Psoriasis Support Groups And Counseling
Education of psoriasis patients is one of the foundations for managing this chronic and typically relapsing disorder. Patients should be familiar with the treatment options in order to make proper informed decisions about therapy. The National Psoriasis Foundation is an excellent organization that provides support to patients with psoriasis.
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.
What Is Psoriasis What Causes Psoriasis Two Important Questions Answered
According to the International Federation of Psoriasis Associations , Psoriasis affects nearly 3% of the world population. Most often mistaken as a skin condition, it is an immune condition that can have a physical and psychological impact. People affected with psoriasis often face discrimination and embarrassment in public places simply because others fear that it is contagious, when in fact, it is not.
What is Psoriasis?
Psoriasis is a chronic, inflammatory, immunemediated proliferative skin disorder that commonly involves the skin, nails, and joints. Psoriasis on neck and legs is also common. It accelerates the process of skin replacement i.e. the usual process of new skin growth which typically takes three to four weeks but in Psoriasis, can happen in just a few days. The skin cells grow too quickly, causing them to pile up and form visible patches or spots on the skin.
Psoriasis varies from person to person and can be limited to a few lesions or affect large areas of the skin. These lesions are not contagious, neither are they infected nor are an open wound.
What causes Psoriasis?
Some people are more likely to develop psoriasis than others, particularly if there is someone else in their family who has psoriasis: in other words, it is a genetic or hereditary disease. However, the trigger for psoriasis to appear is often an outside event, such as a throat infection, stress or an injury to the skin.
Is psoriasis hereditary?
Read about other healthcare disorders here:
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Triggers That Make Itchiness Worse
When you have an itch, the temptation is to scratch. Yet scratching can increase inflammation and make itching even worse. That creates a vicious pattern known as the itch-scratch cycle.
Scratching can also damage the skin, leading to the formation of even more itchy plaques and even infection.
Stress is another itching trigger. When youre under stress, youre more likely to have a psoriasis flare, which can set off another bout of itching.
Weather conditions can also influence itching. In particular, very dry conditions and warm weather have both been known to trigger or exacerbate itchiness.
Flexural Or Inverse Psoriasis
Flexural or inverse psoriasis often appears in skinfolds, such as under the breasts or in the armpits or groin area. This type of psoriasis is red and often shiny and smooth.
The sweat and moisture from skinfolds keeps this form of psoriasis from shedding skin scales. Sometimes its misdiagnosed as a fungal or bacterial infection. The skin-on-skin contact can make inverse psoriasis very uncomfortable.
Most people with inverse psoriasis also have a different form of psoriasis in other places on the body.
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When Should I See A Doctor For Psoriasis
Since psoriasis is a systemic disease of inflammation with dramatic skin involvement, most people should seek medical advice early in its course when symptoms and signs appear. Besides arthritis, people with the condition are more likely to be obese and to have coronary artery disease and/or diabetes. Psoriasis, if limited to small areas of skin, may be an inconvenience for some people. For others, it may be disabling.
- Those with psoriasis commonly recognize that new areas of psoriasis occur within seven to 10 days after the skin has been injured. This has been called the Koebner phenomenon.
- People should always see a doctor if they have psoriasis and develop significant joint pain, stiffness, or deformity. They may be in the reported 5%-10% of individuals with psoriasis who develop psoriatic arthritis and would be a candidate for systemic therapy. Psoriatic arthritis can be crippling and cause permanent deformity.
- Always see a doctor if signs of infection develop. Common signs of infection are red streaks or pus from the red areas, fever with no other cause, or increased pain.
- People need to see a doctor if they have serious side effects from their medications.
How Is The Immune System Involved
In the past several decades, researchers have identified psoriasis as a chronic immune-mediated disease.
Immune-mediated diseases are thought to be triggered by an abnormal immune response. An overly active immune system attacks healthy cells as if they were foreign invaders.
In psoriasis, the immune system targets the skin, which results in the rapid growth of skin cells. This causes the redness and flaky skin typical of psoriasis.
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Medical Treatment Topical Agents
The first line of treatment for psoriasis includes topical medications applied to your skin. The main topical treatments are corticosteroids , vitamin D-3 derivatives, coal tar, anthralin, and retinoids. These drugs may lose potency over time, so often they are rotated or combined. Ask your doctor before combining medications, as some drugs should not be combined.
Common Triggers Of Psoriasis On Legs
Treatment for psoriasis on legs varies. Its focused on keeping the symptoms at bay and preventing flare-ups.
Even for people who suffer from mild psoriasis on legs prevention is the key to an improved quality of life.
One of the most common ways to treat psoriasis on legs is to make a list of triggers. For that, patients have to monitor their behavior and keep a log of what they eat and do. This can help them figure out which actions lead to flare-ups.
