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Dr Marcus de Brun. Rush Family Practice

Medical guide




Psoriasis is a chronic inflammatory disease of the skin. It causes debilitating and unsightly lesions that can be associated with itching. This disease sometimes has significant repercussions on daily life.

What is psoriasis?

Psoriasis is a chronic inflammatory disease of the skin that can develop at any age.
Its origin is unknown, but it is partly genetic. It is characterised by the appearance of red plaques covered in a thick whitish skin that seems to peel.
It mainly affects zones located around the elbows and knees (rub zones).
The lesions can sometimes extend to the scalp, palms of the hands and soles of the feet, around joints. Genital organs and wrinkles can be affected.
Psoriasis is not a contagious disease.

Why does my skin react in this way?

Your skin has an excessive inflammatory reaction.
Epidermal cells normally renew themselves every 28 days.
If you have psoriasis, this renewal period may be reduced to every five days, or even three.
These cells accumulate in thick white crusts.
After scaling, the plaques leave zones of red skin.

Take care of your skin, avoid environmental factors that are known to aggravate psoriasis and if the psoriasis affects your life, talk with your doctor.

Take care of your skin, avoid environmental factors that are known to aggravate psoriasis and if the psoriasis affects your life, talk with your doctor.

Take care of your skin, avoid environmental factors that are known to aggravate psoriasis and if the psoriasis affects your life, talk with your doctor.

How does psoriasis develop?

The development of this disease is unpredictable. Psoriasis can regress and disappear over several years, or it can reappear following a life change, shock or period of fatigue.

What aggravates the development of psoriasis?

There is a family genetic predisposition in 30% of cases. Flare-ups and the development of psoriasis are aggravated by environmental factors.

You may have one or several triggering factors:

  • Taking certain drugs
  • A skin trauma
  • Sunstroke
  • A period of stress, overwork, fatigue, trauma
  • overweight/ obesity
  • An insect bite or wound

Alcohol consumption and smoking are aggravating factors.
Sun exposure often improves psoriasis (70% of cases) but in some cases (10%) can aggravate it, and it has no effect in 20% of cases.

Are additional tests required?

Diagnosis is clinical. In the event of doubt, your doctor can decide to perform a skin biopsy.

How should I take care of my skin?

  • Use non-irritant toiletries.
  • Apply hydrating cream over your whole body after washing.
  • Avoid scratching affected zones.
  • Coat the plaques in an oily cream to soften them.

Are there treatments that can heal me?

At this point, psoriasis cannot be cured definitively, but several solutions exist to act against flare-ups (flare-up treatment) and to contain the disease (maintenance treatment). You need to consult your doctor.
The treatment suggested depends on the severity of the psoriasis, which is assessed according to the area of skin affected and the impact on quality of life.
It is often necessary to continue long-term maintenance treatment, which is a trait of a chronic disease.
You must visit your doctor regularly, every three to six months, so that they can ensure the effectiveness of the treatment in the long term.


Localised psoriasis
Local treatments are suitable for this type of psoriasis.

  • Dermal corticosteroids significantly improve psoriasis, although plaques often reappear when treatment is stopped.
  • Vitamin D analogues act on the multiplication of skin cells, although the maximum applicable quantity is limited.

Sometimes, when plaques are too thick, treatments must be applied after previous scaling of the affected zone with a mixture of greasy substances and salicylic acid.
Hydration of the skin is very helpful. The use of hydrating products in the bath or hydrating creams targets dry skin and softens it.


Prolonged psoriasis

  • Phototherapy is effective for lesions that cover more than 30% of the surface of the epidermis. These are UVA or UVB sessions performed in a dermatology practice. The number of sessions varies depending on the extent of the psoriasis and its regression.
  • PUVA treatment consists of exposure to UVA in a clinic. Before the session, you should have taken a drug which increases your sensitivity to ultraviolet rays.
  • UVB phototherapy does not require any specific drug to be taken.


Severe psoriasis

  • In the most severe cases, a drug treatment may be prescribed. This is systemic treatment. NB: The treatment prescribed is specific. Do not self-medicate.

Publication date:   12/20/11

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Dr Marcus de Brun MRNZCGP

General Practice

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