Psoriasis: Diagnosis, Treatment, Prevention, Diet and Medication

February 25, 2023 | by Yashaswi Pathakamuri | Posted in Psoriasis

Diagnosis of psoriasis

Psoriasis is a chronic autoimmune condition that affects the skin and sometimes the joints. It causes the skin cells to multiply rapidly, leading to thick, scaly patches on the skin that are often red and itchy. Psoriasis can occur anywhere on the body, but it most commonly affects the elbows, knees, scalp, and lower back.

There are several types of psoriasis and can be triggered by stress, certain medications, infections, and other factors. Psoriasis can also be associated with other health conditions, such as psoriatic arthritis, metabolic syndrome, and cardiovascular disease.

While there is no cure for psoriasis, with proper management, most people with the condition can live full and active lives. It is important for individuals with psoriasis to work closely with their healthcare provider to develop an individualized treatment plan that addresses their unique needs and goals.

Diagnosis

Psoriasis is a chronic skin condition that can often be diagnosed by a healthcare provider based on its appearance and symptoms. Here are some of the common methods used to diagnose psoriasis:

Physical Exam

A healthcare provider will examine the affected skin areas, looking for red, scaly patches that are characteristic of psoriasis. They also ask about any other symptoms, such as itching or pain. They may ask questions about the patient’s medical history, including any family history of psoriasis, as well as about their symptoms and any triggers that may worsen their symptoms.

The healthcare provider may use a special instrument called a dermatoscope to closely examine the skin and nails for signs of psoriasis. They may also perform a skin biopsy, which involves removing a small sample of skin to be examined under a microscope to confirm the diagnosis.

In addition to the physical examination, the healthcare provider may also ask the patient about their lifestyle and any medications they are taking. They may also recommend blood tests or imaging studies to check for related conditions such as psoriatic arthritis or cardiovascular disease.

Medical History

The medical history of psoriasis refers to a patient’s past experiences with the condition, including any previous diagnoses, treatments, and related medical conditions. A detailed medical history is important for diagnosing psoriasis and developing an effective treatment plan.

A healthcare provider will ask about a person’s medical history, including any previous skin conditions, family history of psoriasis, and current medications.

Biopsy

A biopsy of psoriasis involves removing a small sample of skin for laboratory analysis. It is typically done to confirm a diagnosis of psoriasis and rule out other skin conditions that may have similar symptoms.

During the biopsy procedure, a healthcare provider will clean the affected area of skin and inject a local anesthetic to numb the area. They will then use a small instrument called a punch or shave biopsy tool to remove a small sample of skin tissue. The sample is usually just a few millimeters in size and does not typically require stitches.

The skin sample is sent to a laboratory for analysis. A dermatopathologist, a specialist in skin diseases, will examine the tissue under a microscope to look for specific changes in the skin that are characteristic of psoriasis.

The results of a skin biopsy can help confirm a diagnosis of psoriasis and determine the type and severity of the condition. This information is important for developing an effective treatment plan for the patient. Biopsy results may also be used to monitor the effectiveness of treatment over time.

Blood Tests

Blood tests may be done for psoriasis to help diagnose the condition, determine its severity, and monitor the patient’s response to treatment. While there is no definitive blood test for psoriasis, blood tests may be used to rule out other conditions that can cause similar symptoms, such as rheumatoid arthritis.

Some common blood tests used in psoriasis include:

  • Complete blood count (CBC): This test measures the number of red and white blood cells in the blood. It can help identify anemia, which is common in people with psoriasis.
  • Erythrocyte sedimentation rate (ESR): This test measures the rate at which red blood cells settle in a tube. It is often elevated in people with psoriasis and can be a sign of inflammation.
  • C-reactive protein (CRP): This test measures the level of a protein produced in response to inflammation. It can help determine the severity of inflammation in people with psoriasis.
  • Liver function tests: These tests measure the levels of enzymes and other substances in the blood that are produced by the liver. They can help evaluate the liver’s function and identify any damage or inflammation that may be related to psoriasis or its treatments.
  • Lipid profile: This test measures the levels of cholesterol and other fats in the blood. It can help identify risk factors for cardiovascular disease, which is more common in people with psoriasis.

