In psoriasis, the skin renews itself faster than in healthy people, which is noticeable in the form of scales on a reddened base (plaques) and itching. Due to the dandruff, psoriasis can significantly reduce the quality of life of patients.
Psoriasis is the medical term for psoriasis. It is a non-contagious, chronic inflammatory skin disease . In addition to the skin, nails, soft tissues, eyes, blood vessels, joints and even organs can also be affected by psoriasis. Psoriasis often occurs in phases. Due to the visually striking changes in the skin, many sufferers have high levels of suffering. In order to draw attention to psoriasis and to inform about the disease, the 29.10. declared Psoriasis Day worldwide.
Rapid skin renewal
The skin flakes typical of psoriasis are caused by excessive skin cell renewal. Our skin normally renews itself in about a 28-day cycle. The skin cells migrate from the inside out to the skin surface and are repelled. With psoriasis, skin renewal only takes 3 to 6 days, which is much faster than with healthy skin.
In psoriasis, the skin cells cluster on the surface of the skin and create the typical complexion. Due to the increased skin cell formation, the affected areas are well supplied with blood. That is why the skin flakes appear on a mostly reddened base.
Because of the rapid growth, the flakes of skin do not lie very firmly on the skin. But they are still connected to the lower layers of the skin. Therefore, when the scales are lifted off, the lower layers of the skin also loosen (phenomenon of the last membrane). After the scales have been removed, punctiform bleeding often remains (phenomenon of bloody dew or Auspitz phenomenon).
The following parts of the body are particularly often affected by psoriasis:
- Extensor sides of the arms and legs (especially elbows, shins, and kneecaps)
- Hands, feet (especially knuckles, often with painful cracks or blisters)
- Abdomen, chest and back (especially armpits, sacrum and navel area)
- hairy scalp (the thicker the hair, the more difficult the treatment) and facial area (including eyebrows and earlobes)
- Fingernails (pitting and discoloration as so-called dotted and oil-stained nails)
- Sex organs, anus area (especially gluteal folds)
- Severe psoriasis can affect the entire skin.
Psoriasis affects around 2 to 3 percent of all Central Europeans.
Primarily, the symptoms of psoriasis show up on the skin. Affected skin areas are reddened and covered with silvery-white scales. These spots can be punctiform and small, but also up to the size of a palm. Usually psoriasis foci are very limited, but can also flow together over a large area. The skin flakes have a sebum-like consistency (so-called candle wax phenomenon) and usually do not itch (exceptions are possible).
Doctors differentiate between different forms of psoriasis. Psoriasis vulgaris, the so-called common psoriasis, is the most common with around 90 percent of all forms of psoriasis. It almost always begins before the age of 40 and often occurs in families. There are also special forms, for example:
- Psoriasis geographica: similar to a map, psoriasis foci converge
- Psoriasis punctata: psoriasis foci the size of a match head, often all over the upper body
- Pustular psoriasis: severe inflammatory form of psoriasis, more pustules than dandruff, especially on the soles of the feet and palms
- Psoriasis inversa: Symptoms not on the extensor sides, but much more on the flexor sides, in spaces between the skin (intertriginous) as well as in the armpit, groin and genital region
- Psoriasis arthritis (also psoriasis arthropatica): Involvement of the joints (in about 10 to 15% of all psoriasis patients). Joint inflammation can occur with or without skin symptoms; finger and toe joints as well as wrists and ankles are often affected.
In any case, a strong hereditary component can be assumed to be the cause of psoriasis. But that does not mean that psoriasis is always passed on directly from parents to children. There are even cases where both parents with psoriasis have healthy children and the next cases of psoriasis don’t appear until several generations later.
Genetic predisposition alone does not seem to be a sufficient cause of psoriasis. Further triggers are needed for a disease flare-up, such as:
- Infections (e.g. colds , angina , otitis media )
- Metabolic disorders and hormonal fluctuations
- certain medications (e.g., antimalarials, lithium, beta blockers, interferons, or non-steroidal anti-inflammatory drugs such as acetylsalicylic acid or ibuprofen)
- excessive nicotine and alcohol consumption
- Environmental influences and stressful or changing climatic conditions
- emotional strain and stress
- Skin injuries or irritation ( sunburn , tattoos, scratching, rubbing clothing such as belts or bras).
The diagnosis of psoriasis is easy based on the obvious skin symptoms. Your doctor will be able to identify the phenomena typical of psoriasis – candle wax phenomenon, phenomenon of the last membrane and bloody dew even with a superficial examination of the skin. It is not necessarily obvious at first glance whether the joints are also affected by psoriasis. To identify psoriasis on joints, an x-ray is necessary.
Therapy for psoriasis by a dermatologist in new delhi can often relieve the symptoms of the disease very well. However, psoriasis is currently not curable. A variety of therapeutic approaches are followed to relieve symptoms, usually combined with drug treatment for psoriasis. In the following you will first read about the drug options, then about the other therapies for psoriasis.
Drug therapy for psoriasis
Drug therapy for psoriasis depends on the severity of the disease. In mild cases it is often sufficient to use the following externally applicable and over-the-counter drugs:
- Ointment bandages with lactic acid or salicylic acid help to remove the flakes of skin.
- Coal tar and sulfur have an anti-itch effect and slow down cell division.
- Dithranol (cignoloin) also inhibits cell division.
- Creams and lotions with vitamin D derivatives (derivatives) such as calcipotriol, calcitriol and tacalcitol have anti-inflammatory effects.
- In the case of severe infestation or in exceptional situations (such as celebrations or social appearances), medication containing cortisone can be applied.
- Vitamin B12 in an ointment base made from avocado oil is said to relieve the skin symptoms of psoriasis.
- Urea-containing oils, creams or ointments have a nourishing effect and keep the skin supple.
Drugs for severe psoriasis
In the case of pronounced psoriasis, a so-called systemic therapy, i.e. therapy that affects the entire body, can be useful. Often prescribed drugs contain active ingredients such as methotrexate (MTX), vitamin A derivatives (retinoids such as acitretin, also together with UV radiation), cortisone (also as an injection), ciclosporin and fumaric acid ester. There are also so-called biologics that are used when other active ingredients and light therapies have not been sufficiently effective. Such biotechnologically produced substances are the so-called TNF blockers adalimumab, infliximab and ustekinumab as well as the fusion protein etanercept.