psoriasis

introduction

The term psoriasis or psoriasis is an itchy and scaly skin disorder that can affect all areas of the body. In addition to the skin, other organs of the body, such as joints can be affected. Psoriasis is a chronic inflammatory skin disease that can be inherited.

One distinguishes between an early type (type 1) and a late type (type 2). The Frühytp breaks out before the 40th year of life, the late type after the 40th year of life. Even in childhood, it can lead to psoriasis. The psoriasis runs in spurts, which in addition to the basic treatment then also makes an acute push treatment necessary.

Causes of psoriasis

In 30-40% of those affected a genetic predisposition is the cause of the disease. As a rule, there are direct family members who also suffer from a more or less pronounced psoriasis.
If only one parent is affected by psoriasis, the likelihood of the child also suffering from this skin disorder is about 10%. If both parents suffer from the disease, the risk increases to 30%.

In addition to the hereditary component, the skin type is also responsible for whether the disease breaks out in one and not in the other. Thus, lighter skin types are affected much more frequently than darker ones.
All these are favorable factors for the occurrence of psoriasis.

In addition to these factors, there are then directly triggering factors that lead to an outbreak of the disease. These may be: infections, especially streptococcal infections of the tonsils or ears in childhood and adulthood, intestinal diseases, HIV infections and infestation of the scalp with pathogens.
In these pathogens, especially the yeast fungi are mentioned, which can lead to an outbreak of psoriasis.

In addition to infections, mechanical irritation can also contribute to the onset of psoriasis. Tattoos, strong and recurrent sunburn, severe itching, scratching and manipulation of healed skin are a major risk to the onset of psoriasis.
In addition to certain medications and stress, smoking and being overweight can also increase the likelihood that psoriasis will be triggered.

Also certain hormonal changes of the body can contribute to the outbreak of psoriasis.
To mention in this context, especially the menopause, but also a pregnancy.

Psychic factors are also ascribed a strong triggering effect of psoriasis. Thus, severely stressed and mentally handicapped persons are much more frequently affected by psoriasis than mentally balanced persons.

Climatic influences are also blamed for the onset of psoriasis.
Very dry climates essentially have a calming effect on the skin, while humid and warm weather can favor psoriasis.
Also reactions to chemical substances can lead to the development of psoriasis. Chemical substances that can penetrate the skin in the form of shower gels or detergents and thus lead to an allergic irritation of the skin should be mentioned here.

Drugs that can lead to the onset of psoriasis are mainly so-called ACE inhibitors, which are used in high blood pressure but also beta blockers or certain special anti-inflammatory drugs, such as indomethacin can lead to an outbreak of troublesome scaly skin disease.

diagnosis

As a rule, the diagnosis of psoriasis is based on examination and inspection by the doctor.
The typical reddish and thickened areas of skin on certain parts of the body strongly suggest the presence of psoriasis.

The patient also indicates the annoying itching, possibly even the familial occurrence and possibly other risk factors.
All these components confirm the diagnosis of psoriasis. Scratch marks and bloody dried skin abrasions also point to psoriasis.

In addition to the inspection, the doctor will also carefully detach a dandruff. In fact, if psoriasis is present, a thin cuticle typical of the disease appears beneath the detached dander. The structure, also referred to as the " last cuticle, " can also be replaced by the doctor. A resulting small bleeding would also be characteristic of psoriasis. The small hemorrhage is also referred to as " bloody dew " or " Auspitz phenomenon ".

Also typical of psoriasis is the so-called " Koebner phenomenon ": Here it comes with experimental irritation of the skin to psoriasis-typical changes. Tesafilm strips, for example, can be used as stimuli, which are glued to unbonded skin and quickly peeled off again.

When diagnosing psoriasis, it is also important to rule out other diseases that have a similar effect. In order to do this successfully, diagnostic procedures such as skin smears and blood samples are possible.

