The Stress Of Quarantine Is Triggering Psoriasis Flare
One 23-year-old shares the reality of having an autoimmune skin condition amid coronavirus pandemic panic.
Psoriasis can be an ordeal in the best of times. For many people with this chronic autoimmune disease, trying to manage symptoms under lockdown is taking its toll. Stassi Schroeder can relate. The Vanderpump Rules star shared a last week with a caption that referenced her “psoriasis covered face.
Schroeders definitely not the only one. Other people with psoriasis are sharing their lockdown skin stories, such as 23-year-old Hannah Williams, who lives in the UK. She posted a graphic facial photo on Instagram and wrote in the caption, If anyone is wondering how my lockdown is going… not well but at least no one can see how bad my skin looks rn.
All the uncertainty right now and being in lockdown has increased my stress levels, which has made my skin break out, Hannah tells Health. She was first diagnosed with psoriasis at age 13. It started on my scalp and eventually travelled down my body, she recalls. Over the past few years, Ive gone from being clear to covered head to toe. At the moment its mainly on my face.
Hannah treats her psoriasis with a combination of moisturizers, a topical corticosteroid cream and Dovobet, a prescription medication. She also gets comfort and stress relief through connecting with other people with psoriasis on Instagram.
Psoriasiform Drug Eruption And Drug
âPsoriasiform drug eruptionâ is a broad term referring to a heterogeneous group of disorders that clinically and/or histologically simulate psoriasis at some point during the course of the disease. A psoriasiform eruption is used also to describe a histological reaction pattern, which exhibits presence of cellular infiltration, papillomatosis, and epidermal hyperplasia with elongation of rete ridges. Hypergranulosis and parakeratosis may also be observed in selected cases.â This type of eruption can also be seen with seborrheic dermatitis, pityriasis rubra pilaris, secondary syphilis, pityriasis rosea, mycosis fungoides, drugs, and some malignancies. These psoriasiform reactions are elicited by inflammatory events that cause dysregulation of cytokines, growth factors, and abnormal keratinocyte proliferation. Depending on the disorder, the lesions may vary in size, shape, extent and type of scaling, and anatomic distribution.
Not Taking Meds On Time
Even if you feel fine, its still important to take your medication as prescribed to prevent psoriatic arthritis from flaring up again. Sometimes people miss some medication doses and they flare, Dr. Husni says. Then we look back with the patient to figure out why and they say, Oh, I was a little late taking it.
Read Also: How Do You Prevent Psoriasis
Are There Complications Of Psoriasis
In some people, psoriasis causes more than itchiness and red skin. It can lead to swollen joints and arthritis. If you have psoriasis, you may be at higher risk of:
- Use medicated shampoo for scales on your scalp.
Other steps you should take to stay as healthy as possible:
- Talk to your healthcare provider about lowering your risk for related conditions, such as heart disease, depression and diabetes.
- Lower your stress with meditation, exercise or seeing a mental health professional.
Beta Blockers And Drug
Clinical manifestations of beta-blocker-provoked psoriasis. In the past, beta blockers have been known to cause drug-induced/exacerbation of psoriasis, psoriasiform dermatitis, eczematous eruptions, and lichenoid changes. Psoriasiform eruptions are the most common cutaneous consequence of beta-blocker therapy, seen more frequently in patients with no past or family history of psoriasis., Clinical improvement after withdrawal of the implicated drug is the distinguishing feature in many cases suggesting drug-induced psoriasis. In a case-controlled and case-crossover study of 110 patients who were hospitalized for extensive psoriasis vulgaris, beta blockers were considered a major factor in triggering or aggravating psoriasis.â Practolol is the prototype cardioselective beta blocker, which is no longer available due to the high incidence of cutaneous side effects reported, including psoriasiform eruptions and exacerbations of pre-existing psoriasis. Transformation of plaque-type psoriasis into pustular psoriasis with pindolol has also been observed. In addition, atenolol has been reported to precipitate psoriasiform pustulosis. Topical application of timolol in the treatment of open-angle glaucoma has been reported to induce psoriasis and to transform psoriasis vulgaris into psoriatic erythroderma through the passage into the systemic circulation via the conjunctiva.,
Also Check: Manuka Honey For Plaque Psoriasis
Tips For Managing A Psoriasis Flare
When youre in the middle of a psoriasis flare-up, you just want something that will relieve the itchiness that comes with those thick, red, scaly patches of skinand you want it fast.
