Psoriasis (psoriasis): causes, symptoms, treatment

What is psoriasis?

Psoriasis is referred to in medical parlance as psoriasis and is one of the most common skin diseases worldwide. In some countries of the world, up to 11% of the population is affected by this disease. Psoriasis can occur at any age. Women and men are affected about the same number of times.

Typical: reddened, thickened, scaly skin

The exact cause of psoriasis has not yet been clarified. It is known, however, that in the genesis of the genes and the immune system and other external influences such. Infections, sun exposure and stress can play a role. An overactive immune system causes inflammation of the skin, and skin cells are stimulated to divide more. This causes reddish, thickened and scaly skin lesions, called plaques. These may itch and hurt but are not contagious.

Psoriasis can also affect joints, vessels and internal organs such as the heart or liver. The disease often occurs in spurts and can vary greatly from person to person. So far there is no chance of a cure, but there are many effective therapies available to control the condition and improve quality of life.

causes

Overactive immune system

Certain cells of the immune system become excessively activated in psoriasis and cause inflammation of the skin. How and why this has happened has not yet been elucidated.

The inflammation of the skin manifests in a redness and itching or even pain. In addition, by releasing pro-inflammatory neurotransmitters, the cells of the skin begin to multiply. Since this is up to eight times faster than with healthy skin cells, the cells do not have enough time to fully develop. For this reason, they do not detach from the uppermost skin layer and instead accumulate on the skin surface. This results in plaques typical of psoriasis with silvery shingles.

The role of genes

Scientists currently assume that both genetic inheritance and the immune system as well as certain external influences in the development of psoriasis interact. For example, a large-scale study of identical twins with identical genetic material has shown that in 70% of the cases, both siblings were affected by psoriasis. In 30% of the cases, however, only one twin was affected despite the identical genome. For this reason, it can be assumed that not only genes play a role in the onset of the disease.

Other known triggers of psoriasis

In addition to the immune system and genetic inheritance, infections caused mainly by streptococci (for example, tonsillitis) are among the known causes of psoriasis. In addition, infectious agents such as viruses (such as HIV) or yeasts, as well as chronic infections of the teeth, sinuses or gastrointestinal tract.

In addition, mechanical irritation of the skin (e.g., tight-fitting clothing), sunburn, or tattooing can lead to the onset or worsening of existing psoriasis.

Hormone fluctuations, such as e.g. on pregnancy, as well as certain drugs (e.g., beta-blockers, lithium salts, or ACE inhibitors) have also been identified as causing psoriasis. Finally, there is also evidence that depression and mental stress (for example, stress in everyday working life) can lead to an outbreak or worsening of existing psoriasis.

Read also:
Questions and answers about the causes of psoriasis

symptoms

In psoriasis different manifestations are distinguished. The most common form, accounting for about 90%, is psoriasis vulgaris. The manifestations of psoriasis guttata, inversa and intertriginosa, however, occur much less frequently. There are also special forms of psoriasis: psoriatic arthritis and psoriasis pustulosa.

In about half of all those afflicted with psoriasis, the nails are affected in addition to the skin.These can then have pits and yellowish-brown discolorations that can easily be mistaken for fungal infestation.

Psoriasis vulgaris: silvery shiny plaques

Psoriasis vulgaris is characterized by sharply defined, reddish skin lesions called plaques. Compared to the healthy, surrounding skin, they are slightly raised and have a silvery shingling on their surface.

The plaques in psoriasis vulgaris are mainly found on the elbows, knees, hairy head, genitals, navel and lower back. Quite often, only a specific area of ​​the skin is affected, such as the scalp. The diameter of the plaques varies greatly. Some sufferers may affect the entire body.

Rare: psoriasis guttata, inversa and intertriginosa

Psoriasis gutatta is characterized by small, reddish and punctate skin lesions. The diameter is usually less than 1 cm. These are mainly found on the trunk and often occur in children and adolescents a few weeks after a streptococcal infection.

The appearance of psoriasis inversa is very rare. This form primarily affects the flexion of the large joints. The psoriasis intertriginosa is also very rare and affects especially the large body folds, that is, the abdominal fold, the groins and the axillary fold.

Infestation of the joints: psoriatic arthritis

Psoriatic arthritis is the best-described accompanying disorder of psoriasis. This disease causes inflammation of the joints (= arthritis). There are different types of courses, depending on whether the small joints of the fingers and toes, the spine or the large knee and elbow joints are primarily affected.

Psoriatic arthritis occurs in some countries of the world in up to 42% of those with psoriasis. Studies indicate a relationship between the extent of skin involvement and the development of psoriatic arthritis: the more pronounced the skin involvement, the higher the likelihood of arthritis occurring. In addition, the risk of psoriatic arthritis increases when psoriasis is present with nail involvement.

