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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.
See also: Guttate psoriasis
Psoriasis is a very common condition. The disorder may affect people of any age, but it most commonly begins between ages 15 and 35.
The condition 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. See also: Inflammatory response
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:
In general, psoriasis may be severe in people who have a weakened immune system. This may include persons who have:
Up to one-third of people with psoriasis may also have arthritis, a condition known as psoriatic arthritis.
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:
Psoriasis may affect any or all parts of the skin. There are five main types of psoriasis:
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.
The goal of treatment is to control your symptoms and prevent infections.
In general, three treatment options are used for patients with psoriasis:
Most cases of psoriasis are treated with medications that are placed directly on the skin or scalp:
If you have an infection, your doctor will prescribe antibiotics.
You may try the following self-care at home:
Some people may choose to have phototherapy.
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:
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.
Call your health care provider if you have 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.
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.
Gottlieb A, Korman NJ, Gordon KB, Feldman SR, Lebwohl M, Koo JY, et al. Guidelines for the management of psoriasis and psoriatic arthritis. Section 2. Psoriatic arthritis: overview and guidelines of care for treatment with an emphasis on biologics. J Am Acad Dermatol. 2008;58:851-864.
Menter A, Korman NJ, Elmets Ca, Feldman SR, Gelfand JM, Gordon KB, et al. American Academy of Dermatology guidelines of care for the management of psoriasis and psoriatic arthritis. Section 3. Guidelines of care for the management and treatment of psoriasis with topical therapies. J Am Acad Dermatol. 2009;60:643-659.
Menter A, Gottlieb A, Feldman SR, Voorhees ASV, Leonardi CL, Gordon KB, et al. Guidelines for the management of psoriasis and psoriatic arthritis. Section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics. J Am Acad Dermatol. 2008;5:826-850.
Stern RS. Psoralen and ultraviolet a light therapy for psoriasis. N Engl J Med. 2007;357(7):682-690.