Six common psoriasis questions, answered by dermatologists
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Psoriasis affects more than eight million people in the United States. Often painful and occasionally embarrassing, what is it, and how can it be treated? The Dermatologists at Skin Cancer & Dermatology Institute answer these and other common questions.
Q: What is psoriasis?
A: Psoriasis is an auto-immune disorder that, according to the American Academy of Dermatology, causes the body to accelerate the production of skin cells in days rather than weeks. As cells begin to pile up on the skin’s surface, scaly patches are created. Patches can grow anywhere; however, the most commons areas are the scalp, elbows, knees, and lower back. Symptoms can start at any age, more often beginning between the ages of 15 and 25. Men, women, and children of all skin tones can get psoriasis.
Q: What causes psoriasis?
A: People who have certain genes are more likely to get psoriasis. If your parents, grandparents, or siblings have psoriasis, it increases the likelihood of getting it.
Your immune system also plays a significant role. White blood cells (T-cells) are cells that help our body combat bacteria and viruses. With psoriasis, something goes awry in the immune system, causing the T-cells to attach to the body’s skin cells leading to the accelerated production of cells and the patchy areas. Once this process begins, it usually turns into a life-long concern. There is one exception for some children who get guttate psoriasis, a one-time condition that does not return.
Q: What are the types of psoriasis and their symptoms?
Plaque psoriasis: is the most common form, affecting roughly 80-90% of those who develop psoriasis. Dry, scaly patches form anywhere on the scalp, elbows, knees, or lower back. Plaques vary in size, with small plaques frequently joining to create large plaques.
Guttate psoriasis: tiny bumps appear on the skin out of nowhere, covering most of the torso, legs, and arms and at times also developing on the face, scalp, and ears. The bumps are small and scaly, and the color varies from salmon-colored to pink. This type of psoriasis tends to clear up within a few months, or even weeks, and sometimes does not return.
Inverse psoriasis: develops in areas where skin touches skin, such as armpits, and creates smooth, red patches of skin that look raw. Fungal infections can trigger this type of psoriasis.
Pustular psoriasis: This rare form of psoriasis causes pus-filled bumps that appear on the feet and hands, sometimes mimicking an infection, although the skin is not infected. Extremely sore or painful skin with brown dots and sometimes scales as the pus-filled bumps dry. Since this type attacks mostly hands or feet, it makes activities like walking painful.
Generalized pustular psoriasis: causes pus-filled bumps, similar to pustular psoriasis, with the main difference being the bumps develop on most of the skin. According to the American Academy of Dermatology, when a flare-up occurs, it causes a sequence of events: skin on most of the body suddenly turns dry, red, and tender. Within hours pus-filled bumps cover most of the skin. Typically, within a day, the bumps pop, and pools of pus leak. Within 24-48 hours, the pus dries, leaving dry, peeling skin with a smooth, glazed surface. The cycle tends to repeat itself a few days or weeks later. Fever, headaches, muscle weakness may develop in tandem.
Erythrodermic psoriasis: causes the skin on most of the body to look burnt. Other symptoms include chills, fever, muscle weakness, rapid pulse, and severe itch. Immediate medical care is required. This is the least common type of psoriasis.
Nail psoriasis: causes tiny dents in your nails with white, yellow, or brown discoloration under one or more nails. Some people experience crumbling and rough nails.
Psoriatic arthritis: this occurs when psoriasis affects the joints. If you suffer from any form of psoriasis, it is essential to pay attention to any irregularities in your joints. Some signs include swollen and tender joints, especially in a finger or toe, heel pain, swelling on the back of your leg, and stiffness in the morning that fades during the day. Without treatment, psoriatic arthritis can hinder movement.
Q: What triggers a psoriasis flare-up?
A: Everyday things can be triggers and vary from person to person. Some of the most common triggers are stress, skin injury (including a bad sunburn), infection (e.g., strep throat), some medication, weather (especially cold, dry weather), tobacco, and alcohol.
Q: Is psoriasis contagious?
A: Rest easy. Psoriasis is not like chickenpox; it is not contagious.
Q: Can psoriasis be cured?
A: The disease is often a sub-chronic disorder which ebbs and flows but does not resolve completely.
“While psoriasis is not curable, it is treatable with topical corticosteroid creams, light therapy, laser treatment or with injectable immunomodulatory drugs like etanercept (Enbrel®) or adalinumab (HUMERA®). Recent versions of similar medications like secukinumab (COSENTYX®) or risankisumab (SKYRIZI™) have become more targeted by diminishing inflammatory mediators specific to psoriasis without affecting other immune functions,” said Skin Cancer & Dermatology Institute’s newest Board-Certified Dermatologist, Adam Wallach. “There can be little to no blood work monitoring required, and while early immunomodulatory drugs consisted of weekly injections, some of the current ones call for only one self-administered shot just four times a year. Laser treatments can also deliver consistently predictable results. The clinically proven excimer laser, XTRAC®, can quickly clear psoriasis with many patients seeing significant improvement and long-lasting remissions.”
If you or a loved one are ready to take control of psoriasis, book a Medical Dermatology consultation online at SkinCancerDerm.com or call 775.324.0699.
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