Psoriasis: Diagnosis, Treatment and Everything You Need to Know

things you need to know about psoriasis

Figures from the American Association of Dermatology show that psoriasis affects up to 7.5 million people in the United States. Psoriasis mostly occurs in people between the age of 15 and 35 years, with about 10 to 15 percent of this demographic getting it before age 10.

The condition has been found to affect up to 3.6 percent of Caucasians compared to just 1.9 percent of African Americans.

Psoriasis affects men and women at an equal rate. While psoriasis can affect anyone, people with illnesses such as heart disease and diabetes, or those with depression have a higher risk of developing this condition.

Psoriasis can be a serious autoimmune condition characterized by red, scaly patches that appear raised on the scalp, elbows or knees.

However, the rash can appear on any part of the skin including on the chest, back and in the armpits too. In most instances, the inflamed patch causes an itchy, burning sensation. Psoriasis is not contagious.

Causes of Psoriasis

Scientists are still unclear about the exact cause of Psoriasis. What is certain is that the immune system plays a significant role in the development of this condition. Psoriasis can also be genetically inherited.

A stimulus often triggers inflammation of the skin, causing the skin cells to multiply abnormally fast and resulting in the fiery patches associated with psoriasis.

Diagnosing Psoriasis

To determine whether a person has psoriasis, a dermatologist would examine the affected skin. A biopsy may be necessary for diagnosis- this entails examining a piece of the affected skin under a microscope.

Usually, skin affected by psoriasis is inflamed and thicker than that affected by eczema.

psoriasis

In addition to examining your skin, your skin doctor may ask for information about your family history. Genetics are a major risk factor for psoriasis. Up to a third of people with a family history of psoriasis get the disease, according to research by the National Psoriasis Foundation.

Types of Psoriasis

The type of psoriasis you have will determine the most appropriate treatment for you. The different types of psoriasis include:

Plaque psoriasis

The most common type of psoriasis, plaque psoriasis typically affects the lower back, knees, elbows and scalp. It shows up as red patches covered by a layer of silvery white dead skin cells. The lesions can be itchy and this can cause them to crack and bleed.

Guttate psoriasis

Guttate psoriasis is common in children and young adults. A strep infection is a common trigger for guttate psoriasis, which appears as small dots on the skin.

The second most popular type of psoriasis, guttate affects as many as 10 percent of those who develop psoriasis.

Inverse psoriasis

Inverse psoriasis typically develops alongside another type of psoriasis that is already affecting a person.

This type of psoriasis appears as extremely red and shiny lesions behind the knee, groin or armpit.

Pustular psoriasis

Pustular psoriasis shows up as small blisters or pustules filled with pus and surrounded by inflamed skin that appears reddened. The pus is noninfectious. This type of psoriasis mostly affects the hands and feet but can appear on any part of the body.

Erythrodermic psoriasis

Erythrodermic psoriasis is the most serious type of psoriasis. It appears as extremely red patches covering most of the body. These patches can be severely itchy and painful, causing the skin to peel off.

Erythrodermic psoriasis is rare, appearing in only 3 percent of people who have psoriasis and mostly in those who have an unstable form of plaque psoriasis.

Note: If you suspect that you have erythrodermic psoriasis, it is recommended that you see a doctor immediately.​

Parts of the Body Typically Affected by Psoriasis

Psoriasis can affect any part of the body including nails, lips, mouth, feet, armpits, elbows, knees and beneath skin folds. Different treatments would be required for the different areas affected by the condition. Below are the parts that are most commonly affected by psoriasis:

Scalp

Psoriasis of the scalp can be either very mild or very severe. Mild psoriasis appears as slight scaling of the scalp and easily goes away with treatment. Severe psoriasis can result in thick plaques that cover the whole scalp and may extend to the back of the neck, ears and the forehead.

Face

When psoriasis affects the face, it often appears on the eyebrows, upper lips, the area between the nose and the lip, and on the forehead. Facial psoriasis needs careful treatment given the sensitivity of facial skin.

Genitals

Inverse psoriasis mostly affects the genital region but other types of psoriasis can also affect this part of the body. Mostly diagnosed in men, genital psoriasis requires immediate treatment to mitigate the uncomfortable and often painful skin inflammation.

Skin Folds

Inverse psoriasis may also develop beneath the breasts, in the armpits and inner thighs. Sweating and rubbing can cause further inflammation and worsen the psoriasis on these areas.

Feet, nails and hands

Just like facial psoriasis, hand and foot psoriasis needs to be treated immediately and with care. Often, the red patches may appear in the form of blisters and cracks that may be prone to infections.

Psoriasis of any type usually causes nail changes in up to 80 percent of people with this condition.

Levels of Severity

Psoriasis can be severe, moderate or mild depending on the extent to the body is affected and the impact it has on an individual’s quality of life.