In about 15% of cases occurs first a psoriatic arthritis and then psoriasis. Also, an improvement or deterioration of joint inflammation does not necessarily mean an improvement or deterioration of dermatitis. For this reason, a skin disorder is not necessarily a prerequisite for the subsequent development of psoriatic arthritis. However, it facilitates the diagnosis.

On the other hand, a diagnosis of psoriatic arthritis is problematic if no psoriasis of the skin can be detected. The diagnosis in this case should not take too long, since otherwise an irreversible destruction of the joints may have occurred.

Pustules in psoriasis pustulosa

In up to 12% of cases, people with psoriasis are affected by the pustular form. In this form, yellowish pus-filled blisters develop on pre-existing plaques. These contain no pathogens and dry up after a while or burst. These lesions are therefore not infectious.

It is usually affected here, small areas of the body, especially the palms and soles. Rarely, the whole body can be affected. In severe cases, it can cause fever and chills due to the extensive inflammation, so the disease must be treated in the hospital.

More about this topic can be found here:
Questions about the symptoms of psoriasis

diagnosis

The diagnosis of psoriasis is made by the physician primarily based on the changes on the skin and nails. For this reason, a thorough examination of the entire body is necessary. In addition, questions are asked about the medical history and illnesses in the family. If comorbidities occur, they must be clarified by further investigations.

Thorough inspection of the entire skin

Usually the diagnosis of psoriasis is made on the basis of a skin examination. When rubbing or scratching, the affected skin areas in psoriasis take on a characteristic appearance.

The doctor checks this, for example by rubbing with a wooden spatula. Psoriasis will replace dandruff that makes the skin look like white candle wax. If the doctor rubs off the scales completely with a wooden spatula, a thin layer of moist, shimmering skin appears underneath. If this cuticle is further scraped, typical point-like bleeding occurs, which is called the "Auspitz phenomenon". This phenomenon is characteristic for psoriasis and can not be observed in any other skin disease.

However, if a clear diagnosis can not be made, it may be that a skin examination alone is not sufficient for a reliable diagnosis.In this case, the removal of a skin sample can help. Under the microscope in the laboratory, certain changes in the skin can be detected that would not be visible to the naked eye.

Further examination methods

If additional concomitant diseases occur, further tests may be used in addition to a skin examination. For example, if joints are affected, X-rays, magnetic resonance imaging (MRI), or blood tests may be needed.

More information here:
Questions and answers about diagnostics

treatment

No cure, but significant relief

At present it is not possible to cure psoriasis. There are, however, three different forms of therapy with the aim of stopping the progression of the disease, alleviating symptoms and avoiding new relapses.

In the majority of those afflicted with a mild form, topical therapy, ie. a local therapy of the diseased skin area, used. If the symptoms do not improve, this form of therapy can be supplemented by light therapy. Systemic therapy of the entire body is required in severe cases or in the presence of psoriatic arthritis.

The drugs used in this form of therapy suppress the immune system and are therefore referred to as "immunosuppressive" (suppressive). In addition, other alternative forms of therapy also play an important role in some countries, such as traditional Chinese medicine, homeopathy or climate therapy.

1. Mild courses: topical therapy

In the topical (= topical, external) therapy of the skin, there are a variety of drugs that can be applied in the form of ointments, creams, lotions, gels or shampoos depending on the skin type and affected area of ​​the skin.

Hornlösende agents

The horn-releasing agents include salicylic acid, lactic acid or urea. These substances remove dandruff, soften keratinized skin and prepare it for other active ingredients, which can better penetrate the skin.

Agents for inhibiting cell growth

Among the longest known substances for the treatment of psoriasis include dithranol or tar. They counteract the excessive production of skin cells. However, since these agents can cause irritation of the skin and discoloration of clothing, they are rarely prescribed.

Active ingredients derived from vitamin D

This group of active ingredients includes calcitriol, tacalcitol or calcipotriol. They interfere with the regulation of the immune system by suppressing the production of pro-inflammatory messengers. In this way, an excessive division of the skin cells is reduced.

Active ingredients derived from vitamin D are considered to be relatively gentle and are therefore suitable for long-term treatment. An overdose should, however, be avoided, otherwise the calcium level in the blood may rise. Excessive levels of these agents can also cause skin irritation, which is why long-term treatment in combination with cortisone should be avoided. Besides, these drugs are usually not prescribed during pregnancy and lactation.

glucocorticoids

Topically applied glucocorticoids inhibit the inflammation of the skin and are offered in different potencies. Low dosage is used for face and skin wrinkles, while high levels of glucocorticoids are more likely to be applied to soles and palms.

In the case of long-term glucocorticoid treatment, the skin should be checked regularly by a doctor, as these medicines dry out and thin the skin.