Symptoms of psoriasis

The symptoms of psoriasis are usually triggered by a very rapid and uncontrolled growth of the epidermis, which leads to the classic keratinous structure of the skin. Almost 7-8 times faster than a healthy skin, skin cells begin to surface.
For this reason, psoriasis is first noticeable by whitish shingles on certain parts of the body.
First and foremost, the extensor sides of the forearms are usually affected.

The legs (especially the tibia), scalp or back can often be affected by psoriasis. Also on the face, forehead and eyebrows, in the area of ​​the belly around the navel, on the hairline and on the hands, it can come to the classic expression.

The affected skin can very easily itch to moderate, the dander can be easily raised with the fingernails.
The classic shape and distribution of affected skin areas may resemble a map.
Since simple psoriasis affects the skin only, other organs and body parts are not affected - except for the joints.

These can also be relatively common (in about 10-20% of psoriasis patients) also affected, which then leads to movement-related pain, swelling and redness in the affected joints.

Psoriasis with joint involvement

In some cases, apart from the skin, certain joints are also affected by psoriasis. The disease is then referred to as psoriatic arthritis and is added to the rheumatological spectrum.

In the case of psoriatic arthritis, an excessive reaction of the immune system leads to an inflammatory change of both certain joints, as well as to the changes in the skin typical of psoriasis.

Sometimes it can happen that the joints are affected by psoriatic arthritis, but not the skin.
It can also happen that it does not come to a simultaneous occurrence of joint pain and skin changes, but only at a staggered occurrence.

The joints are sometimes reddened and swollen in psoriatic arthritis. Painful pressure is also indicated by the patients. Also, habitual movements in the affected joints can often not be performed painlessly.

Localization of psoriasis

Psoriasis on the scalp

To protect the scalp, low-stimulus shampoos should be used.

In some cases, only the scalp is affected by psoriasis.
In most cases, the scalp is also affected by psoriasis in conjunction with other skin areas.

It becomes clear that psoriasis on the scalp is affected by reddish and itchy minor skin changes between the hair roots. The skin is very scaly and dandruff is also visible in the area of ​​the hair. It can come to individual spurts of psoriasis on the scalp, in which the inflammatory lesions appear more prominent.

Often a latent redness and scaling of the skin is permanent. Spontaneous healing is virtually nonexistent. It is important in the case of psoriasis disease to irritate the scalp as little as possible. So scratching and loosening the scaly skin should not be done. Furthermore, gentle shampoos and washing lotions should be used for the skin. Furthermore, no perms should be screwed into the hair and not hot-blown. This would put a heavier strain on the hairline areas and thus lead to a reduced healing of the inflammatory skin areas. The treatment of psoriasis is done by applying special lotions to the scalp.

Psoriasis on the nails

The nail psoriasis is relatively common. It occurs in many patients in parallel to the typical skin changes on the body.

Often the toenails are affected, which are then changed by their appearance and shape. The combination of psoriatic arthritis and nail psoriasis is particularly common.

Almost 2/3 of all patients who have psoriatic arthritis also suffer from a nail infestation of the hands or feet. In psoriasis patients, in which only the skin is affected, only about 5% suffer from a nail infestation. The nail, which is affected by psoriasis, is typically altered and shows some small indentations on the nail surface.

Therefore, this modified nail is also referred to as Tüpfnagel . Sometimes a psoriatic attack of the nails also leads to inflammation of the nail bed, which can lead to parts of the nail turning yellowish in some parts.
These kinds of changes are also called oil spikes .

In the so-called crumb nails, the surface of the nail is so damaged that the nail surface is no longer smooth, but rough and crumbly.

There are also nails under the surface of which a dandruff appears. This will cause the nail to loosen and lift off sooner or later.
In many cases, it then falls off.

Often not only single but several nails of the hand or feet are affected. The diagnosis is usually made as a gaze diagnosis by the doctor.

