Psoriasis: Symptoms, Causes, and Treatments

What is psoriasis?

Psoriasis is a chronic skin disease characterized by non-contagious, scaly skin lesions (skin wounds which shed).

Symptoms

The main symptoms of psoriasis include:

red and scaly lesions: they can appear anywhere on the body but are most common on the elbows, knees, scalp, and lower back
itching: psoriasis lesions can be accompanied by intense itching
possible nail changes: there are forms of psoriasis that cause joint pain

Psoriasis is a chronic and recurrent condition, meaning symptoms can come and go throughout life, and it can also affect the nails, causing changes such as thickening and detachment.

Causes

The exact causes of psoriasis are not completely known, but some factors contribute to its development:

genetic factors: having first-degree relatives with psoriasis increases the risk of developing the disease
immune system dysfunction: although the cause of the disease is not entirely clear, it is known to be related to the excessive activation of T cells in the immune system
psychological factors: stress and anxiety can play a role in triggering or worsening psoriasis in some people, although they are not the main causes

Diagnosis

The diagnosis of psoriasis is usually based on the clinical evaluation by a professional such as a dermatologist, who examines the skin and checks for characteristic symptoms of the condition. No specific test is needed to diagnose psoriasis in most cases. The main aspects considered in the diagnosis include:

physical examination: the skin is examined to identify typical lesions, which are usually red or pink elevations with scales
clinical history: questions are asked about the symptoms, such as when they started, how they have progressed, and if there were any triggering factors
exclusion of other conditions: since many skin conditions can have similar symptoms, the responsible professional must rule out other skin diseases, such as contact dermatitis or fungal infections

In some cases, a skin biopsy may be necessary to confirm the diagnosis, especially when symptoms are atypical or do not respond to conventional treatment. During the biopsy, a small sample of skin is taken and examined under a microscope to check for specific characteristics of psoriasis.

Treatment

The treatment of psoriasis aims to control symptoms, reduce inflammation, relieve itching, and improve patients' quality of life. It can vary according to the severity and type of psoriasis, as well as the individual needs of the patient. The main treatments are:

topical treatment: patients use medications in creams and ointments, applied directly to the skin
systemic treatment: use of medications in tablets or injections, usually indicated for patients with severe psoriasis with psoriatic arthritis (a type of inflammatory arthritis)
biological treatment: use of injectable medications, indicated for the treatment of patients with severe psoriasis
phototherapy: consistent exposure of the skin to ultraviolet light under medical supervision. The treatment must be performed by specialized professionals

Since psoriasis is an autoimmune condition, there is no definitive cure, and patients must always be attentive to treatment.

Prevention

There is still no guaranteed way to prevent psoriasis, however, there are some strategies that can help reduce risk factors and minimize the severity of disease outbreaks:

manage stress: it can trigger or worsen psoriasis symptoms in some people. Learning to cope with stress through relaxation techniques such as yoga, meditation, and breathing exercises can be beneficial
avoid skin injuries: trauma or wounds to the skin can trigger the development of psoriasis lesions, known as the "Koebner phenomenon." Therefore, it is necessary to be careful to avoid cuts, scratches, and wounds
be cautious with sun exposure: excessive sun exposure can worsen the disease, making the use of sunscreen and limiting direct sun exposure indispensable