Psoriasis Treatment

Psoriasis is a chronic, non-contagious skin disease of unknown cause that affects skin cells, causing them to peel off and accumulate in many layers, and may be accompanied by inflammation. The areas of the elbows, knees and scalp are the areas most prone to the emergence of symptoms of the disease, with the possibility of their appearance in the rest of the different areas of the body. It occurs in the form of attacks or seizures, that is, it disappears and then reappears.

The signs and symptoms of psoriasis can vary from person to person, but may include one or more of the following:

Red spots on the skin covered with silver scales.

Small, scaly patches (usually seen in children).

Dry, cracked skin that may bleed.

burning or pain.

Thick, pitted, or wrinkled nails.

and stiff joints.

Patches of psoriasis can range from a few patches of dandruff-like scales to a large rash that covers large areas of the skin. Most types of psoriasis go through cycles, where they flare up for a few weeks or months, then subside for a while, or until they are completely calm.

There are several types of psoriasis, including:

Plaque psoriasis

causes Plaque psoriasis dry, red, raised skin lesions (plaques) covered with silvery scales. The plaques are itchy or possibly painful and can occur anywhere in the body, including the genitals and the soft tissues inside the mouth. You may have a few or many plaques.

Nail psoriasis

Psoriasis can affect the toenails of the hands and feet, causing pitting, abnormal growth, and discoloration. Psoriasis nails may become loose and separate from the nail bed (onychomycosis), and severe cases may cause brittleness.

Scalp psoriasis

Psoriasis appears as red, itchy patches with silvery or white scales. Often the red or scaly areas extend beyond the hairline, and you may notice flakes of dead skin in the hair or on the shoulders, especially after scratching the scalp.

Guttate psoriasis

This type mainly affects young adults and children, and is usually caused by a bacterial infection such as strep throat. It is characterized by small, water-drop-shaped sores on the trunk, arms, legs, and scalp. The sores are covered with a thin crust that is not thick, and you may have the disease once and then go away on its own, or you may have recurring attacks.

Inverse psoriasis

This type mainly affects the skin in the armpits, groin area, under the breasts and around the genitals. Infold psoriasis causes red patches of inflamed skin, exacerbated by friction and sweating. This type of psoriasis may occur due to a fungal infection.

Pustular psoriasis

This uncommon form of psoriasis can occur in widespread patches (generalized pustular psoriasis) or in smaller parts on the hands, feet, or fingertips. Generally, this psoriasis develops quickly, with pus-filled blisters only appearing hours after the skin becomes red and tender. Blisters may appear and go away frequently, and generalized pustular psoriasis can cause fever, chills, severe itching, and diarrhea.

Erythrodermic psoriasis

Erythrodermic psoriasis, the less common type of psoriasis, can cover the entire body with a red, scaly rash that can itch or burn intensely.

Psoriatic arthritis

In addition to inflamed squamous skin, psoriatic arthritis causes discolouration, pitting, and swelling and tenderness in joints, which are common symptoms of osteoarthritis. Symptoms vary from mild to severe, and it can affect any joint. Although the disease is not usually disabling as other forms of arthritis, it can cause stiffness and progressive joint damage that can lead in the most serious cases to permanent deformity.

The cause of psoriasis

The cause of psoriasis is not yet known , but it is believed to be related to immune system problems related to cells in the body, where there is a major white blood cell type called a T lymphocyte or T cell. It is not yet fully known what causes T-cell dysfunction in people with psoriasis , and researchers have found genes associated with the development of psoriasis, but environmental factors also play a role.

Psoriasis usually begins or is exacerbated by a trigger that he may be able to challenge and avoid. Factors that may trigger psoriasis include:

Infection, such as a sore throat or skin infection.

Injury to the skin, such as a cut, scratch, insect bite, or severe sunburn.

– Stress.

– Cold weather.


Excessive alcohol use.

some medicines, including lithium, which are prescribed to treat bipolar disorder; high blood pressure medications such as beta-blockers; antimalarial drugs; and iodide.

Complications of psoriasis

If you have psoriasis, you are more likely to develop the following diseases:

In psoriasis, this can cause joint damage and loss of function in some, which can be debilitating.

