Items Tagged With Psoriasis

Your doctor can often recognize psoriasis by the appearance and location of the patches on your skin, scalp, or nails. Psoriasis usually involves bright red areas of raised patches that are often covered with loose, silvery, scaling skin and are commonly located on the knees, elbows, scalp, hands, feet, or lower back.

Special tests are usually not needed. If it is hard to diagnose the condition by looking at your skin, your doctor may remove a small skin sample (biopsy) and send it to a lab for analysis. If you have joint pain, X-rays may be taken to diagnose psoriatic arthritis. Blood work may help rule out other forms of arthritis.

Guttate psoriasis is a less common type of psoriasis. The small (less than 1 cm in diameter), scaly, circular elevations (papules) that occur with guttate psoriasis appear more on the trunk of the body than on the arms or legs. If you have these papules, your doctor may perform a throat culture to determine whether streptococcus bacteria are present.⁵

Sometimes a skin KOH test is done to rule out a fungal infection.

Psoriasis  Psoriasis Exams  Psoriasis Tests 

Skin care at home can help control psoriasis. Skin care and treatment may include using creams or lotions, pills, baths or soaks, and ultraviolet (UV) light. Skin care for psoriasis includes the following:

• Take care of your skin, and keep it moist and lubricated.
• Gently soften and remove psoriasis crusts by putting cream on the crusts and then peeling the loose crusts off. Removing crusts may help creams and lotions to be absorbed in the skin. However, this should be done very carefully so that the skin is not irritated.
• Follow instructions for skin products and prescribed medications. It may take a period of trial and error until you know which skin products or procedures work best for you. For mild symptoms of psoriasis, various nonprescription medications, such as aloe vera, may be soothing.
• Follow your schedule for sunlight or ultraviolet light treatments.
• Seek information or counseling from your doctor. Psoriasis day care centers may be available in limited locations. To find a center near you, ask your doctor or contact the National Psoriasis Foundation at http://www.psoriasis.org.

For more information on caring for your skin, see:

Skin care for psoriasis.

Other helpful suggestions to control psoriasis include:

• Protecting your skin. Treat all infections promptly, and try to avoid skin injuries and irritation.
• Taking care of your scalp. When you have psoriasis on your scalp, treat your scalp, not your hair.
• Trimming your nails. Keeping your nails trimmed may prevent the spread or flare-ups of psoriasis.
• Being careful in the sun. Although short periods of sun exposure reduce psoriasis in most people, too much sun exposure can damage the skin and cause skin cancer. In addition, sunburns can trigger flares of psoriasis.
• Being aware of possible medication reactions. Certain medications can trigger psoriasis or make symptoms worse.

Studies have not found any "psoriasis diet" that can cure or improve the condition, despite claims over the years. Try to eat a balanced, low-fat diet and maintain a healthy weight.

Psoriasis  Psoriasis Home Treatment  Psoriasis Treatment 

Medications applied to the skin or taken by mouth are usually used to treat psoriasis. For moderate or severe cases, topical and oral medications may be combined with exposure to sunlight or ultraviolet (UV) light. In rare cases, medications may be injected into a psoriasis sore or patch.

Softening and removing psoriasis crusts and scale can help creams and other skin products be absorbed into the skin. Psoriasis crusts can be removed by gently rubbing cream into the crusts to soften them and then carefully peeling the crusted patches off. However, this should be done with great care so that the skin is not irritated.

Scalp and nail psoriasis can be difficult to treat. Both conditions are more likely to improve with oral medication. Treatment for the scalp often includes tar shampoos, corticosteroid solutions, or zinc and selenium sulfide shampoos.

If you are taking topical or oral medications for psoriasis, you will need regular follow-up visits with your doctor to check for possible side effects or skin cancer. You may take one medication for a while, then switch to another to reduce the chance that a serious side effect will occur.

