Spectrum Of Treatment Options
Although psoriasis presents differently on various skin types, color doesnât necessarily determine treatment options. Patients should consult with their health care providers to personalize their treatment plans. Creams, ointments and topical steroids are typically the first line of defense against psoriasis, while more severe cases require more aggressive therapies.
âWhen people of color present with psoriasis, especially African-American patients, they often have more hyperkeratotic, or thicker-scaled lesions,â says McMichael. âThat means the lesions are going to take a longer time to control, with medication at higher potency levels.â
If creams donât help, phototherapy can be very effective for people with darker skin pigment, she says, noting the lack of research on treatment for skin of color, as most studies predominantly feature white patients. That situation is changing, however. In 2017, the Patient-Centered Outcomes Research Institute awarded an $8.6 million contract to one of Takeshitaâs colleagues, Joel Gelfand, M.D., a board-certified dermatologist whose clinical work focuses on general dermatology and psoriasis. The PCORI contract is for a clinical trial called LITE. The purpose of LITE is to study the effectiveness and safety of 12 weeks of home-based versus office-based phototherapy for the treatment of psoriasis, and the effects of phototherapy across skin tones.
So What Does Plaque Psoriasis Looks Like
First, let’s talk about why it looks so scaly. People with plaque psoriasis have an overactive immune system that causes their skin cells to grow at a fast pacein only three to four days, says the National Psoriasis Foundation. However, the cells don’t fall off as quickly, which means they build up on the surface of the skin.
This dead skin creates plaques and scales. They can vary in size and form single patches separated by healthy skin or groups of patches that join together and cover large areas of skin.
“Plaques are a little elevated. They form a plateau elevated above the surrounding skin. If you closed your eyes and touched psoriasis, you could feel it,”Robert T. Brodell, MD, chair of the department of dermatology at the University of Mississippi Medical Center tells Health.
He explains that the scales are referred to as “micaceous” because they resemble the mineral mica, which splits into very thin elastic plates.
“If you stuck your finger underneath one of the scales, a broad white flake comes off unlike some other conditions whereby you might have a fine scale, like dandruff, that doesn’t stick together,” he says.
Treatments For Specific Areas
To treat this area, your doctor may recommend:
- Special corticosteroids to treat scaling. But donÃ¢t overuse them. If they get into your eyes, they can lead to glaucoma or cataracts.
- The eczema drugs crisaborole ointment, pimecrolimus , or tacrolimus . They donât cause the side effects of steroids. They can sting the first few days you use them.
Psoriasis medications can put your eardrum at risk, so be cautious when you apply any inside the ear. Your doctor may recommend:
- A prescription corticosteroid you can drip in your ear or apply to the outside of your ear canal
- Calcipotriene or tazarotene usually mixed with a corticosteroid cream or ointment
Mouth and Nose
Read Also: White Spots From Guttate Psoriasis
What Causes A Rash In Rheumatoid Arthritis
Eczema, Sweets syndrome, and pyoderma gangrenosum are all related to autoimmune problems. Both Sweets syndrome and pyoderma gangrenosum are neutrophilic dermatoses, inflammatory skin conditions related to an overload of a type of white blood cell called neutrophils. Neutrophils naturally produce an inflammatory response to infection. In an autoimmune condition, the skin may be attacked as foreign by the immune system, leading to neutrophils overwhelming the skin and causing inflammation as if the skin was infected.
While the precise cause of eczema is not known, it is generally considered to be an autoimmune response that causes inflammation of the skin. Other autoimmune conditions besides RA have been associated with eczema, including Crohns disease and ulcerative colitis.
Rheumatoid vasculitis is caused by inflammation of both small- and medium-sized blood vessels, often as part of an RA flare-up. It usually occurs in people who have had severe RA for more than 10 years. Certain factors play a part in those who are at higher risk for this complication. Most people who develop rheumatoid vasculitis have a high rheumatoid factor in their blood and many smoke cigarettes.
Palmar erythema, reddening in the palms, has a wide variety of causes. When someone with RA experiences red palms, however, it is most likely to be as a result of an autoimmune response. It can also be caused by medication taken to treat RA.
Who Is Susceptible To Get Psoriasis
There is no uniform criterion when it comes to having psoriasis. I have had it for years now. In fact, Psoriasis is quite common in the US and it affects about 125 million people around the globe, thats 2-3 percent of total world population. It can occur at any age. Want to know more about what does Psoriasis look like? Keep reading.
Read Also: What Does The Word Psoriasis Mean
What Does Psoriasis Look Like On Your Face
Psoriasis on your face usually starts out as small, red bumps that grow into reddish-pinkish sores. The sores are then covered in silvery-white scales that may flake off.
Psoriasis signs can appear differently on various parts of the face. Sebo-psoriasis on the scalp usually presents as skin plaques with greasy, yellow scales.
Key Points About Psoriatic Arthritis
- Psoriatic arthritis is a form of arthritis with a skin rash.