Calcineurin inhibitors

Although calcineurin inhibitors such as tacrolism or pimecrolism are officially approved only for the treatment of atopic dermatitis, in individual cases they may also be prescribed for the treatment of psoriasis. Like glucocorticoids, they also have an anti-inflammatory effect and, at the same time, have the advantage that they do not lead to dilution of the skin. However, calcineurin inhibitors can lead to burning of the skin as a side effect.

2. Photo and laser therapy

Phototherapy or light therapy is usually prescribed for moderate to severe psoriasis in long-term use due to the risks of skin aging and skin cancer. Here, the skin is irradiated for several weeks in increasing dosage with ultraviolet (UV) light of certain wavelengths.

Often, the light therapy is also combined with a so-called brine treatment in which affected people are treated with very salty water. The high salt content of 15 - 30% dissolves the dander, and the UV light leads to a normalization of cell division. The high proportion of bromide and magnesium also inhibits horn formation and inflammation.

A disadvantage of the photo-brine treatment, however, is that the effect of this therapy in many affected only relatively short-term. In addition, the risk of skin cancer increases due to UV light.Benefits of this form of therapy should therefore be carefully weighed against the risks by the physician.

As an alternative to light therapy in recent years, a laser beam therapy is offered, which is not paid by the health insurance companies. The advantage over phototherapy lies in the fact that the laser beam can be targeted to affected areas of the skin, so that the healthy skin is not burdened by UV radiation.

3. Severe courses: The internal therapy

In severe cases of psoriasis and the occurrence of comorbidities, an internal therapy in the form of tablets or syringes is often unavoidable. In this form of treatment, influence on the immune system is taken. Cyclosporins, fumarates, methotrexate and the newer group of drugs known as biologics are mainly used here.

cyclosporine

These drugs suppress the immune system and thus also inhibit the excessive proliferation of skin cells. Initially, treatment is usually started at a daily dose of 2.5 mg per kilogram of body weight and increased to a dose of 4 mg per kilogram of body weight. It is important to note when taking that grapefruit juice slows the recovery of the drug. This juice should therefore not be consumed during the treatment.

In addition, during the treatment with cyclosporins, especially the kidney function and the blood pressure should be checked regularly, since side effects can occur here. In addition, it should be noted that the immune system is impaired by the ingestion of cyclosporins in its function. For this reason, it can lead to increased infections.

Fumarate (fumaric acid ester)

Although the exact mechanism of action of fumaric acid esters in the treatment of psoriasis is not yet fully understood, this drug has been used since the 1990s in Germany for severe forms of psoriasis. Presumably the main active ingredient is dimethyl fumarate. The only approved drug is Fumaderm®.

Therapy follows an established dosage regimen. Initially, the drug is administered at a dosage of 30 mg. In the following weeks, the dose is slowly increased. If the symptoms improve, the dose can be reduced again. An improvement of the skin symptoms occurs on average after about three months.

The most common side effects are disorders of the gastrointestinal tract, e.g. Nausea and diarrhea. These occur in about 60% of those affected. On the other hand, if the drug is well tolerated, a high level of effectiveness is to be expected.

methotrexate

As with many rheumatic diseases, low-dose methotrexate has a good anti-inflammatory effect in the majority of patients with psoriasis. Regular controls during treatment are very important for this medicine, as the side effects can lead to dysfunction of the liver and kidney. Also should be dispensed with a child's desire and during pregnancy due to the germ-damaging effect on methotrexate.

biologics

In the so-called biologics such as Adalimumab, infliximab or etanercept are genetically engineered agents that interfere with and suppress the regulation of the immune system. Due to the targeted inhibition of certain immune cells or certain messenger substances, the entire immune system is not inhibited. The rate of side effects is therefore rather low when using biologics.

Problems in taking biologics are more likely to cause allergic reactions or side effects due to the strong suppression of the immune system, i. especially an increased rate of infections.

4. Alternative healing methods

Alternative healing methods such as Treatments with medicinal plants can in many cases be a useful supplement to conventional medical treatment. For example, preparations containing chamomile, calendula or witch hazel are known to have an anti-inflammatory effect. However, alternative therapies should always be considered critically, as the efficacy and tolerability of many methods has not been scientifically proven or investigated.

Read also:
Important questions about the treatment of psoriasis

precautionary measures

Smoking and alcohol: not a good idea

Studies have shown that the risk of psoriasis in smokers is two-fold higher than that of non-smokers. Excessive consumption of alcohol can also lead to aggravation of symptoms in many sufferers.

It becomes particularly critical if the liver is damaged by the consumption of alcohol, as it also breaks down medications for the treatment of psoriasis via this organ. If the liver does not function properly, these drugs can no longer be used. A renunciation of stimulants thus reduces the risk of the onset of the disease and the onset of relapses.

Risk factor overweight

Currently, there is no solid scientific evidence for the influence of a particular diet on the course of psoriasis. For this reason, experts can not recommend a special diet.

