Psoriasis: Symptoms, Types, Causes & Treatment

Psoriasis is a chronic inflammatory skin condition that causes characteristic symptoms such as red, dry patches, that can itch ou cause a slight burning sensation or pain.

Even though this type of condition is relatively common, the exact cause is yet unknown, however, it is frequent for the patches to appear or become more intense in situations that directly affect immunity, such as periods of great stress or auto-immune diseases.

Psoriasis: Symptoms, Types, Causes & Treatment

Types and symptoms of psoriasis 

Most cases of psoriasis are characterized by the presence of red, dry patches on the skin. However, depending on the location affected, psoriasis can be divided into various sub-types that can cause other symptoms to appear:

1.  Common psoriasis

Common psoriasis, also known as plaque psoriasis, is the most common form of the condition and is characterized by red patches with white or silvery scales, or plaques that can be a few millimeters long. 

This type of psoriasis usually happens in the legs, arms, scalp, and lower back region, but it can also affect the nails. Other symptoms such as itchiness or burning can also appear, varying from one person to another.

2. Guttate psoriasis

Guttate psoriasis, also known as eruptive psoriasis, is more common in children, teenagers, and young adults, and it is characterized by patches with a drop-like appearance on the skin.

The patches are smaller than 1 centimeter and they tend to appear on the upper body, armpits, and in the groin area, generally after a streptococcus infection of the respiratory tract. 

3. Pustular psoriasis

Pustular psoriasis happens when little pus-filled blisters appear on the skin, together with the psoriasis patches. These blisters can appear in just one specific area of the skin, or they can spread all over the body. When pustular psoriasis is generalized, the person may present a fever of 102.2º F (39º C) to 104º F (40º C) for several days.

4. Inverse psoriasis

Inverse psoriasis is another type of psoriasis which is easily identified because the patches occur in humid areas of the body, such as armpits, groin area, inframammary region, belly button, or scalp. As they occur in humid locations, these patches do not usually get dry or scaly skin.

5. Nail psoriasis

Nail psoriasis happens when the disease affects the nail area, causing ridges and patches on the nails, and weak nails.

Many times, nail psoriasis appears before psoriasis flares up on the skin, and it may be the only symptom for several years.

How is psoriasis diagnosed

The first sign of psoriasis is normally the appearance of red patches on the skin, which disappear after some time without requiring treatment, but they can appear again, especially during periods of great stress.

If you suspect you have psoriasis check a dermatologist, as they are the most suitable professional to diagnose the condition. In addition to assessing the symptoms, the doctor may also order some tests to rule out other skin problems such as eczema, mycosis, lichen planus or systemic lupus erythematosus.

Psoriasis: Symptoms, Types, Causes & Treatment

Main areas affected

Psoriasis patches are more common in locations like:

  • Arms, elbows, and hands;
  • Legs and knees;
  • Genital organs;
  • Stomach and belly button;
  • Scalp, nape of neck and forehead;
  • Tailbone and bottom of the back.

Nonetheless, psoriasis can arise in any part of the body. So, ideally, every time you notice a change to your skin, you should visit a dermatologist to identify the problem and start adequate treatment.

What causes psoriasis

The specific causes of psoriasis are not known, however, it is known that the disease is caused by an unbalance in the person's immune system. That means that psoriasis is not caused by a virus, fungus or bacteria, and it is not contagious.

Some factors that seem to increase the chances of developing psoriasis include:

  • Blows and other skin traumas;
  • Viral or bacterial infections;
  • Habits like smoking or drinking a lot of alcohol;
  • Use of medication, especially antimalarial, lithium or beta blockers.

Psoriasis also presents a strong genetic link, as over 50% of people affected have cases of psoriasis in the family.

Treatment options

There is no known treatment capable of curing psoriasis, and so psoriasis is considered an incurable condition. There are, however, various types of treatment that can relieve the symptoms and improving life quality.

The main types of treatment are:

  1. Medication and lotions: these are the main way to control symptoms as they act directly on the inflammatory process of psoriasis. The most common type of medications are corticosteroid lotions, which decrease redness and itchiness;
  2. Phototherapy: consists of applying UVB rays on the skin and it is normally used in conjunction with medication and lotions to increase the anti-inflammatory and anti-proliferative effect;
  3. Diet: a suitable diet is another way of complementing the treatment, as it allows the person to avoid having substances that may cause skin inflammation. See which foods can be included in the diet and which ones to avoid.

In addition, there are also some home remedies for psoriasis, which can be used with medical supervision to control the symptoms, without adding side-effects to the treatment. A good example of this is watercress, which helps the body eliminate substances which could cause psoriasis crises or aggravate symptoms.

In the last years, there has also been an increased interest in studying biological agents, such as adalimumab or etanercept, to reduce psoriasis symptoms. These types of medication are a new class of treatment that consists of using proteins or antibodies capable of regulating the immune system.

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References

  • NATIONAL PSORIASIS FOUNDATION. About psoriasis. Available on: <https://www.psoriasis.org/about-psoriasis>. Access in 30 Oct 2019
  • LONGO, Dan L. et al.. Medicina interna de Harrison. 18.ed. São Paulo: AMGH Editora, 2013. 398-399.
  • NHS. Psoriasis. Available on: <https://www.nhs.uk/conditions/psoriasis/symptoms/>. Access in 30 Oct 2019
  • JUNIOR, Walter Belda et. al.. Tratado de dermatologia. 2.ed. São Paulo: Atheneu, 2014. 145-170.
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