- Psoriasis is a chronic skin and nail disease. It causes red, scaly rashes and thick, pitted fingernails. The rash may come before or after the arthritis symptoms.
- Psoriatic arthritis causes inflamed, swollen, and painful joints. It happens most often in the fingers and toes. It can lead to deformed joints.
- Treatment may include medicines, heat and cold, splints, exercise, physical therapy, and surgery.
Don’t Miss: Eczema Or Psoriasis Which Is Worse
What Are Symptoms Of Psoriasis
Symptoms of psoriasis can be mild to severe, and can be in small, limited areas of the body such as the scalp, knees, elbows, hands and feet, or it can be widespread covering much of the body surface in including the face, arms, and legs. Psoriasis can come and go, with flares and periods of remission . Symptoms can also vary depending on the type of psoriasis you have.
Common symptoms of psoriasis include:
- Dry, red, thick skin, covered by silvery scales
- Skin rashes
How Is Psoriatic Arthritis Diagnosed
Psoriatic arthritis is easier to confirm if you already have psoriasis. If you donthave the skin symptoms, diagnosis is more difficult. The process starts with a healthhistory and a physical exam. Your healthcare provider will ask about your symptoms. Youmay have blood tests to check the following:
- Erythrocyte sedimentation rate . This test looks at how quickly red blood cells fall to the bottom of a test tube. When swelling and inflammation are present, the bloods proteins clump together and become heavier than normal. They fall and settle faster at the bottom of the test tube. The faster the blood cells fall, the more severe the inflammation.
- Uric acid. High blood uric acid levels can be seen in psoriatic arthritis but are not used for diagnosis or monitoring.
- Imaging. X-rays, CT scans, ultrasound, MRI, and skin biopsies may all be used to help diagnosis.
Also Check: What Does Arthritic Knee Pain Feel Like
You May Like: Photos Of Plaque Psoriasis On Scalp
Eczema Coping Tips Good Hygiene
Skin affected by eczema is more vulnerable to a range of infections, including impetigo, cold sores and warts. The bacterium Staphylococcus aureus may cause a secondary infection of impetigo, and possibly contribute to the symptoms of eczema.Suggestions for washing include:
- Take lukewarm baths or showers, and avoid really hot showers.
- Dont use ordinary soap, as the ingredients may aggravate your eczema. Wash your body with warm water alone. For armpits and groin, use soap-free products, such as sorbolene cream.
- Bath oils can help to moisturise your skin while bathing.
- When towelling dry, pat rather than rub your skin.
How People Of Color Can Reduce Their Skin Cancer Risk
Dermatologists in the United States tell their patients with skin of color to reduce their risk of getting skin cancer by doing the following:
Seek shade whenever possible. The sun causes many skin cancers.
Wear clothing that protects your skin from the sun. A wide-brimmed hat can shade your face and neck. You also want to wear shoes that cover the entire foot. African Americans often develop skin cancer on their feet.
Wear sunscreen. Yes, people of color should wear sunscreen. Dermatologists recommend that people of color use sunscreen that has:
Apply sunscreen to dry skin 15 to 30 minutes before going outdoors. You want to apply sunscreen to skin that will be bare. Be sure to apply sunscreen every day even on cloudy days.
When outdoors, reapply sunscreen. You want to reapply:
Never use tanning beds or sunlamps. These emit harmful UV rays, which can cause skin cancer.
Skin of color: How to prevent and detect skin cancer
Although people of color have a lower risk of developing skin cancer than Caucasians, when skin cancer develops in people of color, it is often diagnosed at a more advanced stage making it more difficult to treat.
Follow these tips from dermatologists to protect your skin from the sun and reduce your risk of skin cancer.
Recommended Reading: Best Vitamins For Scalp Psoriasis
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:
Skin injury, such as a cut or bad sunburn
Infection, such as strep throat
Some medications, including lithium, prednisone, and hydroxychloroquine
Weather, especially cold, dry weather
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.
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 Has A Telltale Appearanceexcept When It Shows Up On Dark Skin Tones Here The Signs And Symptoms You May Be Missingand How To Treat Them
by Health Writer
When you see the word psoriasis, you may picture angry red patches with silvery scalesthe classic sign of plaque psoriasis, which is the most common form of the chronic skin condition, and what you see most in textbook illustrations and photos. But on dark skin tones, the inflamed areas can take on a very different appearance, making it harder for people to realize they may be experiencing psoriasis.
The inflammatory skin condition is caused by faster-than-normal cell growth that results in a pile-up of skin cells on the surface that itch, burn, and sting. Those rough, irritated patches can also leave lingering signs on Black skin long after the psoriasis plaque or lesion has healed. We talked to Black dermatologists to clarify the signs, symptoms, and treatment options for psoriasis on dark skin tones.
Read Also: How To Tell If It Psoriasis Or Eczema
What Can I Do To Help Treat My Psoriasis
There may not be a cure yet but there is much you can do to help maintain and control your psoriasis. Psoriasis, regardless of location or type, is often irritated by contact, particularly tight clothing such as elasticated waistbands, socks, tights, and underwear. It may be useful to wear looser clothing where psoriasis is likely to be irritated either when flaring or during periods of treatment. Identifying factors that may cause your psoriasis to flare, using a diary, can be helpful.
Also Check: Cual Es El Mejor Tratamiento Para La Psoriasis
How Is Psoriasis Diagnosed And Treated
Psoriasis often has a typical appearance that a primary care doctor can recognize, but it can be confused with other skin diseases , so a dermatologist is often the best doctor to diagnose it. The treatment of psoriasis usually depends on how much skin is affected, how bad the disease is , or the location . Treatments range from creams and ointments applied to the affected areas to ultraviolet light therapy to drugs . Many people who have psoriasis also have serious health conditions such as diabetes, heart disease, and depression. Some people with psoriasis also have an inflammatory condition which affects their joints, called psoriatic arthritis.
Psoriatic arthritis has many of the same symptoms as other types of arthritis, so a rheumatologist is often the best doctor to diagnose it. The treatment of psoriatic arthritis usually involves the use of drugs .
Psoriatic disease may be treated with drugs or a combination of drugs and creams or ointments.
Also Check: How Fast Does Psoriasis Spread
Psoriasis Of The Scalp
Scalp having Psoriasis is quite a common disorder. The scalp has a heavily-crusted, fine, scaly layer of skin. At times, the plaque scalp may come off in flakes or clumps. The condition is similar to seborrheic dermatitis with the exception that in the latter, the scales are greasy. Understand what does Psoriasis look like better through the picture:
For image source, click here
What Kind Of Doctor Treats Psoriasis
There are several types of doctors who may treat psoriasis. Dermatologists specialize in the diagnosis and treatment of skin disorders, including psoriasis. Rheumatologists specialize in the treatment of joint disorders, including psoriatic arthritis. Family physicians, internal medicine physicians, rheumatologists, dermatologists, and other medical doctors may all be involved in the care and treatment of patients with psoriasis.
Recommended Reading: Best Treatment For Pustular Psoriasis
You May Like: Best Eye Cream For Psoriasis
Will Psoriasis Affect My Childs Education
There is no reason why your childs education should be affected, but a visit to the school with your child to make sure their teacher knows the essential facts about psoriasis might help. Take leaflets and fact sheets with you to leave behind. Make sure your child feels comfortable talking about psoriasis with you and the school, so they will bring any problems to your attention. Ask the school how they will tackle any bullying issues if your childs psoriasis is quite noticeable and devise avoidance tactics to pre-empt any possible situations occurring.
The school should realise that there will be periods when your child may not want to participate in P.E sessions during flare-ups and this should be explained to the school so that they can avoid any stressful situations for your child.
Swimming can be a particularly difficult for a child with psoriasis, as the chlorine in the water can make psoriasis patches worse than they actually are and more pronounced, so your child may become upset over this or embarrassed..
As your child gets older consider encouraging him or her with the following advice:
Why Does My Child Have Psoriasis
The heredity factor seems to play a part. About one third of people with psoriasis are able to identify a relative, living or dead, with psoriasis. It is estimated that if 1 parent has psoriasis that there is a 15% chance that a child will develop the condition. If both parents have psoriasis this increases to about 75%. Interestingly, if a child develops psoriasis and neither parent is affected there is a 20% chance that a brother or sister will also get psoriasis. This is because the condition is known to skip generations but somewhere there will be a familial link to a relative via either or both parents.
Recommended Reading: What Vitamins Should I Take For Psoriasis
Eczema Vs Psoriasis Elbow
Fungal Skin Infection Causes. An overgrowth of the fungus Candida is the cause of yeast infections. Candidal infections commonly occur in warm, moist body areas, such as the underarms or where skin folds over itself like breast/chest skin. Usually, the skin effectively blocks yeast, but any skin breakdown or cuts in the skin may allow this organism to penetrate and infect.
What Does Inverse Psoriasis Look Like
The following pictures will give you an idea of what the different types of psoriasis can look like. Plaque psoriasis. Patches of thick raised skin covered with silvery scale form. These patches usually appear on the scalp, elbows, knees, or lower back but they can develop anywhere on the skin. . Inverse psoriasis (left .
Read Also: What Is The New Pill For Psoriasis
Treatment For Psoriasis On The Feet
If you think that you might have psoriasis on your feet, make an appointment with a podiatrist or a dermatologist. These experts can help determine whether psoriasis or another condition may be causing your dry, flaky, itchy feet. Clinical examination of your skin and possibly a skin biopsy will help confirm the diagnosis.
If psoriasis is determined to be the cause of your symptoms, there are several ways you and your doctor can help alleviate your discomfort. Keep in mind that it may take a while to find the right treatment.