Psoriasis

Medical Condition Description
Psoriasis is a chronic, often recurring, non-infectious skin disease characterized by skin rashes covered with silver-colored scales, as well as possible involvement of the scalp, nail, and joint damage, as well as changes in quality of life and psychosocial changes.

Causes of the Condition
The causes of psoriasis are unknown, but factors that can trigger or worsen psoriasis include:
Mechanical skin irritation (friction, pressure, trauma);
Inflammation of the skin caused by irritants and allergens;
Acute and chronic infectious diseases;
Metabolic disorders (e.g., diabetes);
Smoking;
Alcohol consumption;
Medication use (pain relievers, heart disease medications, psychiatric medications);
Other skin diseases;
Dry skin;
Nervous tension, stress.

Symptoms
In psoriasis, the skin is covered with limited, various-sized skin elevations, nodules, which are covered with white scales. The most commonly affected areas are those parts of the body that are frequently traumatized: elbows, knees, scalp. Initially, the rashes are dot-sized, droplet-sized, but over time they enlarge, spread, merge into palm-sized or larger plaques. There are many forms of psoriasis, so the disease manifests differently in different people, and also, over the course of a person’s life, the course of the disease and the nature of the damage can change.

Forms of Psoriasis:
Plaque psoriasis;
Guttate psoriasis;
Severe psoriasis:
– Psoriatic erythroderma;
– Psoriatic arthritis;
– Nail;
– Scalp;
– Palms and soles;
– Intertriginous.
Localized psoriasis.

Diagnosis
The diagnosis is based on clinical symptoms. Laboratory tests are performed to provide additional information before treatment is prescribed, and in case of joint damage, an X-ray examination is performed. A skin biopsy (a 2-3 mm skin sample) may be taken to refine the diagnosis.

Treatment
Treatment of psoriasis is very individual for each patient and is determined by the severity of the disease. Patients can be treated at home or in a hospital.
Mild psoriasis is treated with topical skin preparations – keratolytic agents (urea, salicylic acid) and anti-inflammatory drugs (corticosteroids, tar preparations, dithranol, vit. D derivatives).
Severe psoriasis is treated with systemically acting drugs such as methotrexate, synthetic retinoids, cyclosporin A, corticosteroids.
The best results are achieved when phototherapy is used (treatment with ultraviolet A or B rays) in combination, and patients are taught how to care for their skin.

Source | Author Doctor Nikas Samuolis, reviewed by Prof. Virginijus Šapoka | Vilnius University | Faculty of Medicine | Head of the Department of Internal Medicine, Family Medicine, and Oncology