PSORIASIS
TREATMENT
IN TURKEY
Psoriasis is a long-term (chronic) disease with no cure. This disease recurs for several weeks or a month in a cycle, then subsides for a while or goes into remission. There are some treatment methods to reduce and manage the symptoms of psoriasis. Individuals with psoriasis need to adopt new habits and develop some methods to deal with this situation to help them lead a better quality of life.
WHAT IS PSORIASIS?
Psoriasis is an autoimmune skin disorder that causes skin cells to multiply several times faster than normal. During psoriasis, also known as psoriasis, bumpy red spots covered with white scales begin to appear on the skin.
These scaly patches can grow anywhere on the skin, but are most common on the scalp, elbows, knees, and back. Psoriasis is not contagious, meaning it cannot be passed from person to person. It can be seen in members of the same family with a genetic predisposition.
Psoriasis usually appears in early adulthood. In most cases, only a few areas of the skin are affected. But in more severe cases, psoriasis can cover a large part of the body. Red spots can heal over time and come back throughout the individual's life. Psoriasis is a disease with dandruff. Psoriasis can be seen in both children and adults. While psoriasis in children is seen in the form of droplets in the body, it can progress in the form of plaque and stable in adults. Psoriasis is not just a skin rash disease. Other complaints that affect the whole body and accompany the rashes can be seen in psoriasis patients.
PSORIASIS SYMPTOMS
Psoriasis symptoms can vary from person to person. Common signs and symptoms include:
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Skin spots
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Intense flaking on the skin
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Small red or whitish spots
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Dry and cracked skin prone to bleeding
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Intense itching of the skin
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Thickened and pitted nails
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Swollen and stiff joints
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Red, raised and inflamed patchy sores
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Whitish or silvery patches on red patchy sores
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Pain around some wounds
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Pain and swelling in the joints
WHAT ARE THE CAUSES OF PSORIASIS ?
The reasons that are thought to be effective in the emergence of psoriasis, which is a problem caused by the immune system, are as follows:
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Anomalies in white blood cells: The abnormal functioning of white blood cells (white blood cells) in the blood, which is one of the main elements of the immune system, can cause psoriasis by changing the movements of the cells.
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Genetic factors: Although it has not been fully clarified because the family members of the majority of psoriasis patients also have psoriasis, it is thought that genetic features from the family also pave the way for the formation of psoriasis.
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Excessive alcohol and cigarette consumption: Alcohol and cigarettes, which have negative effects on the immune system, can also cause psoriasis, which is an immune system disorder.
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Psychological reasons: Psychological processes such as stress and depression, which have a negative effect on the immune system, play an important role in the emergence of psoriasis and may lead to recurrence of attacks.
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Infections: The incidence of psoriasis increases in patients with recurrent infections (such as pharyngitis and throat infection). Climate and skin irritation: It is observed that especially cold weather triggers psoriasis and psoriasis patients are relieved in humid weather. Sunburns in the summer months and also wounds can cause this disease.
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Medicines used: Medicines used in the treatment of some diseases (such as heart and blood pressure diseases, malaria, asthma) can lead to the observation of diseases such as psoriasis.
Tooth decay, scrapes and scratches on the skin, skin injuries and urinary tract infections can also cause psoriasis.
HOW IS PSORIASIS DIAGNOSED?
Psoriasis can be easily diagnosed during a physical examination during active periods. During the physical examination, the body is checked, especially the scalp, ears, elbows, knees, belly button and nails. In addition to the physical examination, a biopsy may be requested by the doctor. During the biopsy, a skin sample is taken to check for skin infection in the laboratory. Apart from this, there is no other test used to diagnose psoriasis.
Parapsoriasis, which can be confused with psoriasis due to its similarity, is the medical term for a group of rare skin problems that develop differently. A biopsy may be required by taking a skin sample to be sure that the individual has parapsoriasis. Parapsoriasis can cause serious problems such as cancer cases, so treatment is absolutely necessary.
TYPES OF PSORIASIS
Psoriasis, which has different clinical symptoms, can involve the entire skin from the scalp to the nails. There are varieties of lifelong psoriasis. These can be listed as:
Plaque Psoriasis (Psoriasis Vulgaris)
The most common type of psoriasis is plaque psoriasis. In this type, the scalp, knees, elbows and hips are the most common sites of involvement. It manifests itself as oval or round, reddened, raised plaques with silvery dandruff. There is another subtype of this type. In this subtype, redness, dryness and cracking occur on the palms of the hands and soles of the feet.
Guttate Psoriasis
This type of psoriasis, which is mostly observed in children and adolescents, has red and dandruff rashes under one centimeter. It usually occurs following throat infections.
Erythrodermic Psoriasis
In this type of psoriasis, more than 80 percent of the body takes a red and dandruff appearance. Erythrodermic psoriasis is a severe form of the disease and patients with this condition should be hospitalized immediately.
Pustular Psoriasis
It appears as pus-filled pimples, commonly all over the body. There is also a local form of this type that can affect the palms of the hands and soles of the feet.
Psoriasis of the Joints
While there may be discomfort in the joints of people with skin involvement, this type of psoriasis can occur on its own only in the joints. While finger joints of the hands and feet are most commonly involved, joint involvement is also common, especially in those with nail involvement. For this reason, nail changes should definitely be reviewed in psoriasis patients. Because by detecting the changes in the joints in the early period, it is possible to prevent permanent damage to these joints.
