Know the signs of psoriasis

By: Annie Oeth, aoeth@umc.edu

Don’t blame cold winter days for patches of red, scaly skin. Finding these patches with silvery scales can be the first sign of psoriasis.

In psoriasis, the body’s immune system becomes overactive, causing skin cells to multiply too quickly. The normal lifespan of a skin cell is about a month, but for those with psoriasis, that’s shortened to only a few days.

These patches of skin, most often on the elbows, knees, torso or scalp build up and then become inflamed and sometimes are so dry that they crack and become sore, said Dr. Stephen Helms, professor of dermatology at the University of Mississippi Medical Center.

“Mainly, the signs of psoriasis are red, scaly plaques,” Helms said. “These plaques are raised and palpable because of the build-up of skin cells.”

Nails that are thick and ridged or pitted and poor sleep quality can also be signs of psoriasis, the National Institute for Skin and Musculoskeletal and Skin Diseases reports.

About 3% of Americans 20 and older have psoriasis, according to a 2021 study published in the Journal of the American Medical Association.  “That may sound like a small percentage,” Helms said, “but it adds up to about 7.5 million people.”

The good news is that psoriasis doesn’t have to be heartbreaking.

Symptoms of psoriasis can ebb and flow, ranging from flares to remission. Anyone can get psoriasis, but it does occur in adults more often than children. Psoriasis affects men and women equally.

"A barely noticeable spot on an elbow could be treated with something as simple as a moisturizer,” Helms said, “but those with more plaques that are noticeable and itchy will benefit from dermatological care.”

While there’s no cure for psoriasis, mild cases are usually treated effectively with over-the-counter or prescription topical ointments and creams.

About 80% to 90% of people with psoriasis have the mildest form, plaque psoriasis, the American Academy of Dermatology reports. Other forms, such as generalized pustular psoriasis and erythrodermic psoriasis, can be severe and even life-threatening.

More severe psoriasis may require light treatments, pills or injections. Narrow band UVB phototherapy as well as injections and prescriptions for topical and oral medications are available through UMMC dermatologists at the UMMC Grant’s Ferry Clinic, the Face and Skin Center in Ridgeland’s Township at Colony Park and at the Jackson Medical Mall.

Those with psoriasis may be more likely to also have conditions such as heart disease, Crohn’s disease, metabolic syndrome, diabetes, osteoporosis, liver disease and kidney disease, so keeping tabs on overall health is especially important.

Eating a healthy diet rich in Omega-3 fatty acids, whole grains and plants is one of the ways patients can reduce the severity of psoriasis symptoms, said Dr. Amy Flischel, associate professor of dermatology.

“Patients need to understand psoriasis is an immune-mediated disease that can wax and wane with symptoms ranging from limited, local plaques to more widespread involvement despite a patient’s best efforts,” she said. “Leading a good lifestyle is important as there can be underlying co-morbidities like heart disease and high cholesterol in patients with psoriasis.”

Tracking psoriasis is essential, she said. “Patients should notify their dermatologist if body surface area increases or areas of involvement become too large to apply topical medications alone. This can lead to earlier intervention with a systemic medication prompting more rapid resolution. Additionally, patients with psoriasis can have arthritis. Psoriatic arthritis can be a destructive condition in the joints and needs to be discussed as well.”

According to the National Psoriasis Foundation, psoriatic arthritis affects about 30% of people with psoriasis.

“While we do not have a cure for psoriasis, we have made huge strides in the field of dermatology in treatment of psoriasis,” Flischel said. “There are many new effective medications with good safety data to treat psoriasis both locally and in those patients with more diffuse involvement. Many more medications are being investigated as well, which will just continue to enhance our ability to treat our patients.”

Got questions or concerns about skin conditions? No referral is necessary to see a UMMC dermatologist. Appointments can be made online or by calling 888-815-2005.

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