Eczema: Red Itchy Irritated Skin
Like psoriasis, eczema is a chronic skin condition that often causes intense itching. Scratching causes redness and inflammation of the skin, leading to a worsening of the eczema. Scratching can also cause a secondary bacterial infection. The most common type of eczema is caused by a reaction to irritants like detergents, soaps, or household cleansers. So if you have eczema, you should be careful to use mild soap and regularly moisturize your sensitive skin. Your doctor may prescribe a steroid cream or other medications if eczema is severe.
Home Treatment For Psoriasis
There are some home remedies that may help minimize outbreaks or reduce symptoms of psoriasis:
- Exposure to sunlight.
- Apply moisturizers after bathing to keep skin soft.
- Avoid irritating cosmetics or soaps.
- Do not scratch to the point you cause bleeding or excessive irritation.
- Over-the-counter cortisone creams can reduce itching of mild psoriasis.
A dermatologist may prescribe an ultraviolet B unit and instruct the patient on home use.
Early Stages Of Psoriatic Arthritis
Recognizing the signs of psoriatic arthritis can be tricky since symptoms differ from patient to patient. For example, one person can experience psoriasis skin involvement and peripheral arthritis, another may experience axial disease , and someone else could have a combination of all three.
Whats more, especially during early disease, you may confuse your symptoms with other conditions. People can mistake enthesitis, inflammation of the entheses for tennis elbow or dactylitis for an infection, explains Dr. Mikulik.
If you have psoriasis and are having pain in your tendon and musculature and you think maybe Ive been too active lately, that may be the first sign of PsA, says Dr. Haberman. Doctors commonly hear people chalk up their symptoms to overuse, such as getting more exercise than usual or doing work around the house.
If you experience any of the following signs of early psoriatic arthritis its important to see your doctor as soon as possible:
- Back pain
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What Can I Do As A Young Person With Psoriasis
Here are some popular home remedies for scalp psoriasis:
- aloe vera cream applied three times a day to the scalp and other effected areas
- apple cider vinegar solution, washing over effected areas
- baking soda and water paste, used to reduce scalp itchiness
- capsaicin cream, used to reduce flaking, redness, and inflammation
- coconut or avocado oil, to moisturize affected areas
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What The Stages Of Chickenpox Look Like
Chickenpox is a highly contagious infection caused by the varicella-zoster virus . Itâs characterized by the outbreak of a blister-like rash that appears first on the face and trunk, and then quickly spreads over the body.
While many can easily identify a case, perhaps because of known exposure or knowledge of what chickenpox looks like, reviewing pictures of chickenpox in its various stages can offer a sense of how the rash will progressand help you know when youâre least likely to pass the virus on to someone else.
From the time symptoms first appear, it usually takes a week or two for the immune system to bring the chickenpox infection under control.
Itching and scratching at night
- sitting on the hands
- worrying about other people seeing or touching the skin flakes
- concerns about cooking or working in a job with food
- skin flakes showing up on dark coloured clothes and hair
- getting distracted and picking at skin flakes
- doing more cleaning, such as hoovering and changing bedding
- finding symptom relief products to gently remove flakes, such as exfoliating gloves for Lucy
- difficulties shaving Damini and Lisa found their skin cut more than usual, though Simon found his psoriasis skin was less prone to bleeding
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Treatments For Plaque Psoriasis
There are a variety of plaque psoriasis treatments. Some people use over-the-counter products, while others get one or more treatments prescribed by a doctor or dermatologist. These include:
Topicals work on the skin surface and are often the first treatment when someone is diagnosed. They can come in gels, ointments or creams that are prescribed by your doctor or bought over the counter.
Oral treatments are medicines you take by mouth. They work within the body by suppressing all or part of the immune system.
Biologics target specific parts of the immune system. They attach to proteins involved with inflammation. Biologics work within the body and theyre typically given by injection.
How Is It Diagnosed
Its hard to diagnose any form of psoriasis, but the main way people are diagnosed with guttate psoriasis is through a physical examination the doctor will assess the spots to see if they are synonymous with what guttate psoriasis tends to appear as.
