Psoriasis, a skin disease that becomes painful as the temperature drops, distinguish it this way

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‘Psoriasis (乾癬, psoriasis)’ is a chronic disease caused by an immunological abnormality in our body. The main symptom is the appearance of red spots (erythema) covered with silvery-white skin keratin (scald), which worsens and improves repeatedly. Because psoriasis repeats exacerbation and improvement, it is easy to develop the disease by neglecting it, thinking that when the symptoms are relieved, it is usually well. On the occasion of World Psoriasis Day designated by the World Federation of Psoriasis Association on October 29, we will learn more about the symptoms and treatment of psoriasis with Professor Soonhyo Kwon of the Department of Dermatology at Kyunghee University Hospital in Gangdong.

Psoriasis is a chronic immunological disease associated with dry skin and other chronic diseases.

Psoriasis is often dismissed as a simple skin disease caused by dry skin, but psoriasis is a chronic polygenic immunological disease. Environmental stimuli such as trauma or infection have been suggested to cause psoriasis in patients with genetic factors. Inflammatory substances stimulate the keratinocytes of the skin by abnormal activity of skin immune cells, causing excessive cell proliferation and skin inflammation. Mainly on the elbows, knees, buttocks, and head, red spots with clear boundaries are covered with silvery-white scales, and when rubbing with hands or taking off clothes, it itchiness and falls like dandruff, and symptoms worsen when cold.

Beware of complications such as metabolic syndrome and psoriatic arthritis

In the early stages of psoriasis, the skin is covered with white dead skin cells on top of the rash, and as the rash progresses, the skin on which the rash occurred becomes thick and the lesions become larger as the rashes merge. Psoriasis symptoms can lead to not only quality of life but also comorbidities. As psoriasis is severe, metabolic syndrome such as cardiovascular disease, high blood pressure, obesity, and diabetes is known to increase and is recognized as a systemic disease. In addition, psoriasis patients may suffer from depression or accompany conditions such as psoriatic arthritis. Psoriasis patients are also known to increase alcohol consumption and smoking rates.

10-30% of psoriasis patients have psoriatic arthritis

Psoriatic arthritis is an inflammatory arthritis affecting the ligaments, spine, and peripheral joints, and is observed in 10-30% of psoriasis patients. It causes swelling, pain, and stiffness, and once it develops, joint damage progresses, so it must be detected and treated early. The site of occurrence is diverse, not only in the spine, but also in the fingers and toes and peripheral joints. In severe cases, joint deformation may occur and cause movement disorders. The main cause is inflammation caused by the occurrence of psoriasis, and for treatment, it is necessary to reduce and control inflammation. Psoriasis itself lowers the quality of life, but the accompanying disease, psoriatic arthritis, is also a disease that requires deep attention. If the symptoms of psoriatic arthritis are mild, it can be treated with nonsteroidal anti-inflammatory drugs. However, if the symptoms are severe, it can damage the joints, so immunosuppressants and biological agents can be used.

It is difficult to completely prevent recurrence, and continuous management is required.

Because psoriasis is an immunological disease, recurrence cannot be completely prevented. However, the purpose of treatment is to eliminate the psoriasis lesion itself and maintain it for a long time through continuous management. Once the psoriatic lesions disappear, they can remain in good condition for several years. According to the diagnosis of a dermatologist, adrenocorticosteroids, vitamin D derivatives, and moisturizers are applied directly to the wound area for treatment. In addition, phototherapy is concurrently performed. Severe psoriasis patients who do not respond to immunosuppressants and the like can effectively manage psoriasis using biological agents.

Other skin diseases that require attention due to similar symptoms to psoriasis

# dry skin

Dry skin is a condition in which the moisture of the skin is lowered to 10% or less, and it is easy to confuse with psoriasis because it occurs a lot in autumn and winter when humidity is low. Although both dry skin and psoriasis have the same skin exfoliation and itching, the difference is that psoriasis develops red and thick dead skin cells. On the other hand, dry skin syndrome is characterized by a dry, dry skin without rash symptoms, and white keratin occurs mainly on the front of the calf and back.

# athlete’s foot

When psoriasis occurs on the nails or toenails, the symptoms are similar to those of athlete’s foot, and many patients mistake it for psoriasis and take or apply athlete’s foot medicine. In addition, psoriasis on the hands and soles of the feet also has the symptoms of dead skin cells and blisters very similar to athlete’s foot.

# eczema

The most common cause of confusion between psoriasis and eczema is itching. However, the difference is that the keratin of the skin is thicker in psoriasis, and eczema may be accompanied by oozing. In particular, when seborrheic dermatitis, a type of eczema, occurs on the scalp, it is more difficult to distinguish because the accumulated dead skin cells fall off like dandruff in the same way as scalp psoriasis. Both psoriasis and eczema are common diseases, but each must be managed with different treatments, so biopsy is sometimes performed to select the right treatment.

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