The most common triggers for psoriasis on legs are:
· Skin injuries, such as cuts, sunburn, insect bites, and the like.
· Emotional stress
· Weather elements that lead to skin dryness
· Illness or infection
· Certain medication
When you speak to your doctor, its important to mention that you have psoriasis on legs. This can help set up the right treatment for other conditions without triggering psoriasis outbreaks.
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Appearance Of Psoriasis On The Legs
Plaque psoriasis develops as flushed, inflamed skin and silvery plaques on light skin tones. On dark skin tones, psoriasis plaques may appear more purple or grey-colored. Patches of inflammation can be darker brown than the surrounding skin.
Healing psoriasis can cause areas of discoloration, which take 312 months to fade. Scratching plaques or picking them off can cause scarring.
Physicians may use a skin biopsy to help diagnose the condition if the appearance is not typical of the disease.
Leg psoriasis can have a variety of triggers, which may also cause a repeat of the symptoms, also known as a flare. Causes and triggers may involve:
- Family history: Many people with psoriasis have a near relative who has developed the disease.
- Stress: Managing stress levels can help people with psoriasis.
- Injury: An injury to the skin can trigger a psoriasis flare. This can include bug bites or even damage from scratching.
- Illness: This can include streptococcal throat infection, bronchitis, earache or other infections.
- Alcohol use: More than two alcoholic drinks a day could reduce the effect of treatment for psoriasis.
- Weather: Some people feel that very hot or very cold weather can trigger psoriasis.
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.
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What Causes Guttate Psoriasis
The cause of guttate psoriasis is not completely understood. Like plaque psoriasis, guttate psoriasis is believed to be caused by an overactive immune system that creates inflammation and overproduces skin cells, according to the American Academy of Dermatology .
In many cases, strep throat appears to be the main trigger of guttate psoriasis. Other possible triggers include:
- Upper respiratory infection
- Sunburn
- Excessive alcohol consumption
Risk factors for guttate psoriasis include a family history of skin disease. People with psoriasis in general also have a higher risk of developing psoriatic arthritis, obesity, certain eye conditions, cardiovascular disease, type 2 diabetes, and other autoimmune disorders including Crohns disease.
What Signs Suggest That Lower Leg Redness Is Dangerous Or Life
Lower leg redness on a single leg and a change in temperature , a loss of sensation, swelling, loss of motion, or a loss of pulse are all signs that you may have a condition that requires emergency care. You may need a physician to assess for subtle signs of pulselessness or swelling in the lower leg that may be signs of a limb-threatening or life-threatening condition.
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What Else Should I Know
Making healthy choices can help with psoriasis. Here are some things you can do:
- If you smoke, quit. Smoking can trigger outbreaks of psoriasis in some people.
- Avoid alcohol. It can make psoriasis treatments less effective.
- Eat healthy foods. Eating a lot of fruits and vegetables can help fend off diseases that might trigger psoriasis.
- Stay at a healthy weight. This decreases the risk of inverse psoriasis.
- Keep skin clean and well moisturized. Bathing daily with bath salts or oils and then applying moisturizer can help ease the symptoms of psoriasis.
People who have psoriasis may feel self-conscious about how it looks. That’s one reason why some people turn to a therapist or join a support group of people who understand what they might be going through.
The key to psoriasis treatment is keeping up on whatever your doctor prescribes. If that means applying an ointment twice a day, then find a way to remind yourself to do it so you don’t forget. Psoriasis is one of those things that you need to stay focused on treating, even when you’re feeling OK.
Whether your psoriasis is mild or severe, learn all you can about it. Talk to your doctor or check websites like:
What Does Psoriasis Look Like
Psoriasis usually appears as red or pink plaques of raised, thick, scaly skin. However, it can also appear as small, flat bumps or large, thick plaques. It most commonly affects the skin on the elbows, knees, and scalp, though it can appear anywhere on the body. The following slides will review some of the different types of psoriasis.
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What Are The Types Of Psoriasis
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 are in places where skin touches skin, such as the armpits, buttocks, upper eyelids, groin and genitals, or under a girl’s breasts.
Severe And Pervasive Psoriasis
Like most skin conditions, psoriasis can become widespread and very irritating. For instance, plaque psoriasis may cover almost the entire surface of the body.
In extreme cases, inflammation can become so severe that it appears and feels like burns.
Extensive, highly painful, burn-like psoriasis can be life-threatening. This requires immediate attention from a health professional.
Other widespread psoriasis may simply require standard treatment to partially heal or resolve.
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What Can Trigger Psoriasis
Plenty of everyday things can act as a trigger, causing psoriasis to appear for the first time. Common psoriasis triggers include:
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Stress
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Skin injury, such as a cut or bad sunburn
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Infection, such as strep throat
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Some medications, including lithium, prednisone, and hydroxychloroquine
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Weather, especially cold, dry weather
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Tobacco
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Alcohol
These triggers can also cause psoriasis flare-ups. Different people have different triggers. For example, periods of intense stress may trigger your psoriasis but cold weather may not.