Blood tests may also be used to monitor the effects of certain medications used to treat psoriasis, such as methotrexate or cyclosporine. Overall, blood tests can provide valuable information for the diagnosis and management of psoriasis, but they are not always necessary for every patient. The specific tests ordered may vary depending on the patient’s individual circumstances and medical history.

Once a diagnosis of psoriasis has been made, a healthcare provider will work with the person to develop a treatment plan based on the severity of symptoms, overall health, and other factors. Treatment options may include topical creams, phototherapy, oral medications, or biologic medications. Regular check-ups and monitoring may be necessary to adjust treatment as needed and manage the condition over time.

Treatment

The treatment for psoriasis depends on the severity of the condition, the location of the affected skin, and the person’s overall health. Here are some of the most common treatments for psoriasis:

patient suffering from psoriasis applying cream.
  • Topical treatments: Creams, ointments, and lotions can be applied directly to the affected skin to reduce inflammation and itching. Topical corticosteroids, retinoids, and calcineurin inhibitors are commonly used.
  • Phototherapy: Exposure to ultraviolet light can help reduce inflammation and slow the growth of skin cells. This treatment may involve using a special light box or going outside during specific times of day.
  • Systemic medications: In more severe cases, oral or injectable medications may be prescribed to target the immune system and reduce inflammation. These may include methotrexate, cyclosporine, or biologic drugs like TNF-alpha inhibitors or IL-17 inhibitors.
  • Lifestyle changes: Certain lifestyle changes may help reduce symptoms of psoriasis, including maintaining a healthy weight, quitting smoking, reducing stress, and avoiding triggers such as alcohol and certain medications.
  • Moisturizers: Applying moisturizers can help reduce dryness and itching associated with psoriasis. Look for fragrance-free, gentle products to avoid further irritation.
  • Other therapies: Alternative therapies such as acupuncture, meditation, and fish oil supplements have been used to manage psoriasis symptoms, although their effectiveness is not well established.

It’s important to work with a healthcare provider to develop a personalized treatment plan for psoriasis. Treatment may need to be adjusted over time as symptoms change and new medications become available. With proper treatment and management, most people with psoriasis can achieve significant symptom relief and maintain good quality of life.

Prevention

Unfortunately, there is currently no known way to prevent psoriasis, as the exact cause of the condition is not fully understood. However, there are certain lifestyle choices that can help reduce the risk of developing psoriasis or reduce the severity of symptoms for those who already have the condition.

Here are some tips:

  • Maintain a healthy weight: Obesity has been linked to an increased risk of psoriasis, so maintaining a healthy weight through diet and exercise may help reduce the risk.
  • Avoid triggers: Certain triggers, such as stress, infections, and certain medications, can cause psoriasis symptoms to flare up. Avoiding these triggers when possible may help reduce the frequency and severity of symptoms.
  • Protect your skin: Avoid injury to the skin, such as cuts or scrapes, which can trigger psoriasis. Use sunscreen to protect against sunburn, which can also worsen symptoms.
  • Quit smoking: Smoking has been linked to an increased risk of psoriasis and can worsen symptoms in people who already have the condition. Quitting smoking may help reduce the risk of developing psoriasis or improve symptoms in those who already have it.
  • Reduce alcohol consumption: Alcohol consumption has been linked to an increased risk of psoriasis and can worsen symptoms. Reducing or avoiding alcohol may help reduce the risk of developing psoriasis or improve symptoms in those who already have it.

It’s important to note that while these lifestyle changes may be helpful in reducing the risk of psoriasis or improving symptoms, they are not a substitute for medical treatment.

