About Types of Psoriasis and Treatment Options at Dermatology Associates of Atlanta
Psoriasis is a chronic disease of immune dysregulation that causes a dry, reddish and scaly rash that is characterized by increased speed of cell production. Originating from the Greek word psora, meaning “being itchy,” psoriasis is a common skin condition that affects nearly 7.5 million people in the United States. Normally, skin cells reproduce every 21-28 days. With psoriasis, skin cells reproduce at a much faster rate of two to six days. The accelerated cell production then causes constant shedding of the skin as the older skin cells are replaced with new skin cells. There are various types of psoriasis that can develop from various triggering agents in all parts of the body and require specific treatment based on the severity of the psoriasis. While psoriasis is a non-contagious skin disorder, many people experience social anxiety as the effects of psoriasis are generally noticeable.
Plaque psoriasis (psoriasis vulgaris) is the most common form of psoriasis affecting 80-90% of patients who develop the condition. Characterized by dry, itchy raised and inflamed red lesions covered in silvery white scales, plaque psoriasis appears on the surface of the skin most commonly on the knees, lower back, scalp, nails and elbows, but can appear anywhere on the body. The flaky white skin cells build up on the inflamed area and over time are dislodged and shed.
Inverse psoriasis is found in skin fold areas that are subject to irritation due to sweating and rubbing of the skin such as the armpits, groin, under the breasts or other folds around the genital and buttock area. Inverse psoriasis is commonly found among overweight individuals and those that have deep skin folds. Bright red lesions, without the white flaky scales, that may appear shiny and smooth in texture are generally the first symptoms of inverse psoriasis.
Guttate psoriasis first appears in childhood/young adulthood and forms many small red spots on the skin. Triggered by upper respiratory infections, streptococcal infection, tonsillitis, stress, skin injuries or medicine, guttate psoriasis generally forms on limbs and the scalp.
Pustular psoriasis is a form of psoriasis characterized by white blisters of non-infectious pus that surround patches of red skin. Affecting less than 5% of psoriasis patients, this less common form of psoriasis afflicts mostly adults and looks like a potentially contagious infection that can develop in localized areas like the hands or feet, or in more generalized patches all over the body. Pustular psoriasis begins as a red rash followed by the emergence of the pustules and eventual scaling on the skin after being triggered by stress, infection, pregnancy, overexposure to ultraviolet (UV) light, reaction to topical agents or other medicine.
Erythrodermic psoriasis is the rarest form of psoriasis. Common among individuals who have unstable cases of plaque psoriasis and undefined lesions, erythrodermic psoriasis is an inflammatory form of psoriasis that develops on most of the body’s surface and causes extensive skin shedding, severe itching and pain. Sudden withdrawal of a systemic psoriasis treatment, allergic reaction to medication or severe sunburn can be triggers for psoriasis. The inflammatory nature of the psoriasis throws the body off balance causing fluid and protein loss that can lead to infection, severe illness, pneumonia, congestive heart failure or even fatality.
• Inflamed red rash
• Flaky, crusty patches of skin covered with silver-white scales
• Joint swelling
• Tenderness and pain
• Generally located on the knees, scalp or outside of elbows
Dermatology Associates of Atlanta’s Psoriasis Treatment Center specializes in identifying and creating the best possible solutions for psoriasis patients. While there is currently no cure for psoriasis, proper treatment is dependent on the severity, type and location on the skin affected by the psoriasis. Topical treatments, phototherapy and/or systemic medications are common treatments recommended for psoriasis patients.
The main objective for psoriasis treatment is to slow down the speed of skin cell production to reduce inflammation, eliminate scales and restore the skin to its original form. For mild cases of psoriasis, creams, ointments and lotions can alleviate symptoms for the body while shampoos, oils and sprays can provide relief for the scalp.
For more severe psoriasis cases, phototherapy is a beneficial treatment for those that do not react to topical treatment. Phototherapy, or light therapy, utilizes ultraviolet (UV) A or B light to penetrate the skin’s deeper layers while targeting and slowing down the growth of the affected skin cells. Systemic medicines (both oral and injectable) may also be used to control the inflammation which produces psoriasis. These medicines are very effective and may be life-changing for those with more severe forms of psoriasis.
Psoriasis treatment has been undergoing revolutionary scientific advances over the last 10 years. At Dermatology Associates of Atlanta, we are adept at employing all methods of psoriasis therapy to achieve the best results possible for our patients.
Who can be affected by psoriasis?
Anyone can be affected. Psoriasis usually develops in people 11 to 45 years old, but any age is prone to developing psoriasis. Scientists have determined that there are genetic links to the development of psoriasis. The right combination of genes, in conjunction with a person’s immune system and other triggers all contribute to psoriasis. 10% of the population inherits the unknown gene but only 2-3% of those carriers will actually develop psoriasis.
What causes psoriasis?
The exact cause of psoriasis is still unknown as the psoriasis gene has yet to be discovered. Each individual that develops psoriasis is a unique case due the nature at which triggers vary on a case by case basis for each individual. Stress, skin injuries such as sunburn, medication, allergies, diet, weather, alcohol consumption or even scratches are types of triggers that have been documented as possible triggers that can affect the autoimmune system and cause the development of psoriasis.
What technologies are available to treat psoriasis?
With ever-evolving advancements in laser technology, ultraviolet (UV) light has proved beneficial in penetrating deeper dermal layers to target the skin cells and slow down the speed of growth. PHAROS EX-308 Excimer Laser is the latest FDA approved laser light procedure that uses a concentrated, yet painless, high-intensity beam of UVB light to treat mild to moderate chronic psoriasis plaque cases that are less responsive to topical treatments. Using a maneuverable hand piece, the PHAROS laser specifically targets only psoriatic plaques, preventing the surrounding skin from being exposed to the UV light. Most patients experience psoriasis remission in 10 or fewer treatments and will stay in remission for several months.
What other medical conditions are common in patients with psoriasis?
Psoriasis may have skin symptoms, but as an immune related disease it is associated with health concerns in a variety of body systems. These health concerns include diabetes, obesity, metabolic syndrome, psoriatic arthritis, cardiovascular disease, and sleep apnea, as well as a variety of autoimmune and psychiatric diseases. It appears that treatment of the psoriasis may actually prevent some of these coexisting conditions. These medical considerations make it especially important for patients who suspect psoriasis to receive a dermatologist’s diagnosis so that their health can be monitored accordingly.