However, several international studies have shown that disease symptoms in psoriasis exacerbate by obesity. Obesity was also associated with poorer psoriasis treatment success. These study results are explained by the fact that the fatty tissue itself has an inflammatory activity.

Inflamed almonds: in case of doubt, get out of it

Infections of tonsils with streptococci have been linked to the onset and worsening of psoriasis. Studies have shown that removing tonsils in adults can improve the course of psoriasis. In individual cases removal of tonsils should therefore be considered in those with recurrent tonsillitis.

Not to be underestimated: stress

About 37-71% of people with psoriasis report psychological stress as the cause of the onset or worsening of their condition. In fact, some studies have shown that intense mental stress in children and adults leads to exacerbation of symptoms in the following month.

How this happens is not yet understood. However, there seem to be people who are more sensitive to stress than their peers. These individuals are suspected of having an imbalance between pro-inflammatory and anti-inflammatory mechanisms in their body. Certain pro-inflammatory mediators gain the upper hand under the influence of stress and lead to an exacerbation of the disease.

To make matters worse, it often happens that the disease itself is perceived as a heavy burden. Many people feel disfigured by the skin changes and suffer from the perceived stigma. As a result, social isolation and depression can occur, and the symptoms of the disease continue to worsen. This can end in a vicious circle from which many sufferers can escape with professional help.

Various methods of relaxation have been found to be very effective, as well as the exchange of experience with other stakeholders, e.g. in the form of self-help groups. Furthermore, massages or acupuncture can contribute to a reduction in stress.

If it does not stay with psoriasis alone

Psoriasis itself can also be a risk factor for other diseases. Studies have shown that there is an association between existing psoriasis and the development of a so-called metabolic syndrome (for example, diabetes mellitus or high blood pressure). In addition, in psoriasis, the risk of other comorbidities such. Crohn's disease or increased rheumatic diseases.

People with psoriasis should always keep this in mind and take regular check-ups in order to detect and treat a possible concomitant disease in good time.

More about the risk factors can be found here:
What a psoriasis can trigger

 

Author: Dr. Julia Spengler

sources

Global report on psoriasis, World Health Organization, 2016, ISBN 978 92 4 156518 9.

Lela A. Lee and Victoria P. Werth. The Skin and Rheumatic Diseases. In: Firestein GS, Budd RC, Herris ED Jr, et al. eds. Kelley's Textbook of Rheumatology. 9th ed. Philadelphia, PA: Elsevier Saunders; 2012: chap 43.

Lonnberg et al., Heritability of psoriasis in a large twin sample. Br J Dermatol. 2013 Aug; 169 (2): 412-6. doi: 10.1111 / bjd.12375.

Quality Care: living well with psoriasis, information leaflet by LEO Pharma GmbH, January 2017.

Schwartz J, Evers AWM, Bundy C and Kimball AB (2016) Getting under the skin: Report from the International Psoriasis Council Workshop on the Role of stress in psoriasis. Front. Psychol. 7:87. doi: 10.3389 / fpsyg.2016.00087.

Comment: The most important questions and answers about psoriasis

Woman - psoriasis

On this portal Navigator medicine we answer health questions around the topic "psoriasis (psoriasis)" - from the causes and triggers of typical patterns and complaints to the medical examination and treatment measures.

Typical skin symptoms

In its most common form psoriasis (medically: psoriasis) occurs as a chronic inflammatory skin disease (psoriasis vulgaris). Typical characteristics are sharply delimited, reddened and slightly raised house-places with strong, silvery-whitish scaling. These plaques can be punctate to palm-sized and occur anywhere on the body. Preferably, they do it on the hairy scalp and on the extensor sides of knees and elbows. The nails can also be affected as skin appendages.

Psoriasis with its typical skin symptoms is relatively easy to recognize. For the experienced dermatologist normally the gaze diagnosis is sufficient.

Autoimmune disease with hereditary predisposition and trigger factors

The exact causes of psoriasis are unclear. According to current understanding, it is an autoimmune disease with hereditary predisposition. Presumably, certain genes play a certain role in helping those affected by their immune system to target their own skin cells. The result is inflammatory processes and a frequently accelerated renewal of the skin surface.

The fact that it comes on the basis of heredity actually to the disease symptoms, is attributable to various triggers. In addition to mechanical, chemical or other stress on the skin, these include various trigger factors such as physical and emotional stress, infections, surgeries or certain medications.

Non-contagious, rarely dangerous, but often stressful

Psoriasis is not contagious and usually not dangerous either. Except when the damaged skin surface and the associated inflammatory process is very large. Or when internal body structures such as joints (psoriatic arthritis) or organ systems are affected, e.g. Heart, liver or metabolism.Psoriasis is a systemic disease that can affect various parts of the body. And it increases the risk of cardiovascular diseases such as heart attack.

