What is psoriasis?
For psoriasis (psoriasis vulgaris) is an acute and/or chronic inflammatory skin disease that tends to run in families. The cause is an interaction of various genetic factors. The disease occurs in flares, which can be influenced by additional trigger factors.
External stimuli (exogenous factors) such as trauma, UV radiation, but also endogenous factors such as infections, stress or various medications can trigger relapses or lead to a worsening of the symptoms. In younger patients, a streptococcal infection is often observed as the initial trigger of a psoriasis flare. The Koebner phenomenon is the localized occurrence of psoriatic skin changes caused by small skin injuries such as tattoos, sunburn, scratch artifacts, etc., which can also occur in the area of scars.
How do you recognize psoriasis?
The classic psoriasis lesions appear in the form of circular, sharply demarcated, slightly raised, reddish foci (plaques) and typically have a silvery, coarse scale. The lifting of these scales often leads to pinpoint bleeding of the skin ( Auspitz phenomenon). With ongoing local therapy and care, the lesions lose their scales and then appear as reddish thickened skin with a smooth surface. Even fresh lesions initially have no scaling.
Psoriasis can affect all areas of the skin and its appendages , and can therefore present in different ways. This circumstance often leads to misdiagnoses or to the fact that the disease remains undetected for a long time.
Clinical manifestations of psoriasis.
How do you treat psoriasis?
The choice of treatment method depends primarily on the severity and localization of the affected regions.
containing cortisone and vitamin D3 in combination with care ointments are the cornerstones of most psoriasis therapies.
The so-called light therapy has also proven effective and proven: treatment with narrow-band UVB light.
Drag the arrows to view the before and after pictures.
Oral intake of psoralen or local application of psoralen in combination with UVA irradiation (PUVA).
Good response and, if well tolerated, can also be used as long-term therapy.
fumaric acid ester:
If the response is good, this is a solid form of therapy with manageable side effects.
Achieve good results with pustular forms and are often used in combination with other therapies.
Can be very effective, but are not suitable as long-term therapy (rebound effect).
Very effective in severe cases, even with joint involvement. However, it can cause serious side effects.
Describes a series of partly completely new drugs consisting of different monoclonal antibodies. These antibodies are directed against specific target structures in the signaling pathway of inflammatory processes (eg: TNF-alpha, IL12, IL23, IL17).
The advantage lies in the administration form as subcutaneous injections, which are administered weekly or monthly, depending on the preparation. Due to the very selective blockade in the signaling pathway, these drugs have fewer side effects than conventional immunosuppressive therapies.
The disadvantage is the high cost of these drugs, which is why they are currently only reserved for severe or therapy-resistant courses of psoriasis.
In recent years, new preparations from this group have been constantly pushing onto the market, which impress with their very good response rates and almost complete absence of symptoms.
Individual consultation: We would be happy to consult you extensively on the individual examinations and treatment options in one of our offices. You are also welcome to schedule an appointment online.