Because this condition can be itchy and painful, it may hinder a person from carrying on with their activities of daily living.

Generally, psoriasis is considered mild if it affects less than 3 percent of the body. It is categorized as moderate if it affects between 3 and 10 percent of the body and severe if the psoriasis covers more than 10 percent of the body.

Treating Psoriasis

No matter the level of severity, psoriasis is a treatable disease. Mild psoriasis can be treated using over-the-counter tropical medications and shampoos but if these do not work, seek a doctor’s advice. Alternatively, take a look at this new FDA approved treatment here.

Doctors usually prescribe oral, tropical or injectable drugs depending on the severity of psoriasis. Mild to moderate psoriasis may only require tropical and oral medication while injectable and biologic medicines are usually prescribed for severe psoriasis.

Light Therapy for Psoriasis

In addition to tropical and/or oral treatment, your doctor may also recommend light therapy, also known as phototherapy. 

Light therapy is a popular method for easing the effects of skin diseases such psoriasis and vitiligo, also known as leucoderma.

uv lamp to treat psiorialis

UVB light therapy utilizes ultraviolet light that is free of photosensitizing agents.This form of therapy seeks to imitate the favorable effects of the sun on the general appearance of the skin if the right dosage of UVB light is exposed to the skin.

Studies show that TL/01-UVB narrowband radiation offers the best and safest results given that the period of exposure is shorter and may therefore reduce the impact of any side effects.

Using UVB Lamp to Treat Psoriasis and Vitiligo

For best results in the treatment of Leucoderma or psoriasis, consistent usage of the UVB lamp is recommended. You may use the light at home but it is strongly advised that you obtain a prescription from the doctor.

Generally, UVB lamps work by exposing affected areas of the skin to the ultraviolet light emitted by the lamp. A short exposure period of up to 5 minutes a day is usually recommended. 

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FREQUENTLY asked questions:

Is UVB phototherapy safe?

UVB phototherapy is safe if you use the lamp according to the manufacturer’s instructions. Avoid over-exposure and you should be able to enjoy the benefits of UVB phototherapy without any further damage to your health.

Is home therapy as effective as being treated in hospital?

Most UVB therapy lamps for leucoderma and psoriasis are designed to work equally in the clinical setting and at home. The only difference is that home lamps allow you to treat your skin problem less expensively and from the comfort of your home.

How do I use my UVB lamp?

Using a UVB lamp is easy even for older children. Generally, you would need to preset the lamp for a certain duration during which you will expose the ultraviolet light to the affected areas of the skin. Be sure to read the manual for specifics on how to operate the UVB you have purchased.

Which diseases are treatable with UVB lamps?

UVB lamps have been found to be effective in reducing the effects of skin pigmentation problems such as atopic dermatitis, vitiligo and psoriasis. Used consistently, the lamp can help you eliminate over 92% of the symptoms associated with these skin conditions.

Who shouldn’t use UVB lamps?

Young children under the age of 12 years should not use a UVB lamp as it may cause melanoma or carcinoma on their highly sensitive skin.

Psoriatic Arthritis

Psoriatic arthritis is a form of psoriasis that causes stiffness, swelling and pain in the joints and may cause nail damage. Studies shows that an estimated 11 percent of people diagnosed with psoriasis also have psoriatic arthritis.

Overall, up to 30 percent of those who develop psoriasis will end up with psoriatic arthritis.Psoriatic arthritis may easily go undiagnosed especially when its symptoms are very mild.

However, as soon as a diagnosis is made, the condition should be treated immediately to avoid permanent damage to the joints.

Psoriasis in Children

According to the National Psoriasis Foundation, 20,000 children aged below 10 are affected by psoriasis each year. Misdiagnosis is common but not prevalent, given that psoriasis can be mistaken for other skin conditions. While rare, psoriasis can also affect infants.

In children, psoriasis may include symptoms such as discolored and pitted nails, diaper dermatitis, and severe plaque on the scalp, midsection of the body and the extremities.

There is a 10 percent chance that a child will develop psoriasis if one of the parents has the condition. The probability increases to 50 percent if both parents have psoriasis.

Even then, there is no way to predict whether a person will get psoriasis.A strep infection can trigger psoriasis in children.

Other factors that may activate psoriasis in children include earache, tonsillitis, bronchitis and other respiratory conditions. Psoriasis may also affect areas of skin that have been injured.

Summary

Psoriasis affects a small percentage of the population, just about 2 to 3 percent. Whether this condition manifests mildly or severely, it is important to have it treated immediately.

It is recommended that you consult with a dermatologist if you have severe psoriasis or if your psoriasis is accompanied by unusual pain and swelling of the joints.

The earlier you treat this condition, the fewer adverse impacts it will have on your quality of life.