, such as conjunctivitis, blepharitis and uveitis, are more common in people with psoriasis.


Type 2 diabetes mellitus.

– Hypertension.

Cardiovascular disease.

Metabolic syndrome, including high blood pressure, high insulin levels and abnormal cholesterol levels.

Other autoimmune diseases, such as celiac disease, sclerosis, and an inflammatory bowel disease called Crohn’s disease.

Parkinson’s disease.

– Kidney disease.

Psoriasis can also affect your quality of life by increasing the risk of low self-esteem, depression and social isolation.

Diseases that can resemble psoriasis

1- seborrheic dermatitis

This type of dermatitis is characterized by oily, scaly and itchy skin. It is often found in fatty parts of the body, such as the face, upper chest and back. Seborrheic dermatitis can also appear on the scalp as itchy dandruff.

2- Lichen planus

Itchy, inflammatory skin disease that appears as rows of flat, itchy bumps (lesions) on the arms and legs.

3- alopecia areata (ringworm of the body)

Alopecia is caused by a fungal infection in the upper layer of the skin. Often, the infection causes a ring or circle of red, scaly rash. This common skin disease usually begins as one large spot (primary rash) on the chest, abdomen or back that later spreads. Often, the rash of pityriasis rosea extends from the middle of the body, and its shape resembles the hanging branches of a pine tree.

Methods of treating psoriasis

Unfortunately, there is no definitive cure for it, but self-help measures can help improve the look and feel of damaged skin. The following may be helpful to you:

1- Take a shower daily, to get rid of scales and soothe inflamed skin. Add bath oil, colloidal oatmeal, Epsom salts, or Dead Sea salts to the soapy water. avoid hot water and harsh soaps, as these can aggravate symptoms; Use lukewarm water and a gentle soap with added oils and fats.

Pat skin dry after showering, then apply a heavy balm moisturizer when skin is still damp. For all dry skin, oils may be preferred, as they contain more active ingredients than creams or lotions and are more effective in preventing water from evaporating from the skin. During cold, dry weather, you may need to apply moisturizer several times a day.

2. Expose your skin to a small amount of sunlight. A controlled amount of sunlight can greatly improve wounds, but prolonged exposure to sunlight can stimulate or exacerbate disease outbreaks and increase the risk of skin cancer. Before beginning any tanning program, ask your doctor about the safest way to use natural sunlight to treat the skin.

3- Know the triggers, if any, that exacerbate psoriasis, and take the necessary steps to prevent or avoid them. Infections, skin injuries, stress, smoking and intense sun exposure can worsen psoriasis. Avoid alcohol. Drinking alcohol can reduce the effectiveness of some psoriasis treatments.

Topical treatments for psoriasis

Topical corticosteroids

These powerful anti-inflammatory medications are most commonly prescribed to treat mild to moderate psoriasis. They slow the movement of cells by suppressing the immune system, which reduces inflammation and relieves the itching that accompanies this inflammation. Topical corticosteroids vary in strength from mild to very strong.

Low-potency corticosteroid ointments are usually recommended for sensitive areas, such as the face or skin folds, and for widespread patches of damaged skin. For small areas of skin, your doctor may prescribe a stronger corticosteroid ointment to treat persistent plaques that appear on the hands or feet, or when other treatments fail. Medicated foams and scalp solutions are available to treat patches of psoriasis on the scalp.

Long-term use or overuse of corticosteroids can cause thinning of the skin and resistance to the benefits of treatments. To reduce side effects and increase effectiveness, topical corticosteroid medications are usually used on outbreaks until they are under control.

Vitamin D analogues

These synthetic forms of vitamin D slow the growth of skin cells. Calcipotriene (Dovonex), a prescription cream or lotion that contains a vitamin D analogue, can be used alone to treat mild to moderate psoriasis, or it can be used in combination with other topical medications or light therapy. This treatment can irritate the skin, and calcitriol (Rocaltrol) is expensive but may be just as effective and may be less irritating to the skin than calcipotriene.


