Psoriasis (patient information): Difference between revisions
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==Overview== | ==Overview== | ||
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. | [[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 [[Scaling skin|scales]]. | ||
[[Image:Psoriasis_on_back.jpg|300px|A young man with psoriasis involving back and arms, source:wikipedia.org]] | |||
==What are the symptoms of Psoriasis?== | ==What are the symptoms of Psoriasis?== | ||
Psoriasis can appear suddenly or slowly. In many cases, psoriasis goes away and then flares up again repeatedly over time. | [[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]]. | |||
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. | |||
* Itchy | * The skin patches or dots may be: | ||
* Dry and covered with silver, flaky skin (scales) | ** [[Itchy]] | ||
* Pink-red in color (like the color of salmon) | ** Dry and covered with silver, flaky skin ([[Scaling skin|scales]]) | ||
* Raised and thick | ** Pink-red in color (like the color of salmon) | ||
** Raised and thick | |||
Other symptoms may include: | * Other symptoms may include: | ||
** [[Genital area|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 (Seborrhea)|dandruff]] on the [[scalp]] | |||
[[Psoriasis]] may affect any or all parts of the skin. There are five main types of [[psoriasis]]: | |||
* | * [[Erythrodermic psoriasis|Erythrodermic]]: | ||
** The skin redness is very intense and covers a large area. | |||
* [[Guttate psoriasis|Guttate]]: | |||
* | ** Small, pink-red spots appear on the [[skin]]. | ||
* [[Inverse Psoriasis|Inverse]]: | |||
** [[Skin]] redness and irritation occurs in the armpits, [[groin]], and in between overlapping [[skin]]. | |||
* [[Plaque-type psoriasis|Plaque]]: | |||
* | ** Thick, red patches of [[skin]] are covered by flaky, silver-white [[Scaling skin|scales]]. | ||
* Guttate | ** This is the most common type of [[psoriasis]]. | ||
* Inverse | * [[Pustular psoriasis|Pustular]]: | ||
* Plaque - | ** White [[blisters]] are surrounded by red, irritated [[skin]]. | ||
* Pustular | |||
==What causes Psoriasis?== | ==What causes Psoriasis?== | ||
[[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: | |||
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 | * [[Bacteria]] or [[viral]] infections, including [[strep throat]] and [[upper respiratory infections]] | ||
* Dry air or dry skin | * Dry air or dry skin | ||
* Injury to the skin, including cuts, burns, and insect bites | * Injury to the skin, including cuts, burns, and insect bites | ||
* Some medicines, including | * Some medicines, including [[Antimalarial drug|antimalarial drugs]], [[beta-blockers]], and [[lithium]] | ||
* Stress | * [[Stress]] | ||
* Too little sunlight | * Too little sunlight | ||
* Too much sunlight (sunburn) | * Too much sunlight ([[Sunburn (patient information)|sunburn]]) | ||
* Too much alcohol | * Too much alcohol | ||
In general, psoriasis may be severe in people who have a weakened immune system. This may include persons who have: | In general, [[psoriasis]] may be severe in people who have a weakened [[immune system]]. This may include persons who have: | ||
* [[AIDS]] | * [[AIDS]] | ||
| Line 59: | Line 61: | ||
* Cancer [[chemotherapy]] | * Cancer [[chemotherapy]] | ||
Up to one-third of people with psoriasis may also have arthritis, a condition known as psoriatic arthritis. | Up to one-third of people with psoriasis may also have arthritis, a condition known as [[Psoriatic arthritis (patient information)|psoriatic arthritis]]. | ||
==Who is at highest risk?== | ==Who is at highest risk?== | ||
Psoriasis is a very common condition. The disorder may affect people of any age, but it most commonly begins between ages 15 and 35. | [[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== | ||
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?== | |||
* Call your health care provider if you have [[Symptom|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== | ==Treatment options== | ||
The goal of treatment is to control your symptoms and prevent infections. | The goal of treatment is to control your [[Symptom|symptoms]] and prevent [[Infection|infections]]. | ||
'''Medical care''' | |||
In general, three treatment options are used for patients with psoriasis: | In general, three treatment options are used for patients with psoriasis: | ||
* Topical medications such as lotions, ointments, creams, and shampoos | * [[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 | * Body-wide ([[systemic]]) medications, which are pills or injections that affect the whole body, not just the skin | ||
* Phototherapy | * [[Phototherapy]] (which uses light to treat psoriasis) | ||
