Psoriasis Treatment: What is psoriasis and how do I know if I have it?

Understanding Psoriasis

Psoriasis is a chronic (ongoing) inflammatory skin condition that gets its name from the Greek word ‘psora,’ which means ‘to itch.’ People with psoriasis develop raised red patches of skin called plaques that are covered with silvery, flaky skin. Psoriasis can be itchy and can burn and sting. The condition isn’t infectious – so you can’t catch or pass it on to anyone else. While there isn’t a cure for psoriasis, it can be managed well with medicines and other treatments prescribed by your doctor and by managing your triggers. Psoriasis can be associated with other serious health conditions, including heart disease and diabetes, and it can also affect your emotional and social well-being. Some people feel self-conscious about the appearance of their psoriasis, and this can cause people to avoid activities like swimming and sports where their psoriasis will be seen. If you have psoriasis, working closely with your doctor to learn more about your condition, how you can best manage it, and where you can find support is important. This can have a positive effect on how you feel.

Psoriasis comes and goes and is different for everyone.

Psoriasis is a life-long condition that can come and go at any time. Most people with psoriasis will have times when their condition is more severe (a flare or flare-up), followed by times when their symptoms are mild or they have none at all (a remission).  The severity of psoriasis also varies greatly from one person to another. In Australia and New Zealand, doctors divide psoriasis into two main groups: 

1. Mild to Moderate
2. Severe

This grading is based on a combination of the plaques’ appearance, the area they cover, and how psoriasis affects quality of life. Classifying psoriasis-like this helps doctors develop a treatment plan and monitor treatment progress.

What does psoriasis look and feel like?

There are five main types of psoriasis. Your doctor will diagnose which type you have and work out a treatment plan with you.

• Plaque psoriasis is the most common type, affecting about 90 per cent of people with the condition. Its telltale plaques recognise it: thick, red skin patches covered with silvery white scales. Plaques can come in all shapes and sizes, and their edges usually have a clear border separating them from the skin around them. They are often itchy and can crack and bleed. Plaque psoriasis most commonly affects the front of the elbows, knees, scalp, and lower back.

There are several other types of psoriasis:

• Guttate psoriasis causes many small teardrop-shaped plaques to appear over the body. It often affects children and young adults and is usually triggered by a virus or strep throat infection. Guttate psoriasis is the second most common type and about 10% of people who have it develop plaque psoriasis. 
• Inverse psoriasis is where patches of very red skin appear in body folds and where skin rubs together: behind the knees, under the arms and breasts, in the groin, belly button and ears, and between bottom cheeks. The patches are usually smooth and shiny without scales. People with inverse psoriasis often have another type simultaneously on a different body part.
• Palmoplantar psoriasis affects the palms of the hands or the soles of the feet with scaling, redness, and sometimes small pus-containing blisters.
• Other rare and serious forms of psoriasis include pustular and erythrodermic psoriasis.

How is psoriasis diagnosed?

There aren’t any specific blood tests or other tests to diagnose psoriasis. Your doctor can usually diagnose psoriasis by examining your skin. Sometimes, they may take a very small piece of your affected skin (a biopsy) and look at it under a microscope to look for changes that suggest psoriasis and look different from other skin conditions. Your doctor will also be interested in your family’s medical history – about one-third of people with psoriasis have a family member with the condition.