Pink/Purple Plaque – Got Psoriasis?
Psoriasis, once thought to be related to leprosy, was finally recognized as its own disease in the 19th century but has probably been around longer than that. Psoriasis is a chronic inflammatory skin disease and is seen in approximately 7.5 million people in the United States. It can be seen in all ages but is most commonly seen in young adults and older adults.
August is National Psoriasis Action month. So, what is psoriasis? Psoriasis is due to the immune-mediated increased production of skin cells which results in redness and scaling. Risk factors include family history of psoriasis, tobacco use, alcohol use, obesity, skin injuries, and some medications.
There are several types of psoriasis, but the most common is plaque psoriasis. Signs and symptoms can vary but most commonly present as an itchy, widespread, bright pink or salmon-colored raised lesion/plaque, with defined borders, and these plaques can have an overlying white and silvery scale. People with darker skin tones can present with more purple or dark brown lesions with a gray scale. It is usually found on elbows, knees, and buttocks but can be found on other parts of the body. Another sign is pinpoint bleeding after removal of the overlying silver scale; this is called the Auspitz sign. Psoriasis can also occur around skin trauma and have pus, nail involvement, arthritis, or widespread redness.
Treatment generally involves keeping the plaques hydrated and moist. Humidity even helps, but not too much humidity because sweat can aggravate psoriasis. Staying hydrated and moist involves soaking the lesions in a bath or shower so that the scales can easily be removed. Emollients such as petroleum jelly and thick creams can help too, and these are usually applied alone or in conjunction to other treatments such as topical corticosteroids. Topical corticosteroids come in different strengths and different forms such as ointment, gels, cream, foam, etc. Most commonly it is used twice a day for 2-4 weeks at a time. For longer use, consult your healthcare provider. Other topical treatments include vitamin D, salicylic acid, and retinoids
The largest barrier to treatment success is sticking to the regimen. It can be hard to remember and want to apply a moisturizer every day. That is why it is important to find a moisturizer and regimen that you will stick to.
Another thing that has been known to help with psoriasis is ultraviolet (UV) and sunshine. So, some short periods in the sun can help but don’t forget to apply sunblock! The other option is to get UV therapy under the supervision of a healthcare provider. For more severe or resistant psoriasis, there are oral and intravenous medications that can suppress your immune system, but these can increase your risk of infection. Risk and benefits should be considered and should be discussed with your healthcare provider.
In addition, reducing risk factors helps improve symptoms and flare-ups of psoriasis. Reducing or quitting tobacco use, and alcohol use can help. Also, a healthy balanced diet and exercise can reduce flare-ups and improve how treatment works. Ask your healthcare provider for further assistance.
This summer, be sure to stay hydrated and moisturized!
Dr. Nguyen is a resident physician who sees patients of all ages and provides obstetrical services at Lone Star Family Health Center, a non-profit 501©3 Federally Qualified Health Center operating facilities in Conroe, Spring, Willis, Grangerland, and Huntsville, and serving as home to a fully integrated Family Medicine Residency Program to increase the number of Family Medicine physicians for Texas and our community.