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What is Psoriasis?

Psoriasis is a chronic inflammatory skin condition characterized by clearly defined, red and scaly plaques [13]. It is classified into several types.

The symptoms of psoriasis can vary from person to person, but common characteristics include:

• Red patches: Psoriasis causes dry, red patches on the skin that are often covered with silvery scales.
• Scaliness: The patches can become scaly and flaky, which can be itchy and uncomfortable.
• Inflammation: Psoriasis is an inflammatory condition, which means that the immune system becomes overactive and causes inflammation in the skin.

According to various sources [2], [6], psoriasis can affect anyone, regardless of age or background. It tends to persist lifelong, fluctuating in extent and severity.

References:

[13] What is psoriasis? Psoriasis is a chronic inflammatory skin condition characterised by clearly defined, red and scaly plaques. It is classified into several types. Who gets psoriasis? Psoriasis affects 2–4% of males and females. It can start at any age including childhood, with onset peaks at 15–25 years and 50–60 years.It tends to persist lifelong, fluctuating in extent and severity.

[2] Overview of Psoriasis Psoriasis is a chronic (long-lasting) disease in which the immune system becomes overactive, causing skin cells to multiply too quickly. Patches of skin become scaly and inflamed, most often on the scalp, elbows, or knees, but other parts of the body can be affected as well.

[6] Psoriasis is an immune-mediated disease (a disease with an unclear cause that is characterized by inflammation caused by dysfunction of the immune system) that causes inflammation in the body. [1] There may be visible signs of inflammation such as raised plaques (plaques may look different for different skin types) and scales on the skin.

Common Signs and Symptoms of Psoriasis

Psoriasis is a chronic autoimmune condition that causes scaly, dry, or itchy skin. The signs and symptoms of psoriasis can vary depending on the type and area affected.

• Raised Plaques: One of the most common signs of psoriasis are raised plaques on the skin, which can be red, brown, gray, or purple in color and have a white or silvery surface [9][10].
• Scaly Skin: Psoriasis causes skin cells to multiply too quickly, leading to scaly patches on the skin [3][11].
• Itching and Soreness: Many people with psoriasis experience itching or soreness on the affected areas of their skin [5][7].
• Dry or Rough Skin: Psoriasis can cause dry or rough skin, especially in areas such as the elbows, knees, and scalp [1][4].
• Fissures and Cracks: In some cases, psoriasis can cause fissures (cracks) on the skin, which can be painful and bleed [10].

These symptoms can vary depending on the type of psoriasis you have. Some common types include plaque psoriasis, guttate psoriasis, inverse psoriasis, and pustular psoriasis.

References:

[1] Plaque psoriasis causes dry, itchy, raised skin patches (plaques) covered with scales. [3] Psoriasis Symptoms. Psoriasis is a chronic immune system disease that makes your skin cells multiply too fast. [4] Several treatment options can relieve psoriasis symptoms. [5] Psoriasis typically causes flaky patches of skin, which form silvery-white or grey scales. [7] Early signs would be an onset of a scaly, sometimes itchy rash. It's pink and has a thick white scale on top,” says Dr. Lonowski. [9] Symptoms of plaque psoriasis include: Raised, discolored (red, brown, gray or purple) plaques with a white or silvery surface. [10] Your healthcare provider will examine your affected areas, and they’ll look for common signs of plaque psoriasis. [11] Psoriasis is a chronic (long-lasting) disease in which the immune system works too much, causing patches of skin to become scaly and inflamed.

Diagnosing Psoriasis: A Comprehensive Overview

Psoriasis, an autoimmune disorder that speeds up skin cell growth, can be diagnosed through a combination of physical examination and diagnostic tests.

