PSORIASIS

General Information

DEFINITION--A chronic, scaly skin disorder characterized by frequent remissions and recurrences.

BODY PARTS INVOLVED--Skin, especially of the scalp, elbows, knees, chest, back, arms, legs, toenails, fingernails and fold between the buttocks.

SEX OR AGE MOST AFFECTED--Begins in late childhood or young adulthood and continues throughout life.

SIGNS & SYMPTOMS

• Skin areas that are slightly raised, have red borders and are covered with large white or silver-white scales. The areas crack and become painful.
• Itching (sometimes).
• Joint pain.

CAUSES--Unknown, but probably caused by autoimmune disorder.

RISK INCREASES WITH

• Family history of psoriasis.
• Rheumatoid arthritis.
• Local injury.
• Infections (viral and bacterial) elsewhere in the body.
• Stress.
• Cold climates.
• Genetic factors. Persons with psoriasis have HLA antigens, and the incidence is highest among Caucasians.
• AIDS.

HOW TO PREVENT--Cannot be prevented at present.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Skin biopsy (See Glossary) if needed to confirm diagnosis.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.
• No permanent cure exists. Steps in treatment depend on the type of psoriasis, extent of the disease, your response to it, and affect on your lifestyle.
• Psychotherapy or counseling (sometimes) to help in adapting to the disorder.

POSSIBLE COMPLICATIONS

• Secondary bacterial infection in the affected area.
• Pustular psoriasis.
• Psoriatic arthritis.

PROBABLE OUTCOME--Symptoms can be controlled but not cured. The disease may have long periods of inactivity. In women, severity decreases during pregnancy.

How To Treat

GENERAL MEASURES--

• Maintain good skin hygiene with daily baths or showers.
• Avoid skin injury, including harsh scrubbing, which can trigger new outbreaks.
• Avoid skin dryness to decrease the frequency of recurrences. To reduce scaling, use non-prescription waterless cleansers and hair preparations containing coal tar or cortisone.
• Expose skin to moderate amounts of sunlight as often as possible.
• Oatmeal baths may loosen scales. Use 1 cup of oatmeal to a tub of warm water.
• Get counseling for any psychological problems caused by psoriasis.
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe the following to decrease inflammation and scaling:

• Ointments containing coal tar.
• Topical cortisone drugs to use under plastic dressings.
• Immunosuppressive drugs (severest cases).
• PUVA (combination of a medication and exposure to ultraviolet light-wavelength A).
• Combination of tar baths with UVB (ultraviolet therapy-wavelength B).
• Antihistamines to relieve itching.
• For pustular psoriasis--etretinate, isotretinoin or oral methotrexate.

ACTIVITY--No restrictions.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of psoriasis, or symptoms recur after treatment.
• During an outbreak, pustules erupt on the skin, accompanied by fever, muscle aches and fatigue.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.