Sometimes doctors will request to perform a biopsy of the affected area, where a small area of the skin is removed to be tested at a laboratory. This is generally done under local anesthetic, so the pain is minimal.
Another option is a blood test. This wont show whether youre suffering from this type of psoriasis specifically, but it will help to rule out other types of infections that may present themselves in a similar way to guttate psoriasis.
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Regressive Stage Of Psoriasis
The regressive stage – or, as it is not quite accurately called, the last stage of psoriasis – comes after a stationary stage.
In fact, it is characteristic of many chronic diseases, a period of significant easing of symptoms and even their temporary disappearance, that is, the stage of remission.
At this stage, the morphological elements of the psoriatic eruptions are resolved: the plaques gradually cease to peel off, all scales are sloughed, the spots become flat itching passes.
Also, the regressive stage is manifested by temporary dyschromia, a violation of the pigmentation of the skin at the site of the disappeared papuloscentus foci. Usually the skin becomes lighter , rarely there is secondary hyperpigmentation.
To date, to achieve a stable remission and retention of the disease at this stage, in fact, and reduces the treatment of psoriasis.
And the definition of the stage of psoriasis, which is carried out on the basis of skin symptoms, is crucial for the selection of medications and physiotherapy to reduce the intensity of the manifestation of the disease.
Where Your Plaque Psoriasis Is Located Also Matters
Psoriasis can appear anywhere on the body, but it most often appears as:
- Psoriasis plaques on the outside of the elbows and knees
- Psoriasis plaques on the lower back
- Psoriasis plaques on the scalp
- Psoriasis plaques on the face
- Psoriasis plaques on the palms of the hands
- Psoriasis plaques on the soles of the feet
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What Are Other Types Of Psoriasis
Plaque psoriasis is the most common type. About 80% to 90% of people with psoriasis have plaque psoriasis.
Other, less common types of psoriasis include:
- Inverse psoriasis appears in skin folds. It may look like thin pink plaques without scale.
- Guttate psoriasis may appear after a sore throat caused by a streptococcal infection. It looks like small, red, drop-shaped scaly spots in children and young adults.
- Pustular psoriasis has small, pus-filled bumps on top of the red patches or plaques.
- Sebopsoriasis typically appears on the face and scalp as red bumps and plaques with greasy yellow scale. This type is a cross between psoriasis and seborrheic dermatitis.
What Is Facial Psoriasis
Facial psoriasis is a chronic skin condition in which there are one or more, persistent, thickened, red and dry patches on the face.
Psoriasis is a common chronic inflammatory skin disease that may affect any skin site. Facial involvement occurs at some time in about half those affected by psoriasis. Although it is usually mild, facial psoriasis is occasionally very extensive involving the hairline, forehead, neck, ears and facial skin.
It is extremely rare to have psoriasis occurring solely on the face. Most patients also have scalp psoriasis and they may also have moderate to severe psoriasis at other sites.
Patients with facial psoriasis often suffer from psychosocial problems due to the presence of unsightly red, scalyplaques on highly visible areas.
Facial involvement presents as a therapeutic challenge because facial skin is thin, sensitive and more complicated to treat.
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Plaque Psoriasis Treatment And Management
Management options for the treatment of psoriasis include:
- First-line therapy which includes traditional topical therapies – eg, corticosteroids, vitamin D analogues, dithranol and tar preparations.
- Second-line therapy which includes phototherapy, broad-band or narrow-band ultraviolet B light, with or without supervised application of complex topical therapies such as dithranol in Lassar’s paste or crude coal tar and photochemotherapy, psoralens in combination with UVA irradiation , and non-biological systemic agents such as ciclosporin, methotrexate and acitretin.
- Third-line therapy which refers to systemic biological therapies that use molecules designed to block specific molecular steps important in the development of psoriasis, such as the TNF antagonists adalimumab, etanercept and infliximab, and ustekinumab, anti-IL12-23 monoclonal antibody.
