They were all cream . it appears on my elbows, feet 'and my back . once they also told me to follow a precised food diet but ntg helped

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34 years

They were all cream . it appears on my elbows, feet 'and my back . once they also told me to follow a precised food diet but ntