Psoriasis – also known as psoriasis – is a non-contagious, chronic inflammatory skin and joint disease that occurs in relapses. A pronounced accompanying symptom of this disease is severe itching. The majority of my patients suffer from psoriasis
psoriasis vulgaris (common psoriasis). How to recognize them, which causes and triggers there are and which treatment options I offer, you can read in this article.
1. What are the causes. Triggers for psoriasis?
2. What symptoms. There are different forms of psoriasis?
3. Diagnosis by your skin disease expert
4. What treatment of psoriasis is possible?
1. What are the causes. Triggers for psoriasis?
To date, the causes have not been fully clarified scientifically. However, we know that a malfunction of the immune system or. A genetic disease susceptibility favors the occurrence of psoriasis. A genetic predisposition (disposition) does not necessarily mean that this skin disease must break out. Trigger factors, on the other hand, can trigger an outbreak.
These triggers can be:
– infectious diseases (z. B. An infection with streptococci, measles, an influenza infection, an HIV infection or chronic inflammations) – medications (e.G. B. Blood pressure and cholesterol-lowering drugs, anti-malarial and anti-rheumatic drugs, painkillers such as ibuprofen or aspirin) – injuries (e.G. B. Pressure points. Mechanical irritation (e.G. B. Tight and abrasive clothing) – addictive substances (z. B. Excessive alcohol consumption and nicotine) – metabolic disorders – hormonal factors (z. B. Hormonal imbalance, such as during puberty, pregnancy or menopause) – psychological factors (e.G. B. Intense stress) – environmental influences – obesity or. Strong weight fluctuations
Psoriasis is not curable, can occur at any age and usually runs in relapses. Some patients may wear tight and abrasive clothing for a long time. Do not experience further relapses after the initial onset for the rest of their lives.
2. What symptoms. Forms of psoriasis exist? Besides psoriasis vulgaris – which I treat most frequently in my dermatology practice in Zurich. Laughter diagnose – there are a number of other forms of psoriasis. I have summarized the most important ones for you.
Psoriasis vulgaris (plaque psoriasis)
This form of psoriasis appears as sharply defined, red and slightly protruding patches on the skin that can be very itchy. These areas are covered with silvery-white scales (plaque). Can vary in size – from pinpoint to palm-sized. In particularly severe cases psoriasis vulgaris can also occur over a large area of the whole body. However, this form often occurs symmetrically on the preferred body parts:
– hairy head – behind the ears – hands – elbows – coccyx area – belly button area – buttock crease – knees – feet
Psoriasis inversa
Psoriasis inversa mainly occurs in larger folds of the skin, such as. B. In the bends of the arms and legs, buttock folds, under the breast in women. It is a subtype of Psiorias vulgaris. As a rule, there is no scaling, but only an intense reddening of the affected skin areas, which can weep over a large area. This form is characterized by severe itching. Usually occurs after a bacterial infection. Psoriasis guttata is recognizable by many small spots. May subside after the infection has healed. It can happen that this form turns into a chronic psoriasis vulgaris.
Pustular psoriasis
This form of psoriasis is accompanied by purulent pustules on the strongly reddened skin areas. However, this rarely occurs. Pustular psoriasis often occurs on the palms of the hands and soles of the feet.
Nail psoriasis
Many patients are also affected by psoriasis on the nails – this is manifested by dents, spots and cornification. The nails can also become porous and fall off.
Psoriatic Arthritis
This is an inflammatory joint, tendon or spinal disease, also called psoriatic arthritis. In about one third of people affected by psoriasis, this rheumatic disease also occurs.
Symptoms of psoriasis may also include the following:
Itching: Up to 80 percent of all psoriasis sufferers experience mild to very severe itching. Psoriasis often affects the psyche. A mental illness can become a concomitant disease. Often affected persons have to fight with stigmatization up to depressions. But psychosocial problems can also trigger psoriasis, or. Reinforce. Psoriasis of the scalp: Psoriasis occurs most frequently on the hairy head. Psoriasis often spreads to the forehead and neck, placing an additional burden on sufferers as they have difficulty hiding these areas.
These different forms of psoriasis can have serious effects on the quality of life of the affected person. In chapter 4 I list proven therapy options for you.
95% of people with psoriasis are diagnosed with psoriasis vulgaris, the common form of psoriasis.
3. Diagnosis by your expert for skin diseases
After a detailed discussion with my patients, I examine the affected skin areas for a suspected psoriasis disease. There are typical skin changes as well as skin tests that allow a clear diagnosis: For example, punctiform skin bleeding occurs after the removal of the skin scales.
If the classification of the existing symptoms is not clear, a biopsy can be performed. With a skin sample I can identify skin diseases with similar symptoms as z. B. Rule out fungal diseases or neurodermatitis.
4. Which treatment of psoriasis is possible?
Psoriasis is not curable. However, there are good therapeutic options to treat the flare-ups and relieve the symptoms to significantly improve the quality of life of sufferers. I will show you here 8 treatment options, with which I have already had good experiences with my patients. Topical therapy with ointments. Creams are applied locally to the affected areas of the skin. Possible side effects z. B. On other areas of the organism are reduced as a result. These topical therapies are among the less expensive forms of treatment and are usually the first choice. However, if this form of therapy does not show sufficient success or if the psoriasis is severe, systemic therapeutics in the form of light therapy, tablets or injections are also used. This is how I determine an individual therapy for my patients in the form of medications. Systematic treatment with the most modern medications, such as biologics, is carried out in close cooperation with the University Hospital of Zurich.
Topical therapies:
Skin care: Oily and lipid-replenishing ointments as well as creams with urea or salicylic acid as ingredients are best suited for the treatment.
Anti-inflammatory therapy: This therapy is given in the form of foams, ointments, or gels z. B. Carried out with corticoids, calcineurin inhibitors or combination preparations. This external form of treatment with ultraviolet light (UVA/B. UVB 311) is a mild form of therapy in addition to being effective. In my dermatology practice in Zurich I also offer this form of therapy. Basically, sunlight also supports relief of the symptoms. Light therapy (using artificial light of certain wavelengths), on the other hand, is clearly more effective and significant improvement is noticeable more quickly to gain more quality of life. Medication: Depending on the effect of topical therapies, severity, age, gender and life circumstances, there is also a good choice of anti-inflammatory medications that can be swallowed or injected. Possible medications for psoriasis treatment are z. B. Acitretin, Ciclosporin, Fumarate, MTX or the currently most modern biologics. Biologics are drugs that work directly in the immune system and z. B. Blocking messenger substances. Thus, severe forms of psoriasis can rapidly improve. Especially when a topical (local) form of therapy does not show sufficient effect.
Other therapy options:
Nutrition: Avoid alcohol, meat and sausage – these increase inflammatory processes in the body. An improvement of symptoms support anti-inflammatory foods such as omega-3 fatty acids (fatty sea fish, linseed oil) and fruits as well as vegetables. Stress reduction: Establish relaxation techniques in their daily life, such as. B. Autogenic training or meditation. Sports and exercise also have a positive effect on psoriasis. Strengthen psyche: If necessary, professional psychological support can also be called upon, as sufferers often suffer from z. B. Exclusion and suffering from a lowered self-esteem. Climatherapy: Spend time in the mountains or by the sea, as this climate, as well as salt water, helps psoriasis subside. In this article I will give you an overview of psoriasis. However, this cannot replace a medical and personal consultation with me in the Skin Center in Zurich or in the dermatology practice at the Lachen Hospital.