Psoriasis: what it is, symptoms, causes, diagnosis and treatments

What is psoriasis

Psoriasis is an autoimmune, inflammatory and non-contagious skin disease. The body’s own defense system begins to attack skin cells for some reason, causing injury. It affects all age groups and both sexes, but is more common in young adults. Data from the Brazilian Society of Dermatology (SBD) indicate that it affects 2 million people in our country.

According to dermatologist Ricardo Romiti, coordinator of the National Psoriasis Campaign of SBD, it is not yet known exactly what its cause is. It is only known that it is related to genetic and immunological factors of each individual.

“In addition, some triggers trigger or aggravate crises: stress, infections, long and very hot baths, use of certain medications and cold weather”, lists Romiti.

Types of psoriasis

Symptoms of psoriasis vary according to the type of the disease (and its intensity). See the main ones:

Plaque or common psoriasis:

It represents 90% of the cases. It preferably affects the scalp, elbows, knees and back, and manifests itself through red and raised lesions, covered with whitish scales.

“They are easily detached from the skin, spreading through clothes and objects of daily contact, such as combs,” reports Romiti. The cracks are accompanied by pain and itching.

Nail psoriasis:

The lesions appear on the nails of the hands and feet, causing them to grow unevenly. The nails get deformed and change color.

Palmoplantar psoriasis:

The palms of the hands and the soles of the feet are hit by the plates.

Inverted psoriasis:

The red spots affect areas of the body that sweat more (underarms, under the breasts, groin and fold of the knees and elbows).

Arthropathic psoriasis or psoriatic arthritis:

Sometimes, the inflammation spreads to other parts of the body besides the skin, reaching the joints. The symptoms are the same as for common arthritis (pain, swelling and stiffness in the joints). This picture tends to take longer to appear.

Pustular psoriasis:

They are the same lesions as the common version, but accompanied by pus blisters. They appear in the whole body or only in a localized way.

Gout psoriasis:

It is characterized by smaller, thinner than ordinary spots, in a drop shape. They are common in children and young adults, appearing on the trunk, limbs and scalp.

Erythrodermic psoriasis:

The whole body is affected by red spots that itch and burn intensely. Luckily, this is the rarest type.

Diagnosis of psoriasis

The problem is confirmed, usually at the doctor’s office. Dermatologists are prepared to recognize you.

“In some cases, it is also necessary to perform a skin biopsy to rule out the possibility of other diseases”, adds Romiti. If you have suspicious symptoms, consult a doctor.

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Is psoriasis curable? Know the treatment

“There is still no cure, but today it is possible to treat it very satisfactorily”, celebrates Romiti. According to him, the available therapeutic arsenal is able to control completely or almost completely the signs and psoriasis symptoms.

The treatment chosen depends on the type of disease, its extent and severity. There are those who only manifest one or another spot from time to time, while other patients are left with a good part of their body covered by the lesions.

“We use everything from topical medications, with anti-inflammatory ointments and creams, to systemic therapies”, teaches the SBD professional. What are systemic therapies? In short, remedies for psoriasis are oral, phototherapy and injectable medications – biological or immunobiological.

One way or another, they try to contain attacks by the immune system on the skin and other affected structures.

Romiti says that the most modern injectable drugs represent extremely effective and safe management measures. Four of them have even been incorporated into the Unified Health System (SUS) for severe cases: adalimumab, secuquinumab, ustequinumab and etanercept.

Learn how to deal with the prognosis and possible complications

Unfortunately, psoriasis is fraught with stigma and prejudice. As we have already said, the disease is not contagious, but there are those who are afraid to approach patients without any justification.

“Because of the apparent injuries, people suffer discrimination and tend to isolate themselves”, laments Romiti. It is common for them to develop depression and anxiety. “Many need multidisciplinary follow-up to deal with the disease in the most appropriate way”, points out the doctor. Psychologists and psychiatrists are often key players in this strategy.

“But I reinforce that, currently, psoriasis is perfectly treatable. This brings back well-being and quality of life ”, adds Romiti.

On the other hand, if not treated properly, the injuries, pain and itching get worse. “Serious cases may require hospitalization due to the high risk of complications, such as infection and shock”, warns the dermatologist. That is why it is so important to seek medical help and not interrupt therapy.

In addition, as we said in the topic about psoriatic arthritis, inflammation is able to spread throughout the body, especially without proper treatment. Although joints appear to be a primary target, psoriasis is able to affect the cardiovascular system, which increases the risk of heart attack and stroke.

Treating, therefore, does not only protect the skin.

Psoriasis and coronavirus

Many of the treatments for psoriasis seek to decrease the performance of the immune system. And there was a fear that this would favor serious cases of Covid-19. However, new studies suggest that the drugs are safe, although it is always good to assess each situation.

Abandoning the therapeutic strategy without talking to a professional before can bring risks to the whole body, as we have already mentioned.

Is there prevention?

Unfortunately, there are no known ways to prevent the disease. But taking certain precautions, it is possible to escape the worsening of the condition or intense crises.

“The tips include healthy lifestyle habits, use of moisturizers and sunbathing for a limited period”, lists Romiti. Ah, do not poke or tear off the scales that form on the skin.

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