Maybe your psoriasis decided to flare after a period of stress or illness. But sometimes a flare arrives for no discernible reason at all. No matter what brought it on, a flare-up doesnt have to be a catastrophe. With a little preparation, you can manage it relatively easily.
Here, dermatologists share some of the best strategies for dealing with your next psoriasis flare.
What Can You Expect During Psoriasis Remission
For some people, psoriasis remission means your skin will clear almost entirely. You wont show any physical symptoms of psoriasis. More severe cases of psoriasis can cause scarring. Even during a remission, those scars may remain. Symptoms wont be triggered by the presence of these scars.
Symptoms may not disappear for everyone. For some people, symptoms may subside enough to no longer be bothersome. This may still be classified as remission depending on your experience and history with psoriasis.
You May Like: Best Lotion For Scalp Psoriasis
Symptoms Of Guttate Psoriasis
The spots you get from guttate psoriasis arenât as thick as the ones from plaque psoriasis. You can sometimes have both kinds of psoriasis at once. You probably would get them on your arms, legs, stomach, and chest.
It can sometimes spread from there to your face, ears, and scalp. But it doesnât show up on your palms, the soles of your feet, or nails like other forms of psoriasis can. Youâre more likely to have a flare-up during the winter, when the air is dry. Your symptoms may clear up more quickly in summer.
Which Type Of Doctors Treat Guttate Psoriasis
People should see a doctor or health care professional if they develop a sudden eruption of small red drop-like lesions of guttate psoriasis. Dermatologists, doctors who specialize in the treatment of skin disease, are best equipped to diagnose and treat guttate psoriasis. This form of psoriasis is usually a mild inconvenience to most people. Most of the time, the lesions last several weeks to a few months. Other times, the guttate eruption can develop into chronic plaque psoriasis. Scarring is not a problem.
The doctor can prescribe treatments that help relieve the itching. This type of psoriasis usually “runs its course” and goes away without medical treatment in a few weeks.
Also Check: Long Term Effects Of Psoriasis
Employ Some Life Hacks
Crow also advises taking shortcuts that can make living with PsA flares easier. These life hacks can help minimize fatigue or joint pain, she says. If your joints hurt, you can change the stuff you are using in your daily life for example, if your hands hurt, you can use a wide-grip fork while eating. You can also change how you interact with stuff, such as choosing to have grocery delivery rather than exerting the energy required to go to the store and bag all the items yourself.
Is It Possible To Prevent Guttate Psoriasis
Guttate psoriasis may not be preventable. However, complications or further flare-ups may be reduced by avoiding anything that triggers a psoriasis outbreak. For example, anyone with psoriasis should try to minimize all forms of skin trauma, such as scratching or vigorous rubbing, which may lead to new psoriatic lesions on previously unaffected areas. This is known as the Koebner phenomenon.
The association between streptococcal infections and guttate psoriasis cannot be overemphasized.
- Early detection and treatment of such infections may prevent an acute flare-up of the skin disease. Samples should be obtained and cultured in patients who are susceptible to psoriasis and have a sore throat.
- Some doctors advocate early antibiotic therapy of any sore throat in individuals who are susceptible.
Also Check: What Oil Is Good For Psoriasis
Create A Psoriasis Outbreak Self
Using either a digital camera or smartphone – or for the more artistically inclined, a piece of paper – record changes in the psoriasis plaques on your body to see where and how much skin is affected by flares. Keep at it each week, and make notes about events such as doctor visits and new treatment to see patterns over time.
Learn to describe the patterns you see. Psoriasis is unique in each person with the condition, but there are certain categories:
- Plaque psoriasis: Most people develop raised, inflamed red skin covered by scales that can be white or silver.
- Pustular psoriasis: Blisters filled with pus usually occur on the hands and feet.