Psoriasis on the face

In the face it can also come to a degree of psoriasis.
The appearance corresponds to psoriasis on other skin areas of the body.

But since the face is not covered by clothing, it is also more exposed to wind, water and other external influences.
Due to the constant irritation, it can also lead to a stronger expression of the skin change. In addition, treatment measures may not work as fast as on protected skin.

If the face is affected by psoriasis, it usually affects the areas around the eyebrows or around the mouth, as well as around the nasal fold.
Since the skin on the face is much thinner than on other parts of the body, medications in the form of lotions or gels are absorbed more quickly and appear more intense.
Read more on this topic on our page: psoriasis on the face

Psoriasis on the ear

Also it can come to an infestation of the skin in or at the ear.
Here are also affected areas of skin reddish and inflammatory changed and show a significant scaling.
The ear can be itchy or painful.

The treatment of psoriasis of the ear corresponds to that of the other skin on the body.
The skin irritation may be stronger at the ear than at other parts of the body, since the ear is exposed to wind and sun and other influences mostly unprotected.

Treatment of psoriasis

Healing and treatment of the cause leading to psoriasis is not possible.

For this reason, treatment strategies have been developed to minimize the frequency of shifts and to limit the duration and intensity of a push.

The treatment consists of an ointment or lotion treatment as well as a light irradiation treatment.
Lotions, such as dithranol, which is applied to the affected area and then washed off again, ensure that the strong cell proliferation is reduced.
It also has an anti-inflammatory effect.

Increased flares of psoriasis can be treated with cortisone preparations. Here, too, creams are used, which are applied to the affected areas of the skin. Cortisone is anti-inflammatory and slows down the immune system.
In severe Psoriasisverläufen it may also be necessary that cortisone is taken in the form of a tablet.

Vitamin D 3 preparations are also often used in the treatment of psoriasis. They also ensure that the cell proliferation of skin cells is reduced. Tazaron, a vitamin A supplement, works in a similar way.

In addition to the local treatment of the skin by lotions, a treatment trial can also be carried out with an irradiation treatment.
For this purpose, the UV radiation is available, through which the inflammatory reactions of the skin are reduced.

The term PUVA is understood to mean a combination treatment from radiation therapy and a drug treatment with the drug psoralen.
This substance ensures that the photosensitivity of the skin increases and so the effect of the radiation is more successful.
The PUVA treatment is mostly used for infestation of larger areas of skin.

In addition to the external treatment of psoriasis, systemic treatments can also be performed.
These are usually used when it is either very pronounced infestations or a local treatment has brought no success.
For systemic treatment immunosuppressive drugs such as cortisone are used. Furthermore, fumaric acid preparations are used.

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Treatment by creams

One of the treatment pillars of psoriasis is the use of creams. Here, especially cortisone-containing creams are applied to the affected skin. These then ensure rapid inflammation inhibition of the areas. There are also creams that contain tar. Whereas previously pure tar cream was applied to the affected areas of the skin, today there are artificially produced tar-like preparations that are very successful in treating psoriasis from the outside.

The drug used today in the form of a cream is called dithranol. It not only reduces the inflammatory response of the skin at the affected site, but also reduces the rapid and excessive cell division of the epidermis. Creams containing vitamin A and D are also widely used in the treatment of psoriasis. In addition to an anti-inflammatory effect, they also reduce the very rapid cell division and have a calming effect on the severely irritated skin.

Home remedies for psoriasis

In addition to conventional medical measures, numerous home remedies have been claimed for many years and their use is always worth a try. An old proven home remedy is the washing of the skin with camomile water. For this you should give chamomile extract in a bowl of lukewarm water and leave to draw. The highly concentrated liquid should then be applied to the affected areas or the entire body skin washed with it. After application, an aloe vera gel can be applied to the skin as a daytime protection. On the use of other washing lotions and shower gels, especially if they are of a chemical nature, should first be dispensed with. Likewise, the consumption of spicy foods and spices should be reduced. Some alternative physicians still recommend not using animal protein. A scientific evidence for a relationship between psoriasis and the consumption of proteins is currently not. Stress should also be reduced as much as possible.

