin. Liquid-filled, yellowish small blisters can also characterize this type.
- Erythrodermic Psoriasis—The skin redness is very intense and covers a large area.
- Palmoplantar Psoriasis—This is a separate entity affecting primarily the palms and soles.
Psoriasis lesions vary in appearance with the type of psoriasis you have. About 80% of people living with psoriasis have Plaque psoriasis or Psoriasis Vulgaris. This type of psoriasis causes patches of thick, scaly skin that may be white, silvery, or red and they can develop anywhere on the skin but are most common on the elbows, knees, lower back, and scalp.
What are the Signs and Symptoms of Psoriasis?
Psoriasis can appear slowly or suddenly and in many cases, psoriasis goes away and then flares up again repeatedly over time. People with psoriasis have irritated patches of skin and the redness is most often seen on the elbows, knees, and trunk but it can appear anywhere on the body. The skin patches or dots can be itchy, dry and covered with silver, flaky skin, pinkish-red salmon in color, or raised and thick.
Other symptoms of psoriasis may include:
- Joint Pain or Arthritis
- Nail Changes
- Severe Dandruff
- Genital Lesions
The first symptoms of Plaque Psoriasis appear as red dots that can be very small. These eruptions slowly get larger, producing a silvery white surface scale that is shed easily. Patches spread over wide expanses of skin and can lead to intense itching, skin pain, dry or cracking skin, and swelling.
Thanks to ongoing research, there are many treatments for psoriasis available today. Treatments can reduce the symptoms of psoriasis and some people see their skin completely clear. Every treatment has benefits, drawbacks, and possible side effects but our dermatologists at Comprehensive Dermatology Center of Pasadena specialize in the diagnosis and treatment of psoriasis and we can help you find a treatment that works for you and fits your lifestyle.
Some topical or skin applied medications include:
- Topical corticosteroids
- Vitamin D analogue creams such as Dovones
- Topical retinoids such as Tazorac
- Topical immunomodulators such as Tacrolimus and Pimecrolimus
- Coal tar
Some oral medications useful in treating psoriasis are:
- Acitretin or Soriatane
- Mycophenolate Mofetil
- Oral Prednisone
There is no known way to prevent psoriasis however keeping the skin clean and moist while avoiding your specific psoriasis triggers may help reduce the number of flare-ups. Your dermatologist will recommend daily baths or showers but do not scrub too hard as this can irritate the skin and trigger a psoriasis attack. Your dermatologist will usually begin with the mildest therapy and work up to the one that is most effective in clearing up your skin problem.