Even if the physical hazard potential of psoriasis is comparatively low: their psychological stress potential due to the disfiguring scaling is even greater. People with visible psoriasis are threatened with a perceived or even actual stigmatization. The associated limitations of social contacts and the quality of life make up for the most part the suffering potential of this disease. Psychosomatic complaints can be the result.

Wide range of treatment without cure

So how do you get rid of this disease? It is not curable, at least not by medical means. About a quarter of those affected are lucky. With them the psoriasis disappears after a single occurrence again and does not return. In most patients, on the other hand, a chronic and / or relapsing process sets in which phases of the subsidence of the skin lesions alternate with those of the blossoming. The treatment spectrum is very broad and varied. Whether that really uses the patient or rather the doctors and the medical industry, let's leave it a question. In any case, with an estimated 2 million psoriasis in Germany and 125 million worldwide, the market is large enough to stimulate the increased interest of the pharmaceutical industry. She is constantly researching new pharmaceutical solutions, in some cases also old ones in new guises. A classic of external treatment is the combination of cortisone with vitamin D3 or the respective derivatives of these substances. Also the irradiation with UV-light (UVA or UVB) promotes the improvement. This is also reflected in the positive influence of sunlight, which is partly responsible for the usually improved skin situation in summer time.

Active and self-determined to stop psoriasis

A breakthrough in the treatment of psoriasis seems to have succeeded with the development of completely new drugs, the so-called biologics. They directly interfere with the immune system and can ensure a complete resolution of the symptoms in a relatively short time. Of course they are not only effective, but also powerful in their effects. And very, very expensive. They are reserved for serious cases and must confirm their safety and efficacy in long-term observations.

Whether a treatment is suitable for you or not, you should, after consultation with the doctor of your confidence, decide for yourself. In an estimated quarter of all patients, the medical efforts have failed so far that the treated stay away from other care services. But the sooner and more consistently you counteract the further spread of psoriasis with the offered therapeutic help, the better. Once the skin is damaged, the restoration of its integrity becomes much more difficult.

Take advantage of your own options to protect your healthy skin and to ward off or at least keep psoriasis in check. In addition to specific skincare, these include general health promotion measures such as balanced nutrition, exercise, adequate sleep, avoidance of alcohol, nicotine and other drugs as well as stress reduction and mindfulness exercises.