This drug is thought to normalize the activity of DNA in skin cells. Anthralin (Dreto-Sculp) can also remove scales to make skin smoother. However, anthralin can irritate the skin and cause smudges on anything it touches, including skin, clothing, kitchen surfaces, tables, and bedding. For this reason, doctors often recommend a short-term treatment, which allows the cream to stay on your skin for a short time before washing off.

Topical retinoids

These medications are commonly used to treat acne and sun-damaged skin, but tazarotene (Tazorac, Avige) was developed specifically to treat psoriasis. Like other vitamin A derivatives, this drug normalizes DNA activity in skin cells and may reduce inflammation. The most common side effect is skin irritation.

It can also increase sensitivity to sunlight, so apply sunscreen while using this medicine. Although the risk of birth defects is much lower for topical retinoids than for oral retinoids, tazarotene is not recommended when you are pregnant or breastfeeding, or if you intend to become pregnant.

Calcineurin inhibitors

Only the calcineurin inhibitors tacrolimus (Prograf) and pimecrolimus (Elidel) are currently approved for treating atopic dermatitis, but studies have shown that these medications are effective in treating psoriasis. Calcineurin inhibitors are also thought to disrupt T-cell activity, which, in turn, reduces inflammation and plaque buildup.

Long-term or continuous use of calcineurin inhibitors is not recommended because of the potential increased risk of skin cancer and lymphoma. These medications may be especially useful in areas of thinner skin, such as around the eyes, where steroid creams or retinoids are difficult to use due to their irritation or potential for adverse effects.

– salicylic acid

Salicylic acid, available both by prescription and without a prescription, promotes shedding of dead skin cells and reduces scaling. Sometimes this medication is used together with other medications, such as a topical corticosteroid or coal tar, to increase its effectiveness. Salicylic acid is available as a medicated shampoo and scalp lotion to treat scalp psoriasis.

– Coal tar

Coal tar, a thick, black by-product obtained from the manufacture of petroleum products and coal, is perhaps the oldest treatment for psoriasis. It reduces scaling, itching and inflammation, and the nature of the action of this product is not yet known. Coal tar has few known side effects, but it is messy, stains clothes and bedding, and has a strong odor.

Coal tar is available as over-the-counter shampoos, creams and oils. It is also available in high concentrations when available by prescription. This treatment is not recommended for women who are pregnant or who are breastfeeding.

– Refreshments

Moisturizing creams, by themselves, won’t cure psoriasis, but they can reduce itching and scaling, and can help combat the dryness that comes with other treatments. Moisturizers at the base of the ointment are usually more effective than lighter creams and lotions.

Oral medications for psoriasis

– retinoids

This group of medications, which are linked to vitamin A, can reduce skin cell production if you have severe psoriasis that doesn’t respond to other treatments. However, signs and symptoms usually return once you stop using the treatment. Side effects may include lip inflammation and hair loss. Because retinoids such as acitretin (Soriatin) can cause severe birth defects, women should avoid becoming pregnant for at least three years after taking the drug.

– methotrexate

Methotrexate, taken by mouth, helps treat psoriasis by reducing the production of skin cells and suppressing inflammation. It also slows the progression of psoriatic arthritis in some people. Methotrexate is generally well tolerated at low doses, but it can cause stomach upset, loss of appetite and fatigue. When used for long periods, it can cause a number of serious side effects, including severe liver damage and decreased production of red and white blood cells and platelets.

– cyclosporine

Cyclosporine suppresses the immune system and is similar in effectiveness to methotrexate. Like other immunosuppressants, cyclosporine increases the risk of infections and other health problems, including cancer. Cyclosporine also makes you more likely to have kidney problems and high blood pressure – the risks increase with higher doses and longer-term treatment.

Medicines that alter the immune system (biological)

Several immunomodulators have been approved for the treatment of moderate to severe psoriasis. They include etanercept (Enbrel), infliximab (Remicade), adalimumab (Humera), and ustekinumab (Stelira). These medications are taken by intravenous, intramuscular or subcutaneous injection and are usually used for people who haven’t responded to conventional treatment or who have psoriatic arthritis.

Biologics block interactions between specific cells of the immune system and specific inflammatory pathways. Although derived from natural sources and not chemical, they should be used with caution as they have a strong effect on the immune system, and may help a person with life-threatening infections. In particular, people taking these treatments should be tested for tuberculosis.