There is no strong evidence that any of the interventions have a disease-modifying effect or impact beyond improvement of the psoriasis itself.
How Is Psoriasis Diagnosed
Doctors usually diagnose psoriasis by examining the skin, scalp, and nails. They’ll also ask whether someone else in the family has psoriasis and if the child recently had an illness or started taking a new medicine.
Rarely, doctors might take a skin sample to check more closely. A biopsy can tell the doctor whether it’s psoriasis or another condition with similar symptoms.
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What Are The Types Of Psoriasis
In children, common types of psoriasis include:
Plaque psoriasis. This is the most common type of psoriasis. It causes plaques and silvery scales, usually on the knees, elbows, lower back, and scalp. They can be itchy and painful and may crack and bleed.
Guttate psoriasis. This type often shows up after an illness, especially strep throat. It causes small red spots, usually on the trunk, arms, and legs. Spots also can appear on the face, scalp, and ears.
Inverse psoriasis. This causes smooth, raw-looking patches of red skin that feel sore. The patches develop in places where skin touches skin, such as the armpits, buttocks, upper eyelids, groin and genitals, or under a womans breasts.
How Many People Have Psoriasis
Psoriasis is a fairly common skin condition and is estimated to affect approximately 1%-3% of the U.S. population. It currently affects roughly 7.5 million to 8.5 million people in the U.S. It is seen worldwide in about 125 million people. Interestingly, African Americans have about half the rate of psoriasis as Caucasians.
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The Role Of The Dermatologist
The recognition and early treatment of PsA is analogous to that of acne. We are aware of the importance of early recognition of acne and the urgency in treating it aggressively in order to induce remission and prevent further damage. The destruction of the joints in PsA follows the same principle: treat early to prevent the damage. The dermatologist who monitors a psoriatic patient can detect PsA at its earliest stage.
A study by Zanolli and Wikle concluded that a large portion of patients with psoriasis presenting to a dermatologist for treatment were recognized to have coexisting joint complaints and the prevalence of PsA is greater than that identified by a nondermatologist.21
The prevalence of psoriasis is greater than PsA, and psoriasis typically precedes the joint complaints.4,11,22 Therefore, the dermatologist is in a unique position to screen patients with psoriasis for PsA by maintaining a high index of suspicion and close follow-up. In limited cases, consultation with a rheumatologist may be necessary to make the diagnosis of PsA.
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How Can I Boost My Immune System To Fight Psoriasis
Salad greens, such as spinach, Swiss chard, and kale, as well as broccoli and cabbage, are full of rich vitamins and minerals. Studies have shown that they contain special immune-boosting compounds too. Filling your plate with these nutritious foods may help protect you from unwanted viruses and more.
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Enhancing Healthcare Team Outcomes
Plaque psoriasis is a complex life long disorder with enormous morbidity. Thus, it is best managed by an interprofessional team.
Insulin resistance and cardiovascular diseases are more common in psoriatic patients as are metabolic comorbidities. Obesity is the most common comorbidity observed in children with psoriasis. Many patients present with reduced quality of life and psychological manifestations and need special attention and counseling. Thus, primary care clinicians should advocate lifestyle modification such as reducing weight, reducing alcohol intake and smoking cessation may help control psoriasis, improve the results of treatment and prevent future complications.
Sudden onset, palmoplantar keratoderma, severe nail dystrophy, the involvement of skin folds should arouse suspicion of associated HIV infection in whom pustular forms are also more common with a higher frequency of arthritis.
Teaching Points
Outcomes
What Are The Symptoms
Guttate psoriasis is a form of psoriasis that isnt isolated to a specific area of the body. You may have a guttate psoriasis flare-up show up anywhere on your body. However, it does tend to show up first on your torso, arms or legs. It may then spread to your scalp and other parts of the body. When it does appear, it shows up in the form of small teardrop-shaped red spots . These can sometimes have a silver sheen to them, or they can be a bit flaky.
