What are some medical treatments for psoriasis?


What is psoriasis?

Psoriasis, also known medically as psoriasis, is a chronic inflammatory disease that manifests itself in very reddened and flaky areas of the skin. The disease is benign, but due to its recurring course it is always unpleasant for affected patients, and especially due to its severe itching, the patients are even more stressed.

What are the symptoms of psoriasis?

Probably the most common symptoms of psoriasis are reddish and slightly raised spots on the skin, which are usually sharply defined. The spots are usually small and rounded, but in some cases they can also take on larger dimensions and cause extensive itching. Normally you can scrape off the superficial layers of the psoriasis, but the deeper layers underneath are more firmly attached to the skin and peeling them off leads to small skin bleeding (so-called Auspitz effect).

On which parts of the body can psoriasis occur?

In general, any part of the skin can be affected by psoriasis, but there are predilection sites that are observed very frequently. This includes:

  • Head (hairy area)
  • knee
  • Elbow
  • Gluteal fold
  • strip
  • Navel region
  • Retro-auricular (behind the ears)
  • Sacrum

If there is a severe form of psoriasis, it is not limited to small areas of the skin, but can occur diffusely on all parts of the body. The psoriasis does not occur continuously, but rather in spurts. How long and how heavy each individual thrust can be, is very different. The symptom-free times between attacks can also vary greatly, with periods ranging from a few weeks to several years being observed.

Which types of psoriasis are differentiated?

Doctors differentiate between different types of psoriasis, depending on the severity, location and type. The most common and widespread type is psoriasis vulgaris, in English: common psoriasis. The other types include:

  • Guttate psoriasis
  • Pustular psoriasis
  • Eruptive-exanthematic psoriasis
  • Psoriatic erythroderma
  • Inverse psoriasis
  • Exudative psoriasis
  • Psoriasis capitis
  • Psoriasis of the nails (spotted nails)
  • Psoriatic arthritis

Guttate psoriasis: A rare form of psoriasis that can often appear after tonsillitis. It manifests itself in the form of many, small reddish spots that can occasionally be itchy. Sometimes the psoriasis withdraws completely after the infection has been successfully overcome, but in some cases it can also turn into chronic psoriasis vulgaris.

Exudative psoriasis: This form of psoriasis is highly inflammatory and has a similar course to exanthematic psoriasis. The spots blush and form a peripheral border. It also pus emerges from the wounds to the surface and forms yellowish crusts that can cover the psoriasis.

Pustular psoriasis: This is a rather rare form of psoriasis. The appearance are vesicles (pustules) filled with pus on reddened skin. Predisposing parts of the body in this form are feet and hands (psoriasis palmoplantaris), but it can also occur in a generalized manner all over the body.

Inverse psoriasis: This form occurs predominantly on parts of the body that are rubbing against each other, such as the armpits, the gluteal folds or the hollows of the knees.

There may also be comorbidities associated with psoriasis, including Psoriatic arthritis, as psoriasis can spread to the joints in some cases and cause an inflammatory reaction there. Psoriasis can also lead to changes in the fingernails and toenails (so-called spot nails).

What are the causes of psoriasis?

The exact causes for the development of psoriasis are still not well understood. What we do know, however, is that psoriasis is not a contagious disease and that there are hereditary predispositions. However, medical professionals also assume that there are autoimmune reactions, which means that a faulty regulation of the body's own immune system can be the basis and favor its development.

In addition to a genetic predisposition, there are also some risk factors that can contribute to the development of psoriasis. For example, patients have been observed who have also developed psoriasis, regardless of its duration, after an almond infection from streptococci. Some drug interactions or severe stress can also trigger psoriatic symptoms. In addition, immunosuppressed people, such as HIV-infected patients, have a higher risk of developing psoriasis.

How does the doctor diagnose psoriasis?

The dermatologist usually recognizes normal psoriasis or plaque psoriasis through his visual diagnosis. It is characterized by typical parts of the body, for example on the elbows, head, anal folds or on the knees. He can also test for Auspitz's phenomenon and further confirm the diagnosis by removing the top layer of the scales and seeing if there is any small bleeding on the skin.

He can also look at the patient's nail changes. Usually this diagnosis is sufficient to identify psoriasis. In some cases, however, it may be necessary to take a sample, for example if the doctor wants to rule out a differential diagnosis compared to other diseases, because the following diseases can also cause psoriatic changes:

  • Fungal diseases
  • syphilis
  • Seborrheic eczema
  • Skin lichen

If there is any reason for psoriasis caused by streptococci, the dermatologist will normally take a swab of the nasopharynx and send it to a microbiological laboratory for diagnosis.

Psoriasis therapy

The treatment of psoriasis depends largely on its location and the severity of its severity. For a mild form of psoriasis, the doctor will mainly rely on gels, ointments, and other medications. These include, for example, cortisone, vitamin D3 or vitamin A therapies. In severe or moderate forms, the specialist relies on immunosuppressants such as ciclosporin or methotrexate.

An effective treatment can be a light therapy be. The skin is irradiated with light rays in the range of about 310 nanometers. This effective method can also be reinforced by certain drugs such as psoralen. In this context there is also laser therapy, which can only be fixed on the diseased skin areas. Many studies have shown that laser therapy has a positive effect on psoriasis without destroying healthy skin tissue.

If the cause of psoriasis is a streptococcal infection, an attempt will be made to destroy the bacteria and thus achieve an improvement. In addition to the above-mentioned procedures, there are also other treatment options such as climate therapy or brine therapy.

Psoriasis disease progression

The disease often occurs in young adulthood, but in some cases it can break out much earlier or much later. It does not arise slowly, but directly and in spurts, which means that there can also be symptom-free periods. The course of the disease can be very specific: localization, severity and type as well as frequency and duration can vary greatly with each episode.

According to current medical knowledge, psoriasis cannot be cured. After the first appearance, it occurs again and again in different forms. Symptom-free phases can spontaneously turn back into psoriasis or they can also be triggered by therapy. Very rarely, psoriasis can go away on its own and never recur.

Which specialists and clinics are specialists in psoriasis?

Are medical experts in the diagnosis and treatment of psoriasis Dermatologists and dermatologists . If the joints are involved, a rheumatologist should be consulted.

We help you to find an expert for your illness. All doctors and clinics listed have been checked by us for their outstanding specialization in the field of psoriasis and are awaiting your inquiry or your treatment request.