Understanding Sebopsoriasis

Psoriasis can occur simultaneously with seborrhoeic dermatitis, a more common scalp condition. This combination is referred to as Sebopsoriasis.

Seborrhoeic dermatitis has some differences from psoriasis. Its scale is usually diffuse throughout the scalp, as opposed to the raised, well defined plaques associated with psoriasis. It also tends to localize on the face and front of the chest. When these symptoms are combined with the symptoms of psoriasis, Sebopsorias results.

Sebopsoriasis has a more yellowish, greasy scale than the typical silvery, dry scale associated with psoriasis. It will occur not only on the scalp, but on the face and chest - similar to the pattern associated with that of seborrhoeic dermatitis. It is deeper red in color, has more defined margins, and a thicker scale than seborrhoeic dermatitis alone.

Nail Psoriasis

Affecting approximately one half of people with active psoriasis, nail psoriasis refers to the changes in finger and/or toenails caused by the disease. About one half of nail psoriasis patients have to stop their normal daily activities because of pain. Nail changes can occur in one or more nails and vary in severity; most likely the severity will mirror the amount of psoriasis in the nail bed, nail plate, nail matrix, and the skin at the base of the nail. In severe cases, where pustular psoriasis may damage the nail bed, the nail may be permanently lost.

Usually, nail psoriasis occurs in patients with psoriasis. It is associated with Psoriatic arthritis (arthritis in fingers and toes), occurring in about 50-85% of these patients.

Nail psoriasis may affect the nail plate, nail bed (the tissue under the nail), nail matrix (the tissue from which the nail grows), nail folds, cuticle, and the bones at the end of the fingers. Signs of nail psoriasis vary according to the part of the nail affected and the nature of the deformity.
It is rare that a person develops psoriasis only on the nails and nowhere else on the body. There are five general types of Nail psoriasis; these changes may occur alone or simultaneously. They include:
Pitting: A deeply pitted nail caused by the deficiencies in nail growth due to psoriasis in the nail matrix, characterized by loss of parakeratotic cells from surface of nail plate.
Discoloration of the nail bed (yellow or yellowish pink) resembling drops of oil under the nail plate, referred to as an “oil drop” or “salmon patch” caused by psoriasis in the nail bed.
The appearance of a white area separating and lifting from the nail plate, caused by pockets of air where the nail bed is lifting from the nail bed. This is referred onycholysis, and may be accompanied by inflamed skin around the nail.
Crumbling and total loss of the nail due to psoriasis causing weakening of the nail matrix.
Psoriasis of the finger and toenails can resemble other conditions such as chronic fungal infection or inflammation of the nail bed.

Defining Flexural Psoriasis

Flexural psoriasis, occurs in the folds of the skin (under the breasts, in the armpits, under the buttocks, near the genitals, or in the folds of the abdomen) in areas which are likely to rub together and sweat. Because the flexion creases, or skin folds are affected, this type of psoriasis occurs more often and more severely in overweight individuals.

Contrary to most common type of psoriasis (plaque psoriasis), flexural psoriasis does is not characterized by scaling. Flexural psoriases, instead, is characterized by inflamed, bright red yet smooth patches of skin that may be painful and itchy. The rubbing together and sweating if the skin folds aggravates irritation of the affected areas.

One cause of flexural psoriasis may be yeast overgrowth, as well as high sensitivity to friction and/or sweating. The skin lesions are further intensified by the sweat and skin rubbing together in the skin folds.

Like most types of psoriasis, flexural psoriasis is generally persistent, and will be difficult to cure with just topical treatments.

Psoriasis Facts

~Psoriasis may disqualify a person from serving in the U.S. military
~About 1 million people in the U.S. population have psoriatic arthritis; that equals about 0.5 percent of the country
~Between 10 percent and 30 percent of people with psoriasis develop psoriatic arthritis
~Psoriatic arthritis usually develops between the ages of 30 and 50, but it can develop at any time
~Generally psoriasis appears before the psoriatic arthritis, but it can develop without the characteristic skin lesions
~There are five types of psoriatic arthritis
Psoriasis patients
~Psoriasis patients make nearly 2.4 million visits to dermatologists each year
~Overall costs of treating psoriasis may exceed $3 billion annually
~150,000 to 260,000 cases of psoriasis are diagnosed each year
~If one parent has psoriasis, children have a 10 percent to 25 percent chance of developing psoriasis
~If both parents have psoriasis, children have a 50 percent chance
~Psoriasis affects an estimated 1 percent to 3 percent of the world's population

The Facts on Inverse Psoriasis

Inverse psoriasis occurs in the folds of the skin (under the breasts, in the armpits, under the buttocks, near the genitals, or in the folds of the abdomen) in areas which are likely to rub together and sweat. Because the flexion creases, or skin folds are affected, this type of psoriasis occurs more often and more severely in overweight individuals.

Contrary to most common type of psoriasis (plaque psoriasis), inverse psoriasis does is not characterized by scaling. Inverse psoriases, instead, is characterized by inflamed, bright red yet smooth patches of skin that may be painful and itchy. The rubbing together and sweating if the skin folds aggravates irritation of the affected areas.

One cause of inverse psoriasis may be yeast overgrowth, as well as high sensitivity to friction and/or sweating. The skin lesions are further intensified by the sweat and skin rubbing together in the skin folds.

Like most types of psoriasis, inverse psoriasis is generally persistent, and will be difficult to cure with just topical treatments.

