THE SYMPTOMS OF PSORIASIS

Individuals with psoriasis experience symptoms such as itching, cracking, stinging, burning, or bleeding. Lack of sunlight and low indoor humidity in the winter months can cause the psoriasis symptoms to worsen. The skin is most likely to crack at the joints where the body bends, or in areas where the individual scratches. Scratching should be strictly avoided, because it can cause bleeding and infection. Psoriasis has also been known to cause pits or dents to form in fingernails and toenails. There is also the possibility that the soft tissue inside the mouth and genitalia can be affected. In some cases, psoriasis will cause joint inflammation that produces arthritis symptoms. This condition is called psoriatic arthritis.

People with psoriasis may notice that there are times when their skin worsens, then improves. Conditions that may cause flare-ups include changes in climate, infections, stress, and dry skin. Also, certain medicines, most notably beta-blockers, which are used in the treatment of high blood pressure, and lithium or drugs used in the treatment of depression, may cause an outbreak or worsening of the disease.

Treatment for Psoriasis

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Exploring the Cause of Psoriasis

Researchers believe the immune system sends faulty signals that speed up the growth cycle in skin cells. Certain people carry genes that make them more likely to develop psoriasis, but not everyone with these genes develops psoriasis. Instead, a "trigger" makes the psoriasis appear in those who have these genes. Also, some triggers may work together to cause an outbreak of psoriasis; this makes it difficult to identify individual factors.Possible psoriasis triggers include: emotional stress; injury to the skin; some types of infection; reaction to certain drugs. Once the disease is triggered, the skin cells pile up on the surface of the body faster than normal. In people without psoriasis, skin cells mature and are shed about every 28 days. In psoriatic skin, the skin cells move rapidly up to the surface of the skin over three to six days. The body can't shed the skin cells fast enough and this process results in patches also called "lesions" forming on the skin's surface

Hand and Foot Psoriasis

Psoriasis that affects the palms of the hands and the soles of the feet is called palmoplantar psoriasis. It may appear as chronic flaky patches that crack and bleed. The nails may be affected as well. In severe cases the condition can be disabling. Palmar-plantar psoriasis: Psoriasis of the palms, of the hands and the soles of the feet, characterized by erythema, thickening and peeling of the skin, blistering is often present. It may prevent patient from opening and closing hands thus leading to a disability. The palms and soles can also be affected by pustular psoriasis. In this condition small, deep, pus-filled blisters appear on the palms and soles. They may have a copper-colored hue on a background of red, flaky skin. This condition may also be called palmoplantar pustulosis or acropustulosis.Red, scaling plaques with small pustules that develop on the palms and the soles of the feet are called palmolatar psoriasis. The pustules are 1–10mm (pin- to dime-sized) in diameter and are often painful, interfering with daily functioning. It predominately affects women.This condition looks very different from common plaque psoriasis and flexural psoriasis, and usually only appears on the soles of the feet and palms of the hands. Instead of inflamed and scaly patches, there are weeping, cracked lesions that can look like masses of tiny yellow blisters. These can be quite painful and look infected, even though there is no infection present. Over a period of days, the pustules turn a brownish color and fall off, often only to be quickly replaced. The production of new pustules to replace the ones that have been shed can go on over a period of years. Psoriasis can affect the feet causing thick scaling and redness. The feet can occasionally be the only area to be affected by psoriasis with no rash elsewhere on the body. When psoriasis is found elsewhere on the body, the feet can also be the area involved with thick scaling, redness and sometimes pustules. The pustules are known as sterile pustules as they do not have infection within them.

