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Raw, red, scaly raised patches of irritated skin could be the onset of a disease known as psoriasis. The skin can feel painful, itchy, burning, stinging, swollen or hot and the irritations can come and go over time. Commonly located in the folds of the skin or in elbows, knees, scalp, hands, feet, nails, armpits, mouth, breasts or genitals, psoriasis can range from a mild irritation to a major disability.

“Psoriasis can change over time. Patients who have a mild case of psoriasis may return some time later and have a severe case,” said Advance ER physician Dr. Alan Dennington. “Since it is a chronic condition, it has to be treated or it will continue to get worse. But there are ways to control it.”

What is psoriasis?

Psoriasis is a chronic skin condition that is considered an autoimmune disorder. It speeds up the growth cycle of skin cells, causing them to rapidly multiply in certain areas.

While doctors don’t know exactly what causes it, it is considered to be the result of overactive white blood cells, such as T cells and neutrophils, that rush to the surface to produce new skin growth at an accelerated pace.

Symptoms:

  • Raised bumps or skin patches
  • Red, raw skin
  • White or silver flakes of skin on the affected areas
  • Red rash
  • Dry, cracked skin that can bleed
  • Small scaly patch of skin
  • Discolored, yellow, thick fingernails
  • Painful joints

Types of psoriasis

There are several different types of psoriasis, depending on the kind of rash and the location where it presents. Your physician can diagnose psoriasis as well as the specific kind. Here are the kinds of psoriasis as well as a brief description:

  • Plaque psoriasis – the most common form. Red, raised bumps with flaking white or silver scales. Itchy and painful and can crack and bleed. Commonly found on elbows, knees, scalp and lower back.
  • Psoriatic arthritis – affects a small percentage of people. The joints swell and are painful. It can be mild and undetected for quite some time. It requires medical treatment to prevent disability.
  • Guttate psoriasis – often found in children or young adults, especially after a throat infection. Small, red dots across the torso, arms, legs or scalp.
  • Inverse psoriasis – found in skin folds, behind knees, under breasts and around groin. Shows as smooth patches of bright red skin, shiny and painful. Can accompany another type of psoriasis affecting a different area of the body at the same time.
  • Nail psoriasis – affect the nails and causes discoloration and pitting. Nails can become loose and crumble.
  • Pustular psoriasis – not a common form. Shows as a red, irritated area with pus-filled blisters that crop up very rapidly. Blisters are not contagious. Most often found in hands and feet.
  • Erythrodermic psoriasis – least common form. Redness covers whole body along with a red rash that is fiery and painful. Skin can come off in sheets. Immediate medical attention is required.

Who is at risk?

It is most common in 15-35 year-olds, but can manifest at any time to any individual. A slightly higher percent of Caucasians, compared to African-Americans, develop psoriasis.

“Genetics and family history can play a major role in triggering psoriasis,” said Dr. Dennington. “Patients can also get it when their immune system is stressed, such as after strep throat infections, bronchitis or tonsillitis.”

Other triggers include: cuts or scrapes, stress, smoking, obesity, sunburns, alcohol and vitamin D deficiency.

Is psoriasis contagious?

It is not contagious and patients with psoriasis lesions are not infectious.

Diagnosis:

When you go to Advance ER, your physician will conduct a physical exam of the irritated skin as well as observe your hair, skin and nails. A complete medical history will be collected. Tests aren’t commonly used for skin conditions, but your physician may order a skin biopsy to confirm diagnosis.

Psoriasis is best diagnosed by a specialist. A dermatologist is available* through Advance ER’s groundbreaking SPECIALIST NOWSM program. Within minutes, you can have a specialist consultation at no additional office charge from the dermatologist.

Treatment:

Depending on the severity of your psoriasis, your physician will prescribe specific creams, lotions, shampoo and other ointments to help you control the symptoms. corticosteroids help reduce inflammation, itching and pain. Topical Vitamin A and Vitamin D synthetics may help decrease inflammation.

Oral medications may also be prescribed. Methotrexate, cyclosporine, retinoids and immune system drugs are all possible medications.

In addition, a specialized therapy using ultraviolet light has been used to help alleviate symptoms. There are several different kinds of photo-therapy that can be used, and your doctor will discuss the options with you. Coal tar has been another treatment successfully used to reduce inflammation and to make skin receptive to photo-therapy.

Certain lifestyle changes may be recommended to help control your symptoms. Alcohol consumption can decrease the effectiveness of some of the medication. Getting a mild amount of sunlight can help your skin, but too much may trigger another outbreak. Taking daily baths with special additives like Epsom salts, Dead Sea salts or colloidal oatmeal may help.

Complications of psoriasis:

If you have been diagnosed with psoriasis, you may have an increased chance of developing additional diseases. Commonly, Type 2 diabetes, heart disease and high blood pressure are associated with psoriasis.

Here are additional complications that can result from psoriasis:

  • Psoriatic arthritis – this is a type of arthritis that causes painful, swollen joints. It is often undiagnosed in its mild forms. If left untreated, permanent joint damage may occur.
  • Depression and emotional problems
  • Obesity
  • Cardiovascular disease
  • Eye disorders such as conjunctivitis (“pink eye”), blepharitis (eyelid infection), or uveitis (eye inflammation)
  • Kidney disease
  • Parkinson’s disease
  • Crohn’s disease
  • Celiac disease
  • Sclerosis
  • High cholesterol

Conditions that can be confused with psoriasis:

There are a few skin conditions that may be confused with psoriasis such as eczema, shingles or skin rashes. Fungal infections and seborrheic dermatitis can also look like psoriasis. In babies, a severe case of diaper rash or hives can be a look-alike. Your dermatologist will examine you to pinpoint the cause of your skin irritation.

When a rash appears, it is important to have it identified by a qualified physician right away. Rashes can be an indicator of a much more serious condition, such as meningococcemia, a deadly condition when bacteria enters the bloodstream and causes organ failure.

When should I go to the doctor?

Any time you have an unknown rash, you should see a physician right away. If you are experiencing skin pain, discomfort, itching or rash, you should see a physician. If your joints are swollen and painful and are not functioning well, you need to see a physician immediately. If you develop a redness and rash that covers your body and is painful, you need to go to the nearest ER since this could be a serious condition.

“There’s no cure for psoriasis, but if you get immediate treatment as soon as it flares up, you should be able to control it,” said Dr. Dennington. “You should always come in when you are in pain or suffering from a condition like this. We can help.”

Where should I go to get medical help?

For fast, No Wait medical care, Advance ER is open 24 hours every day of the year. Within minutes of arrival, you will be shown a private room where you will be seen by a board-certified physician with years of experience. If needed, a dermatologist may be called* using our SPECIALIST NOWSM program. The unparalleled concierge service that you receive at Advance ER ensures top quality medical care, right when you need it.

* Access to specialists through Advance ER’s SPECIALIST NOWSM program is contingent on the specialist’s availability.

Advance ER is available in two locations for your convenience:
Advance ER – Galleria Area

12338 Inwood Road Dallas, TX 75244

Phone: (214) 238-6270

 

Advance ER – Park Cities

5201 W Lovers Lane Dallas, TX 75209

Phone: (214) 238-6440

 

Meet Dr. James Alan Dennington:

James Alan Dennington, M.D., is board-certified in emergency medicine. He received his medical degree from the University of Texas Southwest Medical Center, Dallas, TX. He specializes in emergency medicine including wound care and closure. Dr. Dennington has been providing quality medical care for a decade for patients of all ages.