Psoriasis is a chronic and non-contagious disease consisting of red and scaly patches of different sizes on friction or exposed skin areas such as the scalp, knees, elbows and the trunk. Our Dermatologists are experts in treating any type of psoriasis in London and use many different types of procedures and treatments. Ask for a consultation and we will try to examine and evaluate your psoriasis and propose a treatment plan.
What is psoriasis?
Psoriasis is a skin disease that consists of red plaques covered by white or gray scales. It is chronic and lasts for years and usually appears in youth or adulthood. Psoriasis plaques appear on cutaneous areas exposed to friction or trauma, such as the elbows, knees, the back or buttocks.
Generally, psoriasis plaques only affect the skin. However, nails can also be affected, palms and soles may show a special type of Psoriasis called Pustulosis. The scalp is another area that suffers from Psoriasis in some patients.
What causes psoriasis?
Psoriasis is a genetic disease and is triggered by trauma or friction to the skin. The turnover of the skin is tremendously accelerated. The epidermis of the skin usually takes 30 days to renew completely whereas in psoriasis this happens in less than one week.
This is the reason why psoriasis characteristically develops on sites of trauma and not on protected areas of the skin such as the armpits, groin, or flanks of the trunk.
Clinical signs and symptoms in Psoriasis
The most frequent signs of psoriasis are:
Red squamous plaques on the skin
The most common lesion is a red plaque covered with thick scales or scaly erythematous plaques. There are no other general symptoms such as fever or pain. These plaques a very well demarcated and there is a clear cut limit between healthy skin and affected skin.
Dandruff and scaly scalp
Psoriasis also affects to the scalp. In this case there is itchiness, scaliness and resistant to treatment dandruff. The scales involve hair roots and cannot be removed with normal shampoos.
Inverted psoriasis
In some cases, psoriasis plaques appear in the armpits, in the groin or in the gluteal fold. This type of psoriasis is called inverted psoriasis and is due to friction between surfaces of skin rather than exposure to rubbing or trauma with external materials like clothes, tables or sitting.
Nail psoriasis
Occasionally, psoriasis affects the nail producing small depressions called pitting, yellowish areas of the nail called oil spots and white plaques (leukonychia) affecting the distal part of the nails. This is called nail psoriasis and is often confused with fungal infection. The way to distinguish this is the location: whereas fungus affects mainly the first two nails and very rarely the finger nails, Psoriasis affects the fingernails much more, especially in the right hand.
Diagnosis of psoriasis
The diagnosis of psoriasis is clinical, that is, the observation of clinical signs and lesions in characteristic places allows a well trained dermatologist to make the diagnosis without the need of a skin biopsy.
On some occasions, a skin biopsy can be performed to determine whether or not the patient is suffering from psoriasis.
When psoriasis affects the joints (3-5% of patients), it is known as arthritic psoriasis and a blood test may be necessary to study the degree of involvement of the patient.
Psoriasis treatment in London
Psoriasis treatment in London will depend on the extension and location of the disease. Although there is no cure and treatment has to be continued for a long time, the goal is to reduce plaques as much as possible.
Corticosteroid cream
Creams containing corticosteroids have been and are still being used to treat psoriasis plaques. However, the chronic application of corticosteroids on the skin has adverse effects such as skin atrophy, so treatment has to be limited in time.
Oral corticosteroids
They may be prescribed for larger, less responsive, more difficult to treat areas. Long-term use or overuse of strong corticosteroids are not recommended because they can cause atrophy in the skin, increase weight and cause dependency.
Corticosteroid infiltrations
These infiltrations are much more effective than topical treatments and can produce remissions lasting several months.
Cyclosporine or Immunosuppressor drugs
They are immunosuppressive substances used in organ transplants that reduce the inflammatory reaction of psoriasis.
Sun exposure or UVA therarpy or UVB therapy
Sunlight and ultraviolet light are good treatments for psoriasis, especially using the UVB band or 308 to 311 nm wavelengths. Sometimes, the effect of the sun is enhanced by taking psoralens. This is better known as puvatherapy.
Calcium channel inhibitors
These drugs are used for many inflammatory skin diseases such as Psoriasis. They are usually applied on the skin in the form of creams, lotions or ointments, depending on the area of the skin treated. Generally, they are applied twice a day, morning and night. They also help normalizing the rate of skin cell growth in the skin.
Er:YAG laser for drug delivery
Er:YAG laser cab be used to make microscopic holes in the skin through which topically applied treatments can easily penetrate. This also enhances treatment response.
Immunomodulators
This type of medication, unlike corticosteroids, have the advantage that they do not cause skin atrophy. They are changing the way we treat Psoriasis today.
Photomodulation or photodynamic therapy with red light (635nm)
Photodynamic therapy has been shown to significantly improve and restore damaged skin through stimulating repair mechanisms and the metabolism of the cell.
Biologicals
A biological is a drug obtained from biological organisms such as cells or bacteria. This type of medication consists usually of antibodies that block mediators of inflammation thus stopping all the disease process. They are injected weekly or monthly, and are prescribed in patients with a Psoriasis affecting very extensive areas of the body. The problem with these treatments is their high price, which is why they are administered only in large public hospitals.
Treatment prices in London
The price of treating psoriasis in London is:
Prevention and control of psoriasis
To prevent the development of new psoriasis plaques, it is important to minimize the trauma that may injure the skin. Trauma to the skin such as resting your elbows on a table, kneeling on the floor, seating for a very long time, should be avoided. It is also important to be able to go to the beach frequently and receive sunlight. In our dermatology clinic in London we also have special moisturizing creams for psoriatic patients and daily use.
Frequently asked questions from our patients
The most frequently asked questions about psoriasis are: