Psoriasis (patient information)

Psoriasis

Overview

What are the symptoms?

What are the causes?

Who is at highest risk?

Diagnosis

When to seek urgent medical care?

Treatment options

Where to find medical care for Psoriasis?

What to expect (Outlook/Prognosis)?

Possible complications

Prevention

Psoriasis On the Web

Ongoing Trials at Clinical Trials.gov

Images of Psoriasis

Videos on Psoriasis

FDA on Psoriasis

CDC on Psoriasis

Psoriasis in the news

Blogs on Psoriasis

Directions to Hospitals Treating Psoriasis

Risk calculators and risk factors for Psoriasis

For the WikiDoc page for this topic, click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

## Contents

* 1 Overview
* 2 What are the symptoms of Psoriasis?
* 3 What causes Psoriasis?
* 4 Who is at highest risk?
* 5 Diagnosis
* 6 When to seek urgent medical care?
* 7 Treatment options
* 8 Where to find medical care for Psoriasis?
* 9 What to expect (Outlook/Prognosis)?
* 10 Possible complications
* 11 Prevention of Psoriasis
* 12 Sources

## Overview[edit | edit source]

Psoriasis is a common skin condition that causes skin redness and irritation. Most people with psoriasis have thick, red skin with flaky, silver-white patches called scales.

## What are the symptoms of Psoriasis?[edit | edit source]

Psoriasis can appear suddenly or slowly. In many cases, psoriasis goes away and then flares up again repeatedly over time.

* People with psoriasis have irritated patches of skin. The redness is most often seen on the elbows, knees, and trunk, but it can appear anywhere on the body. For example, there may be flaky patches on the scalp.

* The skin patches or dots may be:
* Itchy
* Dry and covered with silver, flaky skin (scales)
* Pink-red in color (like the color of salmon)
* Raised and thick

* Other symptoms may include:
* Genital lesions in males
* Joint pain or aching (psoriatic arthritis)
* Nail changes, including:
* Nail thickening
* Yellow-brown spots
* Indentation (pitting) on the nail surface
* Separation of the nail from the base
* Severe dandruff on the scalp

Psoriasis may affect any or all parts of the skin. There are five main types of psoriasis:

* Erythrodermic:
* The skin redness is very intense and covers a large area.
* Guttate:
* Small, pink-red spots appear on the skin.
* Inverse:
* Skin redness and irritation occurs in the armpits, groin, and in between overlapping skin.
* Plaque:
* Thick, red patches of skin are covered by flaky, silver-white scales.
* This is the most common type of psoriasis.
* Pustular:
* White blisters are surrounded by red, irritated skin.

## What causes Psoriasis?[edit | edit source]

Psoriasis cannot be spread to others. Psoriasis seems to be passed down through families. Doctors think it probably occurs when the body's immune system mistakes healthy cells for dangerous substances. Skin cells grow deep in the skin and normally rise to the surface about once a month. In persons with psoriasis, this process is too fast (about 2 weeks instead of 4 weeks) and dead skin cells build up on the skin's surface. The following may trigger an attack of psoriasis or make the condition more difficult to treat:

* Bacteria or viral infections, including strep throat and upper respiratory infections
* Dry air or dry skin
* Injury to the skin, including cuts, burns, and insect bites
* Some medicines, including antimalarial drugs, beta-blockers, and lithium
* Stress
* Too little sunlight
* Too much sunlight (sunburn)
* Too much alcohol

In general, psoriasis may be severe in people who have a weakened immune system. This may include persons who have:

* AIDS
* Autoimmune disorders (such as rheumatoid arthritis)
* Cancer chemotherapy

Up to one-third of people with psoriasis may also have arthritis, a condition known as psoriatic arthritis.

## Who is at highest risk?[edit | edit source]

Psoriasis is a very common condition. The disorder may affect people of any age, but it most commonly begins between ages 15 and 35.

## Diagnosis[edit | edit source]

Your doctor will look at your skin. Diagnosis is usually based on what the skin looks like.

Sometimes, a skin biopsy is done to rule out other possible conditions. If you have joint pain, your doctor may order x-rays.

## When to seek urgent medical care?[edit | edit source]

* Call your health care provider if you have symptoms of psoriasis or if the skin irritation continues despite treatment.

* Tell your doctor if you have joint pain or fever with your psoriasis attacks.

* If you have symptoms of arthritis, talk to your dermatologist or rheumatologist.

* Go to the emergency room or call the local emergency number (such as 911) if you have a severe outbreak that covers all or most of your body.

## Treatment options[edit | edit source]

The goal of treatment is to control your symptoms and prevent infections.

Medical care

In general, three treatment options are used for patients with psoriasis:

* Topical medications such as lotions, ointments, creams, and shampoos
* Body-wide (systemic) medications, which are pills or injections that affect the whole body, not just the skin
* Phototherapy (which uses light to treat psoriasis)

Most cases of psoriasis are treated with medications that are placed directly on the skin or scalp:

* Cortisone creams and ointments
* Creams or ointments that contain coal tar or anthralin
* Creams to remove the scaling (usually salicylic acid or lactic acid)
* Dandruff shampoos (over-the-counter or prescription)
* Moisturizers
* Prescription medicines containing vitamin D or vitamin A (retinoids)

If you have an infection, your doctor will prescribe antibiotics.

Self-care

You may try the following self-care at home:

* Oatmeal baths may be soothing and may help to loosen scales. You can use over-the-counter oatmeal bath products or you can mix 1 cup of oatmeal into a tub of warm water.
* Sunlight may help your symptoms go away. Be careful not to get sunburned.
* Relaxation and antistress techniques may be helpful. The link between stress and flares of psoriasis is not well understood.

Some people may choose to have phototherapy.

* Phototherapy is a medical treatment in which your skin is carefully exposed to ultraviolet light.
* Phototherapy may be given alone or after you take a drug that makes the skin sensitive to light.
* Phototherapy for psoriasis can be given as ultraviolet A (UVA) or ultraviolet B (UVB) light.

Persons with very severe psoriasis may receive medicines to suppress the body's immune response. These medicines include methotrexate or cyclosporine. (Persons who have psoriatic arthritis may also receive these drugs.) Retinoids such as acitretin can also be used.

Newer drugs called biologics specifically target the body's immune response, which is thought to play a role in psoriasis. These drugs are used when other treatments do not work. Biologics approved for the treatment of psoriasis include:

* Adalimumab (Humira)
* Alefacept (Amevive)
* Etanercept (Enbrel)
* Infliximab (Remicade)
* Stelara

## Where to find medical care for Psoriasis?[edit | edit source]

Directions to Hospitals Treating Psoriasis

## What to expect (Outlook/Prognosis)?[edit | edit source]

Psoriasis is a life-long condition that can be controlled with treatment. It may go away for a long time and then return. With appropriate treatment, it usually does not affect your general physical health.

## Possible complications[edit | edit source]

* Arthritis
* Pain
* Severe itching
* Secondary skin infections
* Side effects from medicines used to treat psoriasis
* Skin cancer from light therapy

## Prevention of Psoriasis[edit | edit source]

There is no known way to prevent psoriasis. Keeping the skin clean and moist and avoiding your specific psoriasis triggers may help reduce the number of flare-ups.

Doctors recommend daily baths or showers for persons with psoriasis. Avoid scrubbing too hard, because this can irritate the skin and trigger an attack.

## Sources[edit | edit source]

http://www.nlm.nih.gov/medlineplus/ency/article/000434.htm

Template:WH Template:WS