Nail Changes in Psoriasis
Different symptoms are seen in the nails in psoriasis. Although nail changes usually accompany skin lesions, nail involvement can also be seen without skin symptoms. There may be pits like a pinhead on the nail surface, separation of the nail from its bed, thickening of the nail, a yellow oily stain under the nail, or cases where the natural appearance of the nail is completely deteriorated. Nail involvement may be a sign of joint disease.
HOW IS PSORIASIS TREATED?
Unfortunately, there is no treatment method that can completely eliminate the disease today. Psoriasis has a recurrent feature with attacks and recovery periods.
Physician, patient and patient relatives should cooperate in treatment.
Topical Treatments
It is one of the first-choice treatment methods by applying gels, ointments or creams directly to the psoriasis area. Topical treatment slows the growth of cells that cause psoriasis and aims to treat the disease.
Light therapy (Phototherapy)
Another treatment method is UV phototherapy treatment. UV rays are applied directly to psoriasis and help slow the growth of excess skin cells.
Medical treatment (Oral Treatment)
Usually used for moderate or severe psoriasis, this treatment reduces inflammation and affects the immune system when taken orally in pill or liquid form.
Treatments will reduce the invisible risks of psoriasis that can affect both the visible changes in the skin and the internal organs of the patient such as fatty liver, obesity, hypertension, cardiovascular diseases, insulin resistance and diabetes, etc.
Especially the disappearance of the psoriasis rashes on the skin of the lesions will relieve the patient physically, mentally and socially. It will remove the restrictions of the disease. It will offer a better quality of life.
Psoriasis patients are not only condemned to cream treatment. By making good preparations, the most accurate treatments can be selected by taking into account the age of the psoriasis patient, comorbidities, the medications they constantly use due to these comorbidities, and how much psoriasis affects them physically, psychologically and socially.
Since the severity of psoriasis, the need for treatment and the type of treatment can vary, psoriasis patients should be followed up with controls. These controls will enable early diagnosis and early treatment of diseases such as fatty liver, obesity, hypertension, cardiovascular diseases, insulin resistance and diabetes that may accompany psoriasis.
The frequency of control varies according to the treatment received by the patient and the severity of the disease.
FREQUENTLY ASKED QUESTIONS
What are the Risk Factors in Psoriasis?
Psoriasis can occur in people of all ages. It can be said that approximately one third of psoriasis cases start in the pediatric period (the period from infant age to the end of adolescence). The main risk factors that increase the risk of developing psoriasis are listed below: Family history: Having psoriasis in a family member before is among the main risk factors. Having a parent with psoriasis increases the risk of developing the disease even more. Stress: Stress is an important risk factor that affects the immune system. It has been observed that living with constant high stress may increase the risk of psoriasis. Smoking: Smoking not only increases the risk of psoriasis, but may also cause the disease to progress more severely. Smoking may also play a role in the early developmental stage of the disease.
How does psoriasis affect patients' lives?
Psoriasis, which is a chronic relapsing disease, negatively affects the quality of life of patients, their relationships with their spouses, children, friends and neighbors, and their sexual, social and work lives because it causes visible wounds. Since psoriasis patients are generally withdrawn and depressed in personality, these patients should be approached very carefully. In psoriasis, which is a long and difficult treatment process, doctors, patients and their relatives have to cooperate. Since stress affects the disease negatively, it is appropriate to treat patients not only for their ailments but also for their psychology.
Is psoriasis a painful disease? Will it cause death?
Skin rashes do not normally cause pain. However, pain can be seen in the erythrodermic form, in which the whole body is covered with psoriasis. In erythrodermic psoriasis, continuous flaking of the body skin in the form of dandruff causes protein loss. This form is a very severe disease and both cardiac and secondary problems such as infection may occur. Especially in elderly patients, erythrodermic psoriasis patients, who are at risk of death, should be hospitalized and followed closely.
Is there a place for biological agent treatment in psoriasis?
In more severe cases that do not respond to these treatments, newly introduced biologic agent treatments are applied. This treatment method is related to the immune system. Although the exact cause of psoriasis is not known, it is known that this is a disease related to the immune system and affects the immune system one-to-one.
Psoriasis Patients Should Consider
People with psoriasis need to get rid of psychological triggers first.
It will be a positive development for treatment that they move away from negative emotions such as stress, sadness and anxiety and turn to things that will make them feel better. Scratching, rubbing, peeling off the skin can cause new rashes, so they should be avoided as much as possible.
The sun and the sea have a reducing effect on psoriasis. The duration of exposure to the sun should be as controlled as possible. Excessive sun exposure can increase psoriasis rashes. During the winter months, the moisture content of the skin decreases and becomes drier.
Since dry skin causes more itching in psoriasis patients, moisturizing creams and lotions should be used more carefully in winter months. It is very important to take a shower every day for the relaxation of the skin.
Another important issue is a healthy diet. Psoriasis patients should pay attention to a healthy diet.
As a result of research to understand the connection between nutrition and psoriasis, it has been concluded that some foods affect psoriasis better or worse.
Psoriasis patients should stay away from crusty vegetables and gluten. It is beneficial to reduce protein and milk-containing foods. Foods rich in vitamins should be consumed.