Defining Erythrodermic Psoriasis

Erythrodermic psoriasis appears on the skin as a widespread reddening and exfoliation of fine scales, often accompanied by severe itching and pain. Swelling may also develop. This is a rare condition in which the rash is spread over large sections of the body. The skin is very inflamed which affects its ability to function properly. It does not retain fluid as normal, which results in the patient feeling constantly thirsty and being dehydrated. It also impairs the skin's performance in maintaining body temperature control so the sufferer may lose heat more easily and be more susceptible to hypothermia. This is also a more serious form of the condition and one that needs expert medical management.Erythrodermic psoriasis is a particularly inflammatory form of psoriasis that often affects most of the body surface. It is the least common form of the disease. It most commonly appears on people who have unstable plaque psoriasis, where lesions are not clearly defined

Pustular Psoriasis

Pustular psoriasis usually appears as a large red area covered with yellow-green pustules. They tend to be one to two millimeters in diameter and are quite tender. The yellow color is caused by masses of white blood cells (polymorph leucocytes), which flood into any part of the skin that is damaged or infected, in order to fight infection and aid recovery.After seven to 10 days, the pustules become dispersed and a brown scale appears. This scale will start to shed as new pustules develop in other areas, often in a continuous cycle.The most common type of pustular psoriasis affects the palms and soles. It isn't normally itchy however it can be sore or uncomfortable to use either your hands or feet, for example if you are writing or walking.

Making Psoriasis Less Noticeable

Using moisturizers regularly can help improve the redness and scaling of psoriasis lesions. Also, remove as much scale as possible if you are going to use a cosmetic cover-up. There are two ways you can get rid of psoriasis scale on your own:
Occlusion: You can coat each plaque with a thick layer of heavy, over-the-counter emollient cream and then cover it overnight with a plastic wrap. In the morning, wash away the scales in the shower. Note: never occlude a prescription drug without first consulting your doctor.
Hydration: After soaking for 10 to 15 minutes in warm water and bath oil, gently rub your skin with a towel to remove the scales.

Psoriaisis Cover-ups

People are curious when they see something different, especially on your skin. You have many choices about how to react to their curiosity. You may choose to ignore their attention, or you can explain that psoriasis is a skin disease that is not contagious. Educating people about psoriasis is very valuable because it helps them to accept people who live with skin that is different.
But when you wish to go out in public without addressing your skin condition, certain techniques can help you cope. Wearing long sleeves, pants, turtle necks, hats or scarves, for example, can make coping in public a lot easier on days when you don't have the emotional energy to accept the stares and questions.
Cosmetic cover-up products can help for those times when clothing won't do. Masking psoriasis lesions and camouflaging redness can make it easier to feel confident in social situations. Dermablend is one brand name of a body makeup that some people use. It can be found in major department stores.
Caution: Never apply cosmetic cover-up to open skin lesions, unhealed cuts or raw or irritated skin. Avoid using cosmetics if skin allergies are present. If you're ever in doubt about applying a cover-up, seek the advice of your physician.
Note: Not all types of psoriasis can be camouflaged. Masking pustular or erythrodermic psoriasis is not a good idea, because minor irritants in cosmetics can produce stinging and redness, and this skin is already inflamed.

Get the Latest News on Psoriasis

Biologic Advances in the Treatment of Psoriasis (02/20/2005, American Academy of Dermatology)

How Medication Can Affect Psoriasis

Certain medications are associated with triggering psoriasis.

Lithium: Used to treat manic depression and other psychiatric disorders. Lithium aggravates psoriasis in about half of those with psoriasis who take it. However, people can ask their physicians about alternatives to lithium.

Antimalarials: Quinacrine, chloroquine and hydroxychloroquine may cause a flare of psoriasis, usually two to three weeks after the drug is taken. Hydroxychloroquine has the lowest incidence of side effects.

Inderal: This high blood pressure medication worsens psoriasis in about 25 percent to 30 percent of patients with psoriasis who take it. It is not known if all high blood pressure (beta blocker) medications worsen psoriasis, but they may have that potential. Sometimes other medications can be substituted.

Quinidine: This heart medication has been reported to worsen some cases of psoriasis.

Indomethacin: This drug is used to treat arthritis. It is a nonsteroidal anti-inflammatory drug. It has worsened some cases of psoriasis. Other anti-inflammatories usually can be substituted. Indomethacin's negative effects are usually minimal when it is taken properly. Its side effects are usually outweighed by its benefits in psoriatic arthritis.