Occlusion

The occlusion treatment method uses moisturizers or medicated creams or gels applied to the skin. After the products are applied, the skin is then wrapped with tape, material, or plastic. Occlusion keeps the area moist and can increase the effectiveness of medicated creams. Steroid cream may be used with the occlusion treatment method for small areas, but not for more than a few days.⁵ Occlusion of large areas may cause side effects such as thinning of the skin.

Medication Choices

Topical medications to treat psoriasis include:

• Corticosteroids. Corticosteroids are the most common treatment for psoriasis.¹⁰
• Calcipotriene, which contains vitamin D₃.
• Retinoids, including tazarotene and acitretin.
• Anthralin and tars. The use of anthralin and tars has decreased recently, replaced by other medications such as calcipotriene and tazarotene.⁵
• Zinc pyrithione. Zinc pyrithione (for example, Derma-Cap) is a new product available without a prescription that comes in spray, soap, or solution form. It is used to treat small patches of psoriasis and symptoms, including itching, redness, flaking, and scaling of the skin. It is also used to treat psoriasis of the scalp. For some people, it appears to eliminate scales and sores caused by psoriasis. Very few studies of zinc pyrithione have been completed.

Oral medications to treat psoriasis include:

• Retinoids.
• Cyclosporine.
• Methotrexate.

Newer medicines, approved by the U.S. Food and Drug Administration (FDA) for treatment of psoriasis, are available. Biologics, which must be injected, modify the immune system response that produces the symptoms of psoriasis. Early clinical trials of biologic therapies for moderate to severe psoriasis have produced promising results, but the drugs are expensive and long-term effects are not known.^{11, 12}

• Alefacept (Amevive), efalizumab (Raptiva), and etanercept (Enbrel) have been approved by the FDA for treatment of moderate to severe psoriasis.
• Infliximab (Remicade), which is used to treat other inflammatory diseases such as rheumatoid arthritis, is beginning to be used for psoriasis with good results.¹¹
• Etanercept, infliximab, and adalimumab (Humira) have been approved to treat psoriatic arthritis.

Psoriasis  Psoriasis Medications 

Other treatment for psoriasis includes phototherapy. Phototherapy uses ultraviolet (UV) light exposure to slow the rapid growth of cells that occurs in psoriasis. Exposure to UV light to treat this condition can be effective, but your skin should be checked often by your doctor (at least once or twice a year) for any skin damage or skin cancer.

Complementary or alternative therapies are often used by people with skin diseases, including psoriasis. Complementary therapies include the use of herbs, vitamins, certain diets, and stress reduction. These therapies may relieve psoriasis symptoms in some people. Some notice that natural sunlight and seawater (climatotherapy) clear their symptoms of psoriasis. People seeking this treatment may go to seaside resorts, some of which have special programs and medical assistance for people with psoriasis. For more information, see the Web site of the National Psoriasis Foundation at http://www.psoriasis.org.

Psoriasis  Psoriasis Other Treatments 

There is no way to prevent psoriasis. However, the following tips may improve symptoms or help reduce the number of psoriasis flare-ups.

• Keep your skin moist and lubricated.
• Avoid cold, dry climates. Cold weather may worsen symptoms, while hot, humid weather and sunlight may improve symptoms. (However, hot humid weather may worsen certain types of psoriasis.)
• Avoid scratching and picking skin and skin injuries (cuts or scrapes). An injury to the skin can cause psoriasis patches to form anywhere on the body, including the site of the injury. This includes injuries to your nails or nearby skin while trimming your nails.
• Avoid stress and anxiety. Stress may cause psoriasis to appear suddenly (flare) or can make symptoms worse, although this has not been proven in studies.
• Avoid infection. Infections such as strep throat can cause psoriasis to appear suddenly (called guttate psoriasis), especially in children.
• Try to avoid certain medications. Some, including beta-blockers and lithium, have been found to worsen psoriasis symptoms. Tell your doctor you have psoriasis when any medications are prescribed for you.
• Limit alcohol. This may help control psoriasis, especially for men.
• Don't smoke. Smoking may make you more likely to get psoriasis and may make it more severe. Smoking may also make your symptoms last longer.^{5, 9}

Psoriasis  Psoriasis Prevention