Author: Dr. Hubertus Glaser

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How is the severity of psoriasis assessed?
Unlike other diseases, there is no universal definition of the severity of psoriasis. There are only so-called scores, with which the objectifiable physical complaints are quantified and the impairment of ...
What is the PASI score for?
The PASI score is used to divide psoriasis into certain degrees of severity. PASI stands for "Psoriasis Area and Severety Index" (Area: where are the psoriasis foci ?, Severety: how pronounced are the lesions?). Of the...
From what points in the PASI score is it no longer a matter of mild psoriasis?
The PASI score is used to divide psoriasis into certain degrees of severity. Above all, the spread and the condition of the skin are evaluated. With a PASI score of more than 10 points, it is ...
What blood levels are characteristic of Zumbusch psoriasis?
In the case of psoriasis of the Zumbusch type, an increase in white blood cells (leukocytes) occurs shortly after an initial characteristic fever and parallel to the formation of pustules, and a decrease in the calcium content in the ...
How is psoriasis treated?
For the treatment of psoriasis, there is a smorgasbord of different treatment options available, all of which share a common disadvantage: psoriasis is not curable with them. Push back the ugly ...
What does "topical therapy" mean?
Some doctors are having a hard time taking off their painfully trained medical jargon when dealing with ordinary mortals. "We start with a topical therapy" is one of the classics. Topisch means here ...
When is psychosocial therapy appropriate for psoriasis?
Although psoriasis is only in exceptional cases a threatening disease. Nevertheless, due to their stigmatizing nature, skin lesions can sometimes become a serious burden for those affected, namely in the ...
When do you have to go to the hospital with psoriasis?
In most cases, the treatment of psoriasis can be done on an outpatient basis. However, in about 1 out of every 50 patients hospital care is required at times, and thanks to improved treatment options, this rate can be ...
How does Dithranol work against psoriasis?
Dithranol is one of the oldest medicines for psoriasis. First treatment successes were already documented at the beginning of the last century. It is originally a natural substance derived from the marrow of the Brazilian ...
How to use Micanol cream for psoriasis properly?
Micanol® cream contains the active substance dithranol. Since this active substance can effectively contain the psoriasis herd, but at the same time tends to cause skin irritation and above all to intense brown discoloration, a careful and disciplined approach to ...
Does urea help against psoriasis?
Often already. Urea-containing ointments are part of the standard repertoire of skin care for psoriasis. First and foremost, urea (medical: urea) leads to moistening of the skin. Namely, in which he binds water. That makes the ...
Can Urea Ointments Have Side Effects?
Usually not. If it comes to highly concentrated urea emulsions, urea ointments or creams, it may cause irritation of the skin. However, the usual products from the pharmacies all contain only 3 to 10% ...
Psoriasis: What should be considered when taking Neotigasone?
For certain medications, it is important to know how and when to take them. In fact, problematic interactions can arise between medicines and some foods. Not infrequently, dairy products also play a role in ...
Why should not retinoids be taken during pregnancy?
Retinoids are synthetic derivatives of vitamin A (retinol), which are used in the treatment of psoriasis (and also acne) as an ointment or tablets. Some of their representatives, such as the active ingredients isotretinoin and acitretin, ...
Does neotigasone cause hair loss in psoriasis?
Acitretin (Neotigason®), a group of retinoids, is used to treat psoriasis and other severe skin disorders. In the context of therapy belongs hair loss in addition to the dry skin unfortunately ...
Can I get into the sun with psoriasis despite Neotigason?
For centuries it has been known that sunlight has a positive effect on certain skin diseases. So also with psoriasis. However, medications such as Acitretin (Neotigason®) can reduce the sensitivity of a person's ...
Psoriasis: May I donate blood with Neotigason?
The retinoid acitretin (Neotigason®) can cause damage to an embryo and must not be used during pregnancy or to women of childbearing potential without contraception. In order not to endanger other women, people with ...
Psoriasis: prescription for Neotigasone valid only 1 week?
In Germany, the registered doctor can issue different recipes. Most often comes the red box office recipe, often a blue private recipe. How long a prescription is valid depends on the prescribed medication ....
Psoriasis: What should I watch out for with the Zorac gel?
It is known that systemic (internal) retinoids can cause damage to an embryo. For this reason, these medicines should not be used during pregnancy or on women of childbearing potential without contraception. For the...
Psoriasis: Why is the skin burning under Zorac gel?
Zorac® gel contains the active ingredient tazarotene from the group of retinoids. The vitamin A derivative is used for the external treatment of psoriasis plaque type. It is not uncommon for local therapy to produce strong ...
How does Fumaderm work in psoriasis?
Fumaric acid esters are used in dermatology as an intravenous drug (Fumaderm®) in moderate to severe psoriasis vulgaris. They develop their effect by influencing the immune system with ...
How should I take Fumaderm for psoriasis?
The fumaric acid esters used for the internal treatment of psoriasis are available in two dosages. The lower-dose Fumaderm® initial serves as an introduction to the higher-dose main therapy with Fumaderm®. Both drugs ...
Psoriasis: What to do about side effects with Fumaderm?
Fumaderm® treatment often causes annoying but usually harmless side effects. These are mostly temporary and are mainly due to gastrointestinal complaints, facial flushing with hot flashes or ...
Psoriasis: How are Elidel and Protopic different?