Tea tree oil treatment

The treatment of psoriasis with tea tree oil has also continued as a home remedy for many years. The tea tree oil has an anti-inflammatory and cooling effect and ensures a reduced itching.

First, it should be checked whether the tea tree oil is good from the skin and this does not irritate too much.
For this purpose, a small amount of tea tree oil should be applied to one of the psoriasis unbefallene body of the skin.

If the normal, cooling effects occur but no burning and no reddish skin changes, the tea tree oil can then be applied to a psoriasis infected area.
For this purpose, a drop of undiluted tea tree oil is applied to a scaly skin site and then distributed over the entire surface with a cotton swab.

Also, a cloth may be soaked with tea tree oil and then applied to the affected skin area for a certain time.

Treatment according to Maria Treben

Treatments according to Maria Treben consist of different herbal mixtures, which are also available for the treatment of psoriasis.
The herbs should be prepared in the form of a tea and drunk daily 1.5-2 liters of it.

The tea consists of oak bark, willow bark, meadow goatee, fumitory, walnut shell, celandine, stinging nettle, sharpening, honorary prize and marigold.

The tea should draw for about 3 minutes before it can be drunk. One should drink the tea several days in succession to see a corresponding effect.

Psoriasis treatment with fish

For some time, a mechanical treatment of psoriasis by fish has been known and described as very successful.

Here, fish from the Kangal region are used (kangaroo fish). They need the protein-rich substance of the surface of the human dander and begin to nibble at the surplus skin on the surface. Since psoriasis leads to excessive cell formation of the epidermis, this method should work well.

The fish are kept in a pool, the affected must go into the pool, whereupon the fish swim up to the patients and the affected skin begins to chew.
Patients must bathe 2-3 times a day for a total of 6-8 hours in the pool. A sufficient amount of drinking water and alcohol must be strictly adhered to.

It should be emphasized that this treatment method does not cure the disease: only the symptoms are reduced and this only for the time of treatment.
As soon as the fish are no longer bathed daily, the symptoms quickly increase again.
Experts suggest that much of the effect during the spa treatments is due to the warm climate and strong sunlight in Kengal.

To summarize, although some patients report a positive effect of the fish cure, this has not been proven scientifically.
It is therefore advisable, for example, to exchange information with other patients via Internet forums and to inform accordingly well.

Own urine treatment

The application of myurin to affected skin is also very often described.

The effectiveness is different. The urine not only promotes a faster detachment of the dandruff, but also leads to an anti-inflammatory effect.
However, it should be noted that irritation may occur after applying the intrinsic urine to the affected area of ​​the skin.

The urea dissolved in the urine may have a burning effect similar to a urease ointment. Mostly, however, it soon comes to a speedy recovery.

The natural urine treatment should be done 1-2 times a day for about a week.
Again, it does not cure the underlying disease but to relieve the symptoms and shorten the duration of the disease.

forecast

A cure of psoriasis is currently not possible. However, different degrees of severity of symptoms and relapses may occur in different ages.

So it may happen that the complaints in young adulthood are very common and strong but are then hardly available in older years.
With a basic treatment, which should also be used regularly to prevent relapses, in conjunction with an acute relapse treatment, the course of the disease can be positively influenced.

Home remedies for psoriasis can always be used as a supplement.
Heavy courses affect large areas of the body and are characterized by a frequent shearing frequency.
Here several parallel treatments consisting of radiation, lotion, and tablet treatment must be combined. In addition to the disturbing and itchy effects of psoriasis, the psychological components should not be underestimated.

For example, severely affected patients often suffer from permanent anxiety and stress situations and often do not dare to go public, which can then also lead to a social problem. For difficult cases, an accompanying psychotherapy can be very helpful.


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