Thats why its so important for people who have psoriasis to know what triggers their psoriasis. Avoiding triggers can reduce psoriasis flares.
Youll find common triggers and what you can do to avoid them at: Are triggers causing your psoriasis flare-ups?
If you think you have psoriasis, its important to find out. Treatment can help relieve your discomfort and lead to clearer skin. You can find out how board-certified dermatologists diagnose and treat psoriasis at: Psoriasis: Treatment.
Related AAD resources
1 Gottlieb A, Korman NJ, et al. J Am Acad Dermatol 2008 58:851-64.2 Alexis AF, Blackcloud P. J Clin Aesthet Dermatol. 2014 7:16-24.
ImageGetty Images
References Alexis AF, Blackcloud P. Psoriasis in skin of color: epidemiology, genetics, clinical presentation, and treatment nuances. J Clin Aesthet Dermatol. 2014 7:16-24.
All content solely developed by the American Academy of Dermatology
Psoriasis Is Not The Same As Eczema
Psoriasis is thought to be an autoimmune condition, and its often confused with the most common form of eczema, atopic dermatitis. Psoriasis lesions typically have sharper borders and thicker scaling than atopic dermatitis, according to Wang.
Patients who have atopic dermatitis will usually start experiencing symptoms in early childhood, Wang says, and its often associated with allergic conditions, such as asthma, seasonal allergies and food sensitivities. Compared to psoriasis, atopic dermatitis tends to be itchier, less well-defined and present in different parts of the body, like the face and body fold areas of the arms and the legs.
And when people think of psoriasis, Wang says, theyre usually referring to chronic plaque psoriasis, which is the most common form of the disease. However, there are other subtypes that cause lesions in different areas of the body than is typical, he explains.
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What Causes Psoriasis
No one knows the exact cause of psoriasis, but experts believe that itâs a combination of things. Something wrong with the immune system causes inflammation, triggering new skin cells to form too quickly. Normally, skin cells are replaced every 10 to 30 days. With psoriasis, new cells grow every 3 to 4 days. The buildup of old cells being replaced by new ones creates those silver scales.
Psoriasis tends to run in families, but it may be skip generations. For instance, a grandfather and their grandson may be affected, but not the child’s mother.
Things that can trigger an outbreak of psoriasis include:
- Cuts, scrapes, or surgery
- Belly button
- Nails
Your doctor will give you a full physical exam and ask if people in your family have psoriasis.
Lab tests. The doctor might do a biopsy — remove a small piece of skin and test it to make sure you donât have a skin infection. Thereâs no other test to confirm or rule out psoriasis.
A Life With Psoriasis
Although psoriasis comes and goes over time, its a lifelong condition. A lack of public understanding about psoriasis causes many people with this condition to feel isolated and ostracized.
But most people with psoriasis lead fulfilling, active lives. Here are some tips you can try to avoid psoriasis triggers.
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Things A Dermatologist Wants You To Know About Psoriasis
Its a chronic skin problem with no cure, but heres what experts, and especially sufferers, want you to understand about the condition.
Psoriasis isnt just about looks, and its not contagious. And although this rash consisting of red, scaly and patchy spots is one of the more common skin diseases dermatologists see, public misunderstanding persists, says Michigan Medicine dermatologist Frank Wang, M.D.
Wang, who also directs Michigan Medicines Dermatology Treatment Center, an outpatient clinical program utilizing intensive topical therapies for psoriasis and other inflammatory skin disorders, says its important to be aware that psoriasis impacts both physical and emotional health.
Its a condition to be taken seriously, Wang says. The way patients may be treated by others who are not familiar with psoriasis can really impact their self-esteem and emotional wellbeing.
Here, Wang addresses the five facts more people should know about the condition, which has been a longtime research focus for Michigan Medicine dermatologists.
What Else Should I Ask My Healthcare Provider
If you have psoriasis, ask your healthcare provider:
- How can I prevent outbreaks and control symptoms?
- What medication will work best for me?
- What else should I do to improve symptoms?
- What are my options if creams dont work?
- Will psoriasis ever go away?
A note from Cleveland Clinic
Psoriasis, an itchy skin condition, can come and go throughout your life. Its related to an overactive immune response and is not contagious. If you have skin changes that arent going away, talk to your healthcare provider. There is no cure for psoriasis, but psoriasis treatments can improve symptoms. Your provider may prescribe a special cream or moisturizer or medications. Other therapies are available if creams or medicines dont work. Maintaining your overall health will also help improve symptoms.
Last reviewed by a Cleveland Clinic medical professional on 10/17/2020.
References
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