psoriasis 3

What is Psoriasis?

Psoriasis is a chronic inflammatory skin condition characterized by clearly defined, red and scaly plaques [3]. It is classified into several types.

Key Characteristics:

• Clearly defined, red and scaly plaques
• Chronic (long-lasting) nature of the disease
• Inflammatory in nature

Who Gets Psoriasis?

Psoriasis affects 2–4% of males and females, with onset peaks at 15–25 years and 50–60 years [3]. It tends to persist lifelong, fluctuating in extent and severity.

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Common Signs and Symptoms of Psoriasis

Psoriasis is a chronic immune system disease that makes your skin cells multiply too fast, leading to various signs and symptoms. The most common sign of psoriasis is the appearance of dry, thick, and raised patches on the skin, often covered with a silvery-white coating called scale. These patches can be itchy and may appear on the elbows, knees, lower back, and scalp.

Common Symptoms:

• Dry, thick, and raised patches on the skin
• Itching or soreness
• Flaky patches of skin forming silvery-white or grey scales
• Red or discolored skin
• Cracks (fissures) in the skin
• Bleeding

These symptoms can vary depending on the type of psoriasis you have, and some people may experience additional symptoms such as joint pain, aches, soreness, or discomfort.

References:

• [1] Dry, thick, and raised patches on the skin are the most common sign of psoriasis. These patches are often covered with a silvery-white coating called scale, and they tend to itch.
• [2] Psoriasis can cause many signs and symptoms, including dry, thick, and raised patches on the skin.
• [3] Psoriasis is a chronic immune system disease that makes your skin cells multiply too fast.
• [5] Patches of thick, red skin with silvery-white scales that itch or burn, typically on the elbows, knees, scalp, trunk, palms, and soles of feet.
• [6] Flaky patches of skin, which form silvery-white or grey scales.
• [8] An onset of a scaly, sometimes itchy rash. It's pink and has a thick white scale on top.
• [10] Some common symptoms of plaque psoriasis (which is the most common kind) include: Plaques. On lighter skin, they may appear as red or purple patches with a white or silvery surface.
• [11] Symptoms of plaque psoriasis include: Raised, discolored (red, brown, gray or purple) plaques with a white or silvery surface. Cracks (fissures). Bleeding.

Diagnostic Tests for Psoriasis

Psoriasis diagnosis involves a combination of physical examination, medical history, and sometimes laboratory tests to confirm the condition. Here are some diagnostic tests used to diagnose psoriasis:

• Physical Examination: A dermatologist or primary care doctor will examine your skin, scalp, and nails for signs of psoriasis, such as thick, red, scaly patches and other rashes.
• Skin Biopsy: In some cases, a biopsy may be performed to confirm the diagnosis. This involves removing a small sample of skin tissue from the affected area and examining it under a microscope.

According to [3], your doctor will also ask questions about your health and medical history, such as whether you experience symptoms like itchy or burning skin, had a recent illness or experienced severe stress, and take certain medications. This information helps determine the best course of treatment for psoriasis.

Additionally, a physical exam and skin biopsy can test for and diagnose psoriasis [5]. These tests are usually performed by a dermatologist or primary care doctor.

References:

• [3] - To diagnose psoriasis, your doctor usually examines your skin, scalp, and nails for signs of the condition. They may also ask questions about your health and medical and family history...
• [5] - A physical exam and skin biopsy can test for and diagnose psoriasis. Psoriasis is an autoimmune disorder that speeds up the growth of skin cells and causes raised, thick patches on the body...

Biologics for Treating Psoriasis

According to recent clinical trials, biologics have been shown to be effective in treating psoriasis. In fact, each of the biologic drugs tested lowered psoriasis activity by at least 75% in many people [3]. This suggests that biologics can be a good treatment option for individuals with moderate to severe psoriasis.

How Biologics Work

Biologics work by altering the immune system's response to psoriasis. They target specific proteins involved in the disease process, disrupting the cycle of inflammation and improving symptoms [9]. Several biologic drugs have been approved for treating moderate to severe plaque psoriasis, including infliximab, bimekizumab, ixekizumab, and risankizumab [8].

Benefits and Considerations

Biologics can be an effective treatment option for individuals with moderate to severe psoriasis who haven't responded to first-line therapies. However, they are typically administered by injection and may have potential side effects [9]. It's essential to discuss the benefits and risks of biologic therapy with a healthcare provider to determine if it's the right treatment plan.

References: [3] Jan 10, 2023 — Biologics are good at treating psoriasis. In clinical trials, each of the drugs lowered psoriasis activity by at least 75% in many people. [8] by KT Clebak · 2024 — This Cochrane review supports the use of infliximab, bimekizumab, ixekizumab, and risankizumab to treat moderate to severe plaque psoriasis. [9] These drugs, usually administered by injection, alter the immune system in a way that disrupts the disease cycle and improves symptoms and signs of disease within weeks. Several of these drugs are approved for the treatment of moderate to severe psoriasis in people who haven't responded to first line therapies.

Principal Differential Diagnoses of Psoriasis

Psoriasis, a chronic autoimmune skin condition, can be challenging to diagnose due to its similarity in appearance with other skin conditions. The principal differential diagnoses of psoriasis include:

• Pityriasis Lichenoides Chronica: A rare skin condition characterized by small, scaling patches on the skin.
• Pityriasis Rosea: A common skin condition marked by a herald patch followed by an eruption of oval-shaped patches on the trunk and limbs.
• Secondary Syphilis: A sexually transmitted disease that can cause a rash on the skin, which may be mistaken for psoriasis.
• Tinea Corporis: A fungal infection of the skin, also known as ringworm, characterized by a raised border and slowly extending edge.

These conditions can mimic the symptoms of psoriasis, making accurate diagnosis crucial. A healthcare professional should consider these differential diagnoses when evaluating patients with suspected psoriasis.

References: [3] Aug 1, 2009 — Principal differential diagnoses include pityriasis lichenoides chronica, pityriasis rosea, secondary syphilis, and tinea corporis. [4] Differential diagnosis of psoriasis includes discoid dermatitis (itch, vesicles, dry), tinea corporis (raised border, slowly extending edge, positive mycology), and pityriasis rosea (herald patch, fir-tree distribution of oval plaques, duration less than 3 months).