New Treatments for Psoriasis

The past few years have seen an explosion in treatments for psoriasis and/or psoriatic arthritis that focus on stopping psoriasis in its tracks—not just treating the symptoms.

This chart lists drugs in development in the U.S. market for psoriasis and/or psoriatic arthritis. The treatments focus on those that are in pre-clinical stages or phase I, II, III and IV for psoriasis (click for an explanation of the different phases)—what's known in the pharmaceutical industry as the research pipeline. Information was compiled based on public information, and is as comprehensive as we understand it to be as of May 2005.

Psoriasis Scalp Treatment

Massaging a little warm baby/olive/coconut oil gently into the scalp, preferably before going to bed to allow plenty of time to soak (bind up the head in an old towel) will help. Wash out with cream shampoo (i.e. Dry Hair Products), add a little lemon juice to the final rinse to get rid of excess grease. Only shampoo three times a week, more than this and the natural oils may be washed out. Always treat the head as gently as possible, do not comb or brush harshly. Perms and colorants can be used as long as the skin is not broken. Shampoo the hair and scalp with a tar-based shampoo that can be purchased over-the-counter or by prescription. Shampoos, scalp steroid lotions, vitamin D analogues and some tar preparations such as tar pomade may be used on the scalp.

Getting the Facts on Plaque Psoriasis

Plaque psoriasis is the most common form of psoriasis. It is characterized by raised, inflamed (red) lesions covered with a silvery white scale. The scale is actually a buildup of dead skin cells. The technical name for plaque psoriasis is psoriasis vulgaris (vulgaris means common). Plaque psoriasis may appear on any skin surface, though the knees, elbows, scalp, and trunk are the most common locations.

Sometimes the patches of infected skin are large, extending over much of the body. The patches, known as plaques or lesions, can wax and wane but tend to be chronic. These can be very itchy and if scratched or scraped they may bleed easily.

The plaques usually have a well-defined edge and, while they can appear anywhere on the body, the most commonly affected areas are the scalp, knees and elbows. The face is rarely affected. However, if the scalp is involved, you may develop psoriasis on the hairline and forehead.The actual appearance of the plaques can depend on where they are found on the body. Plaques found on the palms and soles can be scaly, however they may not be very red in color. This is due to the thickness of the skin at these sites.

If the plaques are in moist areas, such as in the creases of the armpits or between the buttocks, there is usually little or no scaling. The patches are red and have a well-defined border.Chronic (or common) plaque psoriasis affects over 90% of sufferers. It appears usually on the scalp, lower back, elbows, arms, legs, knees and shoulders. It is very much an adult condition and is seldom seen in children.Chronic plaque psoriasis is not always itchy, nor is it always an uncomfortable condition, but its appearance, along with the shedding of the skin, can cause many sufferers a great deal of emotional discomfort.

Each psoriatic patch looks like a series of little discs or plaques that have super-imposed themselves on to the body. This plaque-like shape is peculiar to this form of the condition and is what gives it its name. The plaques are often round or oval in shape or they may not have a distinct shape, but they almost always stand out from the surrounding area of the body. The difference between the normal skin and the area affected by psoriasis can be quite marked. Each patch can start as a very small lesion, and then enlarge over a period of days or weeks. Individual psoriatic patches can spread and join with each other to affect a large area of the body. In a typical flare up, the condition can spread quite quickly over a few days or weeks and then stabilize before gradually disappearing. The psoriatic patches become less red and scaly until they reduce in size or disappear completely. The patches are red and rough to the touch and the affected skin incredibly scaly. Scaliness can be kept to a minimum by regularly moisturizing the skin with the relevant creams and ointments. It is important to keep the skin moisturized even when the psoriatic patches seem to have cleared. Often the skin underneath has not yet healed and, if it isn't treated properly, the scaliness may return quite quickly.

Symptoms of plaque psoriasis:
Look on the knees and elbows for red scaly plaques.
small plaques on the knuckles
characteristic plaques located behind the ears or in the ears
psoriatic plaques located elsewhere on the body
pits or onychodystrophy on the nails

If the person has none of the above then the person categorically does not have psoriasis. If the person has all of the above then the person has psoriasis. If the person has some of the above sometimes a diagnosis can be more difficult.

Psoriasis Arthritis

When psoriasis and arthritis occur together, it is known as psoriatic arthritis. (Arthritis is not a single disorder but rather the name for joint disease from a number of causes. Arthritic disease causes painful inflammation of one or several joints, with the inflammation destroying the cartilage in the joints.) The most easily recognizable form of psoriatic arthritis affects the joints of the fingers and toes. Psoriatic arthritis is usually less painful than rheumatoid arthritis. It also usually causes less disability.Psoriatic arthritis generally affects the fingers and toes, but it can involve the wrists, lower back, knees and ankles. Psoriatic arthritis can be a serious disease, with a large percentage of patients reporting that their symptoms limit their work or home activities.Psoriatic arthritis usually appears between the ages of 30 and 50.

Its symptoms usually include at least one of the following:
Pain in one or more joints
Movement that is restricted by pain in the joint or surrounding areas
Morning stiffness
Eye pain or redness

Because there is no laboratory test for psoriatic arthritis, people with psoriasis and joint pain may want to consult a specialist in joint diseases, called a rheumatologist, to evaluate their symptoms. Other joint diseases such as rheumatoid arthritis, gout, and Reiter’s syndrome all may be confused with psoriatic arthritis.