The topical preparations Elidel® (pimecrolimus) and Protopic® (tacrolimus) are both local immunosuppressants. Their effect is based on a suppression of the inflammatory reaction in the skin. Both medicines ...
Are Elidel and Protopic better for psoriasis than cortisone?
Elidel® (pimecrolimus) and Protopic® (tacrolimus) are among the topical (topical) calcineurin inhibitors. They have an anti-inflammatory effect and suppress the immune system. Despite a similar effect, they differ ...
Psoriasis: Can I use Elidel or Protopic in the summer?
The calcineurin inhibitors Elidel® (pimecrolimus) and Protopic® (tacrolimus) are used i.a. used externally in atopic dermatitis and psoriasis. As so-called immunomodulators, they locally affect the immune system and ...
How Does Immunosporin Affect Psoriasis?
Cyclosporin A (Immunosporin®) belongs to the group of immunosuppressants.It is mainly used in transplantation medicine to prevent rejection reactions. For over 20 years, it has also been firmly established in the treatment of ...
How long do I take Immunosporin for psoriasis?
Cyclosporin A (Immunosporin®) belongs to the immunosuppressive drugs as a so-called systemic (internal) calcineurin inhibitor. The drug suppresses the excess immune system via various signaling pathways and has a ...
Psoriasis: What side effects does Immunosporin have?
Immunosporin® (Cyclosporin A) is a systemic (internal) immunosuppressive agent which i.a. is used to treat moderate to severe psoriasis vulgaris. In addition to an anti-inflammatory, immune-suppressive effect ...
Does immunosporin cause skin cancer in psoriasis?
Immunosporin® suppresses the immune system as an immunosuppressant. As a result, there is an increased susceptibility to certain diseases during use, i.a. also for skin cancer. To avoid the risk of developing malignant skin lesions ...
How does methotrexate work in psoriasis?
Methotrexate (MTX) is a drug used both as a chemotherapeutic in cancer therapy and at a low dose for the treatment of autoimmune diseases such as psoriasis. In the latter you make your own ...
How do I use methotrexate for psoriasis?
Methotrexate (MTX) is used not only in cancer therapy but also in the treatment of autoimmune diseases. In the treatment of psoriasis, however, MTX is dosed much lower than is usual in tumor therapy ...
Psoriasis: Can MTX damage my liver and kidneys?
The chemotherapeutic methotrexate (MTX) is used not only in cancer therapy, but also in the treatment of chronic inflammatory diseases. In psoriasis, MTX suppresses the overactive immune system and has an anti-inflammatory effect ....
Can I go into the sun with psoriasis despite MTX?
Methotrexate (MTX) is used to treat the moderate to severe form of psoriasis vulgaris when conventional therapies such as local or phototherapy are not sufficiently effective or appropriate. Also...
What about having children under MTX in psoriasis?
Methotrexate (MTX) is used not only as a chemotherapeutic in cancer therapy, but also low doses for the treatment of autoimmune diseases such as psoriasis. In this context, men and women who want to have children should ...
How do TNF-α antagonists like Humira affect psoriasis?
TNF-α antagonists are biopharmaceuticals that inhibit the inflammatory messenger tumor necrosis factor alpha (TNF-α) in the body. The biotechnologically produced drugs are used in the treatment of autoimmune diseases. In the...
How do I use Humira (Adalimumab) for psoriasis?
The TNF-α antagonist adalimumab belongs to the biologicals. These genetically engineered agents are very similar to our body's own proteins. Through their targeted intervention in the excessive processes of the immune system, they also inhibit ...
Psoriasis: What side effects does Humira have?
The biologic Adalimumab (Humira®) is one of the TNF-α-blockers, a group of "biological drugs" that inhibit the inflammatory messenger TNF-α. Humira® thus intervenes specifically in the excessive processes of the immune system and ...
When should I not take Humira for psoriasis?
Not every psoriatiker can be treated with the Biologikum Humira® (Adalimumab). In particular, the immunosuppressive effect of the drug, which is crucial for the success of treatment of autoimmune diseases, ...
What's behind the effects of Enbrel on psoriasis?
The biologic Enbrel® (etanercept) is used to treat autoimmune diseases and is one of the so-called TNF-α antagonists. The drug inhibits the inflammatory messenger TNF-α. It has a psoriasis a ...
Enbrel in psoriasis: What should I pay attention to before?
Etanercept (Enbrel®) is a biologic and belongs to the group of TNF-α antagonists. It is used successfully in the treatment of autoimmune diseases due to its immunosuppressive, anti-inflammatory action. Psoriasis too ...
How often do I inject Enbrel for psoriasis?
The TNF-α blocker etanercept (Enbrel®) is a genetically engineered protein derived from live cell cultures. The biologic used to treat moderate to severe psoriasis has an immunosuppressive and ...
What causes Remicade (infliximab) in psoriasis?
Infliximab is a biologic and belongs to the group of TNF-α antagonists. The biotechnologically produced protein is an antibody that inhibits the inflammatory messenger tumor necrosis factor α (TNF-α). In the treatment of psoriasis affects ...
How and when is Remicade injected with psoriasis?
Infliximab (Remicade®) is a selective immunosuppressive, anti-inflammatory drug from the group of TNF-α antagonists. It inhibits the inflammatory messenger tumor necrosis factor α. The treatment for psoriasis and other ...
Psoriasis: Is Therapy with Remicade Dangerous?
The drug Infliximab (Remicade®) has an anti-inflammatory effect on psoriasis vulgaris. The biologic is a "chimeric" antibody consisting of human and animal protein. In particular, this circumstance is ...
Psoriasis: Does Remicade restrict my everyday life?
The TNF-α blocker infliximab (Remicade®) is a "biological drug" used to treat autoimmune diseases. It has an immunosuppressive and anti-inflammatory effect on psoriasis. Both the side effect profile ...
When should I not take Remicade for psoriasis?
The decisive factor in psoriasis treatment success of infliximab (Remicade®), as with other TNF-α-blockers also, mainly due to the immunosuppressive effect. Unfortunately, this is also the limiting factor in ...
