It is written by
Dimitrios Malanos,
Dermatologist-Venoretologist
Associate of the Dermatology Department HEALTH
What is psoriasis?
Psoriasis is a chronic inflammatory skin disease with flare-ups and remissions. It is characterized by an increase in the rate of proliferation of skin cells (keratinocytes). This results in red, scaly patches on the skin.
Where is psoriasis usually found?
Psoriasis often affects the elbows, knees and scalp. It can be found on the palms and soles — often with cracks or calluses and cause changes in the nails. In addition, psoriasis can be found on the back, lower back and chest.
How common is psoriasis?
Roughly, 2-3% of the Greek population suffers from some form of psoriasis.
What are the causes of psoriasis?
The exact cause of psoriasis is not fully understood. It is considered a multifactorial disease and includes immunological, genetic and environmental factors.
Is psoriasis contagious?
No. Psoriasis is not contagious.
What are the symptoms of psoriasis?
Key symptoms include:
• Red patches of skin with white scales
• Itching
• Dryness and cracks in the skin
• Changes in the nails (thickening, discoloration, detachment)
• Pain in the joints (in case of psoriatic arthritis)
Can psoriasis be related to other conditions?
Yes. It can coexist with:
• Psoriatic arthritis
• Cardiovascular diseases
• Diabetes mellitus
• Emotional disturbances
What types of psoriasis are there?
• Plaque psoriasis : The most common form, with characteristic erythematous plaques with adherent scales
• Gutular psoriasis: Small tear-shaped lesions, mainly in children or young people after an infection.
• Inverse psoriasis: In the folds of the body (armpits, under the breasts, between the thighs).
• Pustular psoriasis: characterized by the formation of pustules
• Erythrodermic psoriasis: severe form characterized by extensive redness of the skin and systemic involvement (fever, chills, fatigue).
What factors make psoriasis worse?
Certain factors can trigger or worsen psoriasis, including:
• Stress
• Injury to the skin (Koebner phenomenon)
• Infections (eg strep)
• Cold and dry climate
• Certain medications (eg beta-blockers, lithium)
• Alcohol consumption and smoking
How is psoriasis diagnosed?
The diagnosis is made mainly by clinical examination by a dermatologist. In some cases, a skin biopsy may be needed for confirmation.
What are the treatment options?
The treatment depends on the severity of the disease, the co-morbidities as well as the particular needs of each patient.
Includes:
• Topical treatments keratolytics (salicylic acid, urea) corticosteroids, vitamin D derivatives (calcipotriol) calcineurin inhibitors (tacrolimus, pimecrolimus)
• Phototherapy (UVB, PUVA)
• Classical systemic treatments: (methotrexate, cyclosporine, acitretin)
• Apremilast (oral treatment which is a selective phosphodiesterase4 inhibitor)
• Biological agents: Modern targeted therapies with antibodies that modulate the immune system (eg IL‑17, IL‑23, TNF‑α).
The treatment of psoriasis has changed radically in the last decade. Treatment options today provide targeted action with high efficacy and minimal side effects, allowing treatment to be personalized according to the profile and needs of each patient.
How can lifestyle help?
Adopting a healthy lifestyle can improve symptoms:
• Healthy diet
• Maintenance of normal weight
• Avoiding alcohol and smoking
• Stress management
• Good hydration of the skin
Can psoriasis be permanently cured?
No, psoriasis is a chronic condition and there is no definitive cure. However, with appropriate treatment, patients can have long periods of symptom-free remission.
Psoriasis may not be curable, but with the available treatment options that exist today and in collaboration with a specialized dermatologist, it can be effectively controlled, significantly improving the quality of life of patients.