Guttate psoriasis gets its name from the Latin word gutta, which means drop. This reflects the teardrop-shaped spots that appear when someone is suffering from guttate psoriasis.
Another indication that the rash youre dealing with is guttate psoriasis is that the spots can also be quite itchy. Theyre not often painful but try not to scratch at the itch, as this can break the skin and cause the spots to become painful.
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What Are The Stages Of Guttate Psoriasis
Guttate psoriasis has three stages: mild, moderate and severe. Mild guttate psoriasis is where there are only a few spots on your skin, covering about 3% of your body. Moderate guttate psoriasis is the next stage where there may be spots on 3% to 10% of your body. Severe guttate psoriasis is the highest stage and could see spots covering 10% of your skin.
Future Developments And Treatments
To date, a stepwise approach is the treatment paradigm for psoriasis, starting with a topical agent, then phototherapy or a classic systemic medication, and ultimately a biologic therapy. It remains to be determined whether the introduction of even more targeted biologic therapies will influence this paradigm. In the future, there will be additional targeted biologic therapies , topical or oral small molecules , and oligonucleotides that target Toll-like receptors 7, 8 and 9 or function as a STAT3 decoy. Hopefully, the future development of biomarkers that predict individual responses to different therapies will provide a more cost-effective approach to therapy.
For additional online figures and references visitwww.expertconsult.com
eFig. 8.1. Psoriatic plaques.
JÖRG REICHRATH, MICHAEL F. HOLICK, in, 2005
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How Can Parents Help
For some children, psoriasis is just a minor inconvenience. For others, it is a difficult medical condition.
To manage symptoms and make outbreaks less likely, your child should:
- Wash hands well and often and stay away from people who are sick to prevent infections.
- Manage stress through exercise, yoga, or meditation.
- Not smoke or drink alcohol.
- Keep a healthy weight. People who are overweight tend to have more severe psoriasis symptoms.
Kids and teens with psoriasis may feel uncomfortable with the way their skin looks. Help your child understand that psoriasis is common and treatments can help.
Whether your child’s psoriasis is mild or severe, learn about the condition together. Offer to help find a therapist or join a support group if that might help. Talk to your doctor or check websites like:
Racial Disparity In Psoriasis
Psoriasis can affect persons of any race however, epidemiologic studies have shown a higher prevalence in western European and Scandinavian populations. In these groups, 1.5-3% of the population is affected by the disease.
The highest documented disease prevalence is in Arctic Kasach’ye, with 12% of the population affected, followed by Norway, where 4.8% of the population has psoriasis. Lower prevalence rates for psoriasis have been reported among Japanese and Inuit populations.
Psoriasis is thought to be rare in West Africans and African Americans and is nearly absent in North American Indians. Psoriasis was undetected in the Samoan population and in a study that examined 26,000 South American Indians.
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Disease Classification And Clinical And Histological Features
The term psoriasis encompasses a number of distinct clinical phenotypes , sometimes representing a dynamic, anatomical, or qualitative spectrum of the same disease , whereas, in other cases, most likely corresponds to a quite different entity .
Historically, disease classification has been based on clinical appearance, mainly differentiating according to localization and morphology. Here, we follow the recent classification proposed by the International Psoriasis Council, which identifies four main forms of psoriasis: plaque-type, guttate, GPP, and erythroderma, and several further subphenotypes according to distribution , anatomical localization , size and thickness of plaques, onset , and disease activity .
Acne: Blocked Pores That Lead To Pimples
Some forms of psoriasis appear as pus-filled blisters that may be confused with pimples. Pustular psoriasis forms white blisters that are filled with pus and surrounded by red skin. Far more common than psoriasis, acne also causes a pus-filled pimple eruption. However unlike psoriasis acne is caused by excess oil, blocked pores, and bacteria. Acne is common in teens and young adults and occurs on the face, neck, back, or chest. Pustular psoriasis is usually seen in adults and can occur anywhere on the body, but less likely on the face.
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