- Guttate psoriasis: Small inflamed red papules can occur anywhere in this form of psoriasis. The affected skin is thinner and less scaly than plaque psoriasis.
- Inverse psoriasis: Smooth, red skin appears in skin folds in the armpits, groin, or under the breasts.
- Erythrodermic psoriasis: Intensely red areas cover large sections of skin.
What’s The Outlook Like After Having Guttate Psoriasis
- In nearly two thirds of people the spots clear up and never come back.
- Occasionally the spots turn into a more long-term type of psoriasis called plaque psoriasis. This can be treated with similar creams and light treatment.
- Once it’s cleared, sometimes a second outbreak of guttate psoriasis happens. This could happen if the streptococcus bug is lurking in your tonsils.
- Thankfully the guttate psoriasis never properly scars, although sometimes it can leave tiny pale marks where it used to be: these should fade with time though.
You May Like: What Causes Psoriasis In Children
Possible Causes For Psoriasis Remission
The goal of psoriasis treatment is to reduce the symptoms and hopefully end the flare. If treatments are successful, psoriasis may go into remission.
Even without treatment, psoriasis may disappear. Spontaneous remission, or remission that occurs without treatment, is also possible. In that case, its likely your immune system turned off its attack on your body. This allows the symptoms to fade.
This doesnt mean that you wont ever have another flare. Watch for symptoms of psoriasis so that you can begin treating them if they reappear.
How Is Psoriasis Diagnosed
There arent any special tests to help doctors diagnose psoriasis. Typically, a dermatologist will examine your skin and ask about your family history.
Youll likely be given a diagnosis based on this physical exam.
In some situations, doctors will remove a small sample of the skin and examine it under a microscope. This might allow them to get a better look at the affected area and make a more accurate diagnosis.
Also Check: Mejor Tratamiento Para La Psoriasis
What Type Of Psoriasis Treatment Will I Need
Several treatment options can relieve psoriasis. Creams or ointments may be enough to improve the rash in small areas of skin. If the rash affects larger areas, or you also have joint pain, you may need other treatments. Joint pain may be a sign that you have arthritis.
Your provider will decide on a treatment plan based on:
- Severity of the rash.
- Vitamin A or retinoid creams.
How Oral Psoriasis Is Related To Regular Psoriasis
While psoriasis typically appears on the skin, psoriasis in the mouth can occur in rare casesespecially if you already have psoriasis on your skin. That being said, unlike psoriasis in the skin, psoriasis on the lips, tongue, or corner of the mouth does not have a regular pattern caused by known triggers, so outbreaks can come about without any reasons you might associate with outbreaks on your skin.
Psoriasis in the mouth is uncommonbut if you do think you’re experiencing symptoms, talk to your dentist or dermatologist to make sure it’s psoriasis .
Recommended Reading: Early Signs Of Scalp Psoriasis
Pathophysiology Of Guttate Psoriasis
The exact pathophysiologic mechanism in guttate psoriasis is undetermined. Guttate psoriasis is believed to result from an immune reaction triggered by a previous streptococcal infection in a genetically susceptible host.
Studies indicate the importance of chromosome 6 in determining the resultant psoriatic phenotype. HLA-Cw*0602positive patients are more prone to develop the guttate form. Interactions of HLA-C with killer immunoglobulinlike receptors on natural killer cells or natural killer T cells can be deregulated by streptococcal infection. T lymphocytes and cytokines are believed to cause the characteristic inflammatory changes appreciated on histopathologic examination of lesions.
An autoimmune phenomenon has also been postulated to underlie guttate psoriasis because some streptococcal products and components have been found to cross-react with normal human epidermis. Electron microscopic studies of guttate psoriasis have shown that mast cell degranulation is an early and constant feature in the evolution of guttate psoriatic lesions. Furthermore, Langerhans cell migration appears to be impaired during an acute episode of guttate psoriasis.
Signs And Symptoms Of Psoriasis
Psoriasis plaques can range from a few spots of dandruff-like scaling to major eruptions that cover large areas. The diseases symptoms and appearance vary according to the type and severity of psoriasis.
