What is Psoriasis? Symptoms and Treatment

Psoriasis is a chronic and recurrent skin condition that causes skin cells to multiply much faster than normal, building up on the surface. It typically manifests as white or silvery scales on red patches of skin, often appearing on the knees, elbows, scalp, and back. This common condition is the result of an overactive immune system and is absolutely not contagious.

In short:

It is a chronic immune system disease caused by the rapid multiplication of skin cells.
Its most prominent feature is thick, white, or silvery scales on reddened skin.
Genetic predisposition, stress, infections, and certain medications can trigger flare-ups.
There is no risk of it spreading from person to person through contact.
Treatment involves moisturizers, light therapy (phototherapy), and immune-regulating medications.

What is Psoriasis?

In a healthy person, skin cells are produced in the deeper layers of the skin, slowly rise to the surface, and shed as dead cells over the course of about a month. The fundamental answer to what psoriasis is lies in the disruption of this cycle. Due to faulty signals from T cells in the immune system, this process is reduced to just a few days in psoriasis patients.

The rapidly produced new cells accumulate on the skin's surface before the dead cells have a chance to shed. This buildup creates red lesions (plaques) that are slightly raised and covered with thick, silvery-white scales. The size of these lesions can range from 1-2 millimeters to large areas covering up to 40 centimeters.

It is estimated to affect between 1 and 3 percent of the population. While it can appear at any age, the disease most commonly peaks between the ages of 16-22 and 57-60. The severity, spread, and duration of flare-ups vary greatly from person to person.

Causes and Risk Factors of Psoriasis

Although the exact cause of the disease is not fully understood, genetic predisposition and immune system abnormalities are the leading causes of psoriasis. Individuals with a family history of the condition have a much higher risk of developing it. If either parent has psoriasis, the likelihood of it appearing in their children increases.

In people with a genetic predisposition, the onset or flare-up of the disease is usually linked to certain triggers. Physical or emotional stress is one of the most well-known triggers. Additionally, traumatic events that disrupt skin integrity, such as cuts, burns, excessive scratching, or friction, can initiate the disease.

Infections and certain medications are also among the risk factors. Strep throat infections, particularly in children and young adults, can trigger the condition. Furthermore, beta-blockers used for blood pressure, lithium, antimalarial drugs, and some painkillers can cause flare-ups. Excessive alcohol consumption and smoking are significant factors that increase the severity of the disease.

What Are the Symptoms of Psoriasis?

The signs of the disease vary depending on the affected area and the type of psoriasis. Symptoms can sometimes appear simply as tiny pits in the nails, while in other cases, they may present as widespread redness covering the entire body.

The most common symptoms include:

Well-defined red plaques on the skin, especially on the knees, elbows, lower back, and scalp.
Silvery scales on top of these plaques that tend to bleed when scratched.
Dry, cracked skin that may bleed occasionally.
Itching, burning, or soreness in the affected areas.
Thickened, yellowed nails, small pits on the surface (pitted nails), or separation of the nail from the nail bed.
Swollen, stiff, and painful joints (a sign of psoriatic arthritis).

Plaque psoriasis is the most common form. However, inverse psoriasis, which presents as bright red lesions without scaling in skin folds like the armpits, groin, under the breasts, and around the belly button, is also frequent. In some cases, sterile, pus-filled, pimple-like blisters may form on the palms of the hands and soles of the feet.

How Is It Diagnosed at the Hospital?

Psoriasis is usually diagnosed through a detailed physical examination by a specialist. Your doctor will examine your skin, scalp, and nails to evaluate the characteristic plaques and scales. In most cases, the clinical appearance is sufficient for a diagnosis, and no additional testing is needed.

However, in suspected cases where lesions might be confused with eczema, fungal infections, or other skin diseases, a skin biopsy may be performed for a definitive diagnosis. During a biopsy, a tiny tissue sample is taken from the affected area under local anesthesia and sent to a pathology laboratory to be examined under a microscope.

Additionally, for patients complaining of joint pain, blood tests and imaging methods like X-rays may be used to check for the presence of psoriatic arthritis. During this process, the patient's medical history, current medications, and family history are also examined in detail.

Psoriasis Treatment and Home Care

Although there is no definitive cure for the disease, modern methods can largely keep symptoms under control. Psoriasis treatment is personalized based on the severity and spread of the disease, as well as the patient's overall health. For mild cases, treatments applied directly to the skin (topical) are usually preferred.