Diet

There is no specific diet for psoriasis that has been proven to be effective for everyone, as the condition can vary greatly between individuals. However, some people with psoriasis have found that certain dietary changes may help reduce inflammation and improve symptoms. Here are some tips:

  • Eat a balanced diet: A diet rich in fruits, vegetables, lean proteins, and whole grains can help provide the nutrients needed for overall health and may help reduce inflammation.
  • Reduce inflammatory foods: Some people with psoriasis have found that certain foods, such as red meat, dairy, and processed foods, may worsen symptoms. Try reducing these foods or eliminating them from your diet to see if it improves your symptoms.
  • Incorporate anti-inflammatory foods: Some foods may have anti-inflammatory properties that can help reduce inflammation in the body. Examples include fatty fish, nuts, berries, and leafy greens.
  • Stay hydrated: Drinking enough water can help keep the skin hydrated and may improve symptoms of psoriasis.
  • Avoid alcohol: Alcohol consumption has been linked to an increased risk of psoriasis and can worsen symptoms in people who already have the condition. Avoiding or reducing alcohol consumption may help improve symptoms.

Foods to include:

  • Fruits and vegetables: These are generally high in antioxidants and may help reduce inflammation in the body.
  • Whole grains: These are a good source of fiber and can help keep blood sugar levels stable.
  • Lean proteins: Examples include fish, chicken, and beans. These provide essential amino acids needed for overall health.
  • Healthy fats: Examples include nuts, seeds, and avocado. These can provide anti-inflammatory properties and help keep the skin hydrated.

Foods to avoid or limit:

  • Red meat: This may be high in saturated fat, which can increase inflammation in the body.
  • Dairy: Some people with psoriasis may have a sensitivity to dairy, which can worsen symptoms.
  • Processed foods: These may be high in added sugars and unhealthy fats, which can increase inflammation in the body.
  • Alcohol: Alcohol consumption has been linked to an increased risk of psoriasis and can worsen symptoms in people who already have the condition.

It’s important to note that dietary changes alone may not be enough to treat psoriasis and should be used in combination with other treatments, such as medications and lifestyle changes.

Medication

here are several medications available for the treatment of psoriasis. The choice of medication depends on the type and severity of psoriasis, as well as other factors such as age, overall health, and other medications being taken. Here are some common medications used to treat psoriasis:

  • Topical medications: These are applied directly to the skin and include corticosteroids, vitamin D analogs, retinoids, and coal tar. They can help reduce inflammation, itching, and scaling.
  • Systemic medications: These are taken orally or by injection and include methotrexate, cyclosporine, and acitretin. They work by suppressing the immune system to reduce inflammation and slow down the growth of skin cells.
  • Biologic medications: These are newer medications that target specific proteins in the immune system that are involved in psoriasis. Examples include adalimumab, etanercept, and ustekinumab. They are given by injection or infusion and can be very effective in treating moderate to severe psoriasis.
  • Light therapy: This involves exposure to ultraviolet light, either from natural sunlight or artificial sources. It can help reduce inflammation and slow down the growth of skin cells.

It’s important to note that these medications can have side effects and may not be suitable for everyone.

Overall

Psoriasis is a chronic autoimmune condition that affects the skin, causing red, scaly patches that can be itchy and painful. It can occur anywhere on the body and can vary in severity. If you suspect you have psoriasis, it’s important to see a doctor for a proper diagnosis and treatment plan.

It’s always a good idea to discuss the risks and benefits of each medication with a healthcare provider before starting treatment. In addition to medication, lifestyle changes such as stress reduction, regular exercise, and a healthy diet may also be recommended to help manage psoriasis symptoms.

There is no cure for psoriasis, but various treatments can help manage the symptoms. Your healthcare provider can help determine which treatment options are best for you based on the severity and location of your psoriasis. It’s important to work closely with a healthcare provider to develop a treatment plan that is tailored to your specific needs and symptoms.

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