Psoriasis is characterized by sharply demarcated, red-mother-of-pearl colored scabs (plaques) on the outer surfaces of the body, such as knees, elbows and hips, with silver gray-white or psoriasis white dandruff and crusting. Accompanying arthritis (joint involvement) can be seen in approximately 5-10% of psoriasis patients. Typically, pain, swelling, limitation of movement and pain in the lumbar spine joints are expected in the hand toes. Psoriasis, which is not a microbial or allergic disease, is an autoimmune disease that occurs with the effect of environmental factors in hereditary susceptible people and triggered by the immune system. Currently, there is no single curative treatment for the disease and unfortunately the disease is chronic and recurrent. Psoriasis may cause job loss and social isolation in patients due to the external appearance of the lesions. Nail involvement of psoriasis that often accompanies in cases with joint involvement; It manifests itself with findings such as pin-like pitting in the nail (thimble nail), detachment from the nail bed, roughness under the nail and yellowing and opacification in the nail plate. In some cases, psoriasis can also be seen in moist fold areas such as the groin, armpits and under the breasts, buttocks.
Multifactorial factors including genetic factors (familial cases), seasonal changes (exacerbation in winter), medicine use and stress are blamed in the etiopathogenesis. In familial psoriasis cases, it is seen that psoriasis starts at an earlier age, more than one person in the same family has the disease, and the severity of the disease is relatively more severe. Psoriasis, which can typically be seen following throat infection in pediatric patients, can occur after the use of many drugs, especially lithium, terbinafine (fungicides), beta blockers (blood pressure medications) and aspirin (painkillers) in adults. Especially in patients, severe psychological stress can be a trigger. Although the sun plays an active role in the treatment of the disease at moderate levels, intense sun exposure and sunburn may cause exacerbation in some cases with the effect of trauma on the skin. There is an increase in the number of lesions in cases of skin trauma, friction, itching, plucking and similar cases, and any trauma to the skin should be avoided. Habits such as excessive alcohol intake and smoking can also worsen psoriasis. Apart from this, there is no significant relationship between diet and psoriasis.
The diagnosis of psoriasis is often made by dermatological examination. However, a skin biopsy can be done to confirm the diagnosis. Topical treatments (moisturizers, topical steroids, topical retinoids, Vitamin D analogues, topical calcineurin inhibitors), systemic treatments (acitretin, methotrexate, cyclosporine, biologics; etanercept, infliximab, adalimumab, ustekinumab, secukinumab, ixekizumab therapy) can be applied in the treatment of psoriasis.