Most cases of psoriasis are treated with medications that are placed directly on the skin or scalp: | Most cases of psoriasis are treated with medications that are placed directly on the [[skin]] or [[scalp]]: | ||
* [[Cortisone]] creams and ointments | * [[Cortisone]] creams and ointments | ||
* Creams or ointments that contain coal tar or anthralin | * Creams or ointments that contain [[coal tar]] or [[anthralin]] | ||
* Creams to remove the scaling (usually salicylic acid or lactic acid) | * Creams to remove the [[Scaling skin|scaling]] (usually [[salicylic acid]] or [[lactic acid]]) | ||
* Dandruff shampoos (over-the-counter or prescription) | * [[Dandruff]] shampoos (over-the-counter or prescription) | ||
* Moisturizers | * [[Moisturizer|Moisturizers]] | ||
* Prescription medicines containing vitamin D or vitamin A (retinoids) | * [[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: | 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 | * 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. | * Sunlight may help your [[Symptom|symptoms]] go away. Be careful not to get [[Sunburn|sunburned]]. | ||
* Relaxation and antistress techniques may be helpful. The link between stress and flares of psoriasis is not well understood | * 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. | Some people may choose to have phototherapy. | ||
* Phototherapy is a medical treatment in which your skin is carefully exposed to ultraviolet light. | * [[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]] 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. | * [[Phototherapy]] for [[psoriasis]] can be given as [[UVA radiation|ultraviolet A]] (UVA) or [[UVB radiation|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. | 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: | Newer drugs called biologics specifically target the body's [[immune response]], which is thought to play a role in [[psoriasis]]. These [[Drugs (patient information)|drugs]] are used when other treatments do not work. Biologics approved for the treatment of [[psoriasis]] include: | ||
* [[Adalimumab]] ([[Humira]]) | * [[Adalimumab]] ([[Humira]]) | ||
| Line 118: | Line 124: | ||
* [[Etanercept]] ([[Enbrel]]) | * [[Etanercept]] ([[Enbrel]]) | ||
* [[Infliximab]] ([[Remicade]]) | * [[Infliximab]] ([[Remicade]]) | ||
* | * Stelara | ||
==Where to find medical care for Psoriasis?== | ==Where to find medical care for Psoriasis?== | ||
| Line 124: | Line 130: | ||
==What to expect (Outlook/Prognosis)?== | ==What to expect (Outlook/Prognosis)?== | ||
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. | [[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== | ==Possible complications== | ||
* Arthritis | * [[Arthritis]] | ||
* Pain | * [[Pain]] | ||
* Severe itching | * Severe [[itching]] | ||
* Secondary skin infections | * Secondary [[skin]] [[infections]] | ||
* Side effects from medicines used to treat psoriasis | * Side effects from medicines used to treat [[psoriasis]] | ||
* Skin cancer from light therapy | * [[Skin cancer]] from [[light therapy]] | ||
==Prevention of Psoriasis== | ==Prevention of Psoriasis== | ||
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. | 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. | 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== | ==Sources== | ||
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[[Category:Template complete]] | [[Category:Template complete]] | ||
[[Category:Dermatology]] | [[Category:Dermatology]] | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Latest revision as of 02:30, 10 August 2017
|
Psoriasis |
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Psoriasis On the Web |
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For the WikiDoc page for this topic, click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
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?
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:
- 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:
- Plaque:
- Pustular:
What causes Psoriasis?
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?
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
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?
- Call your health care provider if you have symptoms of psoriasis or if the skin irritation continues despite treatment.
- 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
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?
Directions to Hospitals Treating Psoriasis
What to expect (Outlook/Prognosis)?
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
- Arthritis
- Pain
- Severe itching
- Secondary skin infections
- Side effects from medicines used to treat psoriasis
- Skin cancer from light therapy
Prevention of Psoriasis
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.