How does the IL-blocker Stelara (ustekinumab) work in psoriasis?
The biologic Ustekinumab (Stelara®) belongs to the group of interleukin blockers and is used to treat moderate to severe psoriasis vulgaris. By inhibiting the inflammatory messengers Interleukin-12 and -23, the ...
How and when can I take Stelara for psoriasis?
Ustekinumab (Stelara®) inhibits the inflammatory messengers interleukin-12 and interleukin-23 as a human monoclonal antibody. The Biologikum acts thereby immunosuppressant and anti-inflammatory on the psoriasis. The genetically engineered ...
Psoriasis: What side effects does Stelara have?
The interleukin (IL) blocker ustekinumab (Stelara®) used in the treatment of psoriasis has anti-inflammatory and immunosuppressive properties. As with other psoriasis biologics, the immunosuppressant effect in particular is ...
What speaks against Stelara (ustekinumab) in psoriasis?
Many psoriasis now benefit from "biological drugs" such as Stelara® (ustekinumab). The drugs produced with the help of biotechnology and genetically modified organisms have the treatment of autoimmune diseases ...
Psoriasis: What are the benefits of cortisone and vitamin D3 ointments and gels?
Prolonged treatment with cortisone ointments may result in the skin becoming thinner and more porous at the appropriate sites. Because cortisone can damage the collagen fibers in the skin, which are responsible for the stability and ...
How dangerous are cortisone ointments for the skin?
There are two basic opinions about cortisone, and both are wrong. One is that cortisone is highly effective and you do not have to worry about side effects. That's not true, because cortisone preparations are never completely safe. ...
Is it true that the skin gets thinner with prolonged use of cortisone?
Yes. The reason: cortisone can destroy the so-called collagen fibers after prolonged use on the skin. The collagen fibers are responsible for keeping the skin elastic and stable. Will they be under permanent contact with cortisone?
How does Daivobet Gel work against psoriasis?
Daivobet® Gel is a preparation especially for the treatment of psoriasis herds on the scalp. It contains the active ingredients betamethasone and calcipotriol. Betamethasone is a cortisone derivative. Calcipotriol is a vitamin D3 analogue that ...
How does Xamiol Gel work against psoriasis?
Xamiol® Gel is a preparation especially for the treatment of psoriasis herds on the scalp. It contains the active ingredients betamethasone and calcipotriol. Betamethasone is a cortisone derivative. Calcipotriol is a vitamin D3 analogue that ...
What effect does salicylic acid have on psoriasis?
Salicylic acid is a component of many ointments, creams and lotions against psoriasis. The main effect is a detachment of old scales. Salicylic acid thus acts keratolytic, as it is called in technical language. That's not just ...
What side effects can ointments with salicylic acid have?
Salicylic acid plays a major role in the external treatment of psoriasis herds. The ointments, creams or lotions with salicylic acid are often prescribed because of their shed-dissolving properties. On...
How do tar preparations counter psoriasis?
When it comes to tar psoriasis, it's all about coal tar. For more than 100 years, we know about its effect on psoriasis. Externally applied tar preparations slow down the (in psoriasis ...
How does Berniter scalp gel affect psoriasis?
Berniter® Scalp Gel contains the active ingredient coal tar at a concentration of 0.5%. Tar preparations slow down cell growth in the skin and also have anti-inflammatory effects. Since the fat production of skin cells ...
How does Lorinden T ointment affect psoriasis?
Lorinden® T ointment contains the active ingredient coal tar at a concentration of 1.5%. Tar preparations slow down cell growth in the skin and also have anti-inflammatory effects. Since also the fat production of skin cells is limited ...
How Does Iso-Urea MD Baume Psoriasis Treat Psoriasis?
The ointment "Iso-Urea MD Baume Psoriasis" has mainly regenerative properties. The ingredients moisturize the skin and make it smoother. At the same time, the typical plaques of psoriasis become thinner and the scales dissolve ...
What does dead-sea therapy mean for psoriasis?
Behind the idea of ​​"Dead Sea Therapy" is a combination of salt and sun.Specifically, the bathing in strongly salty water and then a subsequent UV irradiation. This can be done in the form of a targeted bath therapy or spa treatment ...
Does the "Dead Sea Medical Bath Salt" help with psoriasis?
That is conceivable, but not proven. Bathing in special sea salt solutions is considered helpful for most experts in psoriasis. Whether the salt but must come from the particularly salty Dead Sea, is questionable ....
Does acupuncture work against psoriasis?
There are a number of studies that show a positive effect of acupuncture on psoriasis complaints. However, none of these studies was substantiated by strict scientific criteria because no ...
Does Homeopathy Affect Psoriasis?
That depends on who you ask. According to traditional medical and strict scientific criteria, the answer is no! No studies that would prove a positive effect of homeopathy. Ask users of ...
Is psoriasis curable?
If we understand "healing" as the demonstrable success of modern medicine: No! If we mean by "healing" the possibility that the disease disappears completely again: Yes! And now once more understandable: At about one ...
How often does a psoriasis disappear on its own?
In about 25% of all people with psoriasis, the disease is just an episode and disappears after a single occurrence by itself again. In other cases, it may eventually become ...
Is psoriasis dangerous?
Normally not. Psoriasis has neither cancer nor allergy and is not contagious. Also on the life of the skin disease has no effect. In some cases, the ...
What does psoriasis have to do with the heart?
A whole lot. What seems nonsensical at first sight is now scientifically substantiated: people with psoriasis are at an increased risk of having a heart attack during their lifetime. Most pronounced is ...