Topical treatments include corticosteroid creams, vitamin D analogues, and rich moisturizers that soften the skin. For moderate to severe cases, phototherapy (light therapy) comes into play. Special ultraviolet (UV) rays, administered under medical supervision, help heal the plaques by slowing down cell multiplication.

In resistant and widespread cases, systemic medications taken orally or by injection, along with biological therapies, are used. These drugs target the immune system directly to suppress the underlying cause of the disease. In terms of home care, it is crucial to keep the skin constantly moisturized, avoid irritating practices like harsh scrubbing or loofahs, and stay away from stress.

Complications and Risk Groups

Psoriasis should not be considered merely a skin problem; it is a systemic condition that can affect the whole body. About one-third of patients eventually develop joint inflammation (psoriatic arthritis). If left untreated, this can lead to permanent joint damage and restricted mobility.

Furthermore, psoriasis patients have a higher risk of developing metabolic syndrome, type 2 diabetes, obesity, and cardiovascular diseases compared to healthy individuals. Chronic inflammation in the body is also known to affect the digestive system; therefore, bloating after meals could be a sign of underlying issues, making comprehensive health screenings highly beneficial for patients.

The visible effects of the disease on the skin can also pave the way for psychological issues such as a lack of self-confidence, social isolation, anxiety, and depression. For this reason, receiving psychological support during this chronic and recurrent process positively impacts the success of the treatment.

When to See a Doctor?

If you notice persistent, spreading, scaling, or itchy red patches on your skin, you should consult a specialist without delay. Early diagnosis and proper treatment planning are critical to halting the disease's progression and improving your quality of life.

If you experience any of the following symptoms, urgent medical evaluation may be required:

Severe redness and skin peeling covering a very large area of the body (risk of erythrodermic psoriasis).
Increased pain, warmth, swelling, or purulent discharge in the areas with lesions (suspected infection).
Sudden, severe joint pain, swelling, and morning stiffness.
High fever, chills, and a general feeling of being unwell.

In such severe flare-ups or emergencies affecting the entire body, you should visit the nearest healthcare facility or call 112 immediately. Prompt intervention helps prevent potential serious complications.

Diagnosis and Treatment Process at BHT CLINIC

At BHT CLINIC İstanbul Tema Hastanesi, the diagnosis and treatment of psoriasis are carried out by our expert physicians using up-to-date medical approaches. Personalized treatment plans are created based on the severity of the disease, and when necessary, our dermatology, rheumatology, and psychiatry departments work in coordination.

In emergencies involving severe flare-ups, widespread skin rashes, or suspected infections, you can apply to our Emergency Medicine department, which provides 24/7 service. In our emergency room, your initial intervention will be performed swiftly to stabilize your condition before directing you to the relevant medical specialties.

Bringing a list of your previous medications and any past test results when you visit our hospital will speed up the process. To receive a comprehensive evaluation and create the most suitable treatment plan for you, you can book an appointment without delay.

Frequently Asked Questions

Is psoriasis contagious?

No, psoriasis is absolutely not contagious. It occurs as a result of the immune system overreacting to its own cells. It does not spread to another person through touch, sharing personal items, or using common areas like swimming pools.

What is good for psoriasis?

The most fundamental answer to what is good for psoriasis is keeping the skin moisturized. Regular use of moisturizers, taking warm baths, and avoiding stress can alleviate symptoms. Additionally, mild sunlight (phototherapy) under a doctor's supervision can help heal the lesions.

Does psoriasis ever go away completely?

Psoriasis is a chronic condition, meaning it can last a lifetime and does not completely disappear. However, thanks to today's modern treatment methods (creams, light therapy, biological agents), the disease can remain completely dormant for many years, and symptoms can be kept under control.

Does stress trigger psoriasis?

Yes, stress is one of the most well-known and powerful triggers of the disease. During periods of intense physical or emotional stress, the immune system is affected, which can cause new lesions to appear or existing plaques to flare up.

Can psoriasis patients go out in the sun?

Mild and controlled sunlight (especially UVB rays) has a therapeutic effect on psoriasis lesions. However, because sunburns can cause trauma to the skin and worsen the disease, you must avoid overexposure and protect yourself exactly as recommended by your doctor.

This article is for informational purposes only; please be sure to consult your physician for diagnosis and treatment.