Psoriasis

Alternative names:

plaque psoriasis

Treatment:

Treatment is focused on control of the symptoms and prevention of secondary infections. It varies with the extent and severity of the disorder.

Severe or resistant cases, or cases involving large areas of the body, may require intensive treatment. Psoriasis lesions that cover all or most of the body are an emergency symptom that require hospitalization. The disorder may be acutely painful. The body loses vast quantities of fluid and is susceptible to severe secondary infections that can become systemic, involving internal organs, and can progress to septic shock and death. Treatment includes analgesics, sedation, intravenous fluids and antibiotics.

Mild cases are usually treated at home. Topical medications include:

• prescription or nonprescription dandruff shampoos
• shampoos or lotions that contain coal tar
• cortisone or other corticosteroids
• lubricants
• antifungal medications
• antibiotics
• phenol
• sodium chloride
• other ingredients

Oral or injected immunosuppressive medications (such as corticosteroids or methotrexate) may be prescribed, but only in very severe cases. Other medications may include retinoids or cyclosporine.

Other treatments may include moderate exposure to sunlight or phototherapy. The skin is sensitized by the application of coal tar ointment or by taking oral psoralens (a medication that causes the skin to become sensitive to light). The person is then exposed to ultraviolet light. Avoid sunburn, which can worsen the condition.

Maintain good general health to reduce the risk of flare-ups. Obtain adequate rest and exercise, eat a well-balanced diet, and avoid stress (see stress management). Treat respiratory and other infections promptly.

Maintain good skin hygiene to prevent secondary infections. Daily baths or showers are recommended. Avoid harsh scrubbing, which can irritate the skin and cause new outbreaks.

Oatmeal baths may be soothing and may help to loosen scales. Commercial preparations may be used, or mix one cup of oatmeal into a tub of warm water.

Support groups:

The stress of illness can often be helped by joining a support group where members share common experiences and problems. See psoriasis - support group.

Expectations (prognosis):

Psoriasis is a chronic, lifelong condition that can be controlled with treatment. It usually does not adversely affect general health, unless it is neglected or occurs in the elderly or very young.

Complications:

• skin cancer
• rapid skin aging
• cataracts
• complications secondary to treatments
• secondary skin infections with spread to internal organs

Calling your health care provider:

Call for an appointment with your health care provider if symptoms indicate psoriasis.

Call for an appointment with your health care provider if psoriasis recurs frequently despite treatment.

Also call if pustules, fever, muscle aches, fatigue, or other new or unexplained symptoms develop.