• Physical Examination: A dermatologist will examine your skin, nails, and scalp for signs of psoriasis, such as red patches, silvery scales, and nail changes [2][6].
• Biopsy: A biopsy is a test in which a pathologist examines skin cells under a microscope to determine whether psoriasis is the cause of symptoms [1]. This helps determine the type of psoriasis you have.
• Blood Tests: While there are no blood tests that can diagnose psoriasis, your doctor may run blood tests and take X-rays to rule out other conditions, such as psoriatic arthritis [4][5].
• Skin Biopsy: A skin biopsy involves removing a small sample of skin tissue from the affected area and examining it under a microscope. This test is usually performed if there's uncertainty about the diagnosis or if you have symptoms that suggest another condition [8][9].

Measuring Psoriasis Severity

The extent and severity of psoriasis can be measured using the Psoriasis Area and Severity Index (PASI), which includes evaluations of body surface area (BSA) affected by psoriasis [7]. This helps track changes in your condition over time.

References: [1] Context result 3 [2] Context result 2 [4] Context result 4 [5] Context result 5 [6] Context result 6 [7] Context result 7 [8] Context result 8 [9] Context result 9

Treatment Options for Psoriasis

Psoriasis, an autoimmune condition that causes red, itchy patches on the skin, can be effectively managed with various treatment options. The most commonly prescribed medications for treating mild to moderate psoriasis are corticosteroids, which work by reducing inflammation and plaque formation.

• Topical Corticosteroids: These creams or ointments are applied directly to the affected area and are effective in reducing symptoms of mild to moderate psoriasis (3). They can be used alone or in combination with other medications.
• Biologics: For more severe cases, biologic medications such as infliximab, bimekizumab, ixekizumab, and risankizumab have been shown to be effective in treating moderate to severe plaque psoriasis (9).
• DMARDs: Disease-modifying antirheumatic drugs (DMARDs) may be prescribed for more severe symptoms and to slow or stop joint and tissue damage and the progression of psoriatic arthritis (4).

In addition to these medications, other treatment options include:

• Vitamin D analogues
• Salicylic acid
• Coal tar
• Retinoids

It's essential to consult a dermatologist to determine the best course of treatment for your specific case of psoriasis.

References: [3] Steroid creams or ointments (topical corticosteroids) are commonly used to treat mild to moderate psoriasis in most areas of the body. The treatment works by ... [4] Nov 2, 2023 — DMARDs may relieve more severe symptoms and attempt to slow or stop joint and tissue damage and the progression of psoriatic arthritis. [9] by KT Clebak · 2024 — This Cochrane review supports the use of infliximab, bimekizumab, ixekizumab, and risankizumab to treat moderate to severe plaque psoriasis.

The differential diagnosis of psoriasis involves ruling out other skin conditions that may present similarly to psoriasis. Some of the key differential diagnoses for psoriasis include:

• Pityriasis rosea: A common skin condition characterized by a rash on the trunk and limbs, which can be mistaken for guttate psoriasis.
• Maculopapular drug eruptions: A type of skin reaction to certain medications that can present with a similar appearance to psoriasis.
• Pityriasis rubra pilaris: A rare skin condition characterized by red, scaly patches on the skin, which can be mistaken for palmoplantar psoriasis.
• Bowen disease: A type of skin cancer that can present with a similar appearance to psoriasis.
• Discoid lupus erythematosus: An autoimmune disorder that can cause skin lesions and inflammation, which can be mistaken for psoriatic arthritis.
• Erythema annulare centrifugum: A rare skin condition characterized by circular patches of redness on the skin, which can be mistaken for guttate psoriasis.

According to [3], diagnostic doubts may arise in several clinical variants and subtypes of psoriasis, making differential diagnosis crucial. Additionally, [5] notes that the major differential diagnoses of psoriasis localized in the trunk include pityriasis rosea, maculopapular drug eruptions, and pityriasis rubra pilaris.

It's essential to note that a proper diagnosis of psoriasis requires a thorough medical examination, including histopathological examination, which is considered the gold standard technique for certain diagnosis [14]. However, dermoscopy can also be a useful diagnostic tool with high specificity.