Some common signs and symptoms include:
- Discolored patches or raised plaques of skin that are covered with scales
- Burning, itching, or soreness near the affected areas
- Pitted or thickened fingernails or toenails
You May Like: Is Sea Salt Good For Psoriasis
Take Care Of Your Mental Health
Managing the mental aspect of psoriatic arthritis is an important treatment component as well. People with psoriatic arthritis are at a greater risk of anxiety and depression than the general population, and flare-ups are difficult for many to cope with, Crow says. Whatever you can do to invest in your mental health is likely a wise choice.
Grenz Ray Climatotherapy Visible Light Goeckerman And Pulsed
Evidence is insufficient to recommend grenz ray therapy for the treatment of psoriasis.
Sufficient evidence exists to recommend climatotherapy for the treatment of psoriasis.
Evidence is insufficient to recommend the use of visible light as a more effective treatment for psoriasis, except in nail psoriasis.
Sufficient evidence exists to recommend Goeckerman therapy for the treatment of psoriasis.
Pulsed-dye laser can be considered for nail psoriasis.
Recommended Reading: How Fast Does Psoriasis Spread
Whats The Treatment For It
There is the suggestion that it will go away on its own in a few weeks to a couple of months. But that can feel like a lifetime when youve got a flare-up. In a similar way to plaque psoriasis, you can also treat guttate psoriasis using medications or phototherapy. Talk to your doctor about the types of medication you could be able to use, such as steroids or hydrocortisone. Alternatively, you could also try several over-the-counter options like coal tar soaps and shampoos, vitamin A and plenty of moisturizing.
Adjust Your Bathing Habits
When your psoriasis is especially itchy, its crucial to avoid showering or bathing in water that is too hot because the heat can just make you itchier, the American Academy of Dermatology explains.
You might also find it helpful to limit your time in the shower or bath because spending a long time in the water can actually make your skin drier. The AAD recommends keeping showers under 5 minutes and baths under 15 minutes.
Also Check: Over The Counter Psoriasis Cream
Stages Of Guttate Psoriasis
- Mild. Only a few spots cover about 3% of your skin.
- Moderate. Lesions cover about 3%-10% of your skin.
- Severe. Lesions cover 10% or more of your body and could cover your entire body.
The stage can also be based on how much they interfere with your daily life and activities. For example, psoriasis on your face or scalp can affect only 2%-3% of your total body surface area, but it could be classified as severe because it affects your appearance and livelihood. Psoriasis on your hands might only cover 2% total body surface area, but could affect your livelihood if you work with your hands. In that case it would be classified as moderate to severe.
Keep Your Skin Moisturized
Keeping your skin lubricated can go a long way in preventing or worsening dry, itchy skin caused by a psoriasis flare-up. It can also help reduce redness and heal the skin, making your flare-up easier to manage.
The National Psoriasis Foundation recommends using heavy creams or ointments that lock in water. Look for moisturizers that are fragrance-free or alcohol-free. Fragrances and alcohol can actually dry out your skin.
If youre looking for a natural or cost-effective solution, you can use cooking oils or shortening to keep your skin moisturized. When in doubt, ask your dermatologist for a recommendation.
Take shorter showers with lukewarm water to help protect your skins moisture. Be sure to use fragrance-free soaps. Always apply moisturizer after showering, washing your face, or washing your hands.
Add oil to bathwater if you prefer taking baths, or are looking to soothe dry, itchy skin. Soaking in Epsom or Dead Sea salts is recommended for itchy skin. Be sure to limit your bath time to 15 minutes and moisturize immediately afterward.
Try putting your creams or moisturizers in the refrigerator. This can help soothe the burning sensation that often accompanies the itching during a flare-up.
Recommended Reading: Psoriasis En Los Pies Fotos
Lasts At Least A Few Days
Dr. Husni also says that a psoriatic arthritis flare usually doesnt go away after an hour or two. If you get better right away we dont really consider that a flare, which usually lasts over a couple of days or a week, she says. But, if the symptoms are really severe, you should still call your doctor even if its only been a short time. Theres no magic number of days or hours its more of how it affects your activities of daily living, Dr. Husni says.