Other medicines

Thioguanine and hydroxyurea (Droxia, Hydrea) are medicines that can be used when other medicines cannot be taken. are a number of new drugs currently under research that have the potential to improve the treatment of psoriasis. Some of the treatments being studied include adenosine A3 receptor agonists; IL-17 receptor antagonists, IL-12/23 antagonists, and IL-17 antagonists; Janus kinase inhibitors; and phosphodiesterase 4 inhibitors.

Light therapy for psoriasis

1 – sunlight

When exposed to ultraviolet rays in sunlight or artificial light, the active protrusion cells in the skin die. This slows the movement of skin cells and reduces scaling and inflammation. Brief, daily exposure to small amounts of sunlight may improve psoriasis treatment, but too much sun exposure can worsen symptoms and cause skin damage. Before beginning a solarium regimen, talk to your doctor about the safest way to use natural sunlight to treat psoriasis.

2- Ultraviolet light therapy

Controlled doses of ultraviolet light from an artificial light source can improve mild to moderate psoriasis symptoms. UVB phototherapy, also called broadband UVB, can be used to treat single spots, widespread psoriasis and psoriasis that’s resistant to topical treatments. Short-term side effects may include redness, itching, and dryness of the skin, and using an emollient may help reduce these side effects.

3- Narrowband UVB therapy

Narrowband UVB therapy, one of the newer types of psoriasis treatment, may be more effective than broadband UVB therapy. It is usually applied two or three times a week until the skin improves, then the treatment may require only weekly sessions. Narrowband UVB treatment may cause more severe and longer-term burns.

4- Jokerman treatment

Some doctors combine UVB therapy with coal tar therapy, which is known as Jokerman therapy. Both treatments are more effective than either alone, because coal tar makes the skin more receptive to UVB light. When a three-week hospital stay is required, a modification to the original treatment can be made in the doctor’s office.

5- Photochemotherapy or ultraviolet A light plus psoralen (PUVA)

Photochemotherapy involves taking a photosensitizing drug (psoralen) before exposure to ultraviolet A light. UVA light penetrates more deeply into the skin than UVB light, and psoralen makes the skin more responsive to UVA exposure.

This tougher treatment improves skin and is often used to treat more severe cases of psoriasis. Photochemotherapy or UVA plus psoralen involves two or three treatments a week for a fixed number of weeks. Short-term side effects include nausea, headache, burning and itching.

Long-term side effects include dry, wrinkled skin, freckles, and an increased risk of skin cancer, including melanoma, which is the most serious form of skin cancer. Because this treatment makes you more sensitive to sunlight, it’s important to avoid sun exposure whenever possible and to use a broad spectrum sunscreen with an SPF of at least 30. To protect your eyes, wear sunglasses that protect against UVA rays.

6- X-ray laser

This type of light therapy, used to treat mild to moderate psoriasis, treats only the area of ​​skin involved. Controlled beams of UVB light of a specific wavelength are directed at the psoriasis plaques to control scaling and inflammation. The skin around the affected spots is not damaged. Excimer laser treatment requires fewer sessions than conventional phototherapy, due to the use of more powerful UV light. Side effects can include redness and blisters.

Health recommendations

Bathe daily, to get rid of scales and soothe inflamed skin. avoid hot water and harsh soaps, as these can aggravate symptoms; Use lukewarm water and a gentle soap with added oils and fats.

Pat the skin dry after showering, then apply a moisturizer when the skin is still damp. For all dry skin, oils may be preferred, as they contain more active ingredients than creams or lotions and are more effective in preventing water from evaporating from the skin. During cold, dry weather, you may need to apply moisturizer several times a day.

Exposing your skin to a small amount of sunlight, which greatly improves wounds. However, prolonged exposure to sunlight can trigger or exacerbate disease outbreaks and increase the risk of skin cancer. And be sure to protect healthy, unaffected skin with a broad spectrum sunscreen with an SPF of at least 30.

Avoid triggers of psoriasis, such as infection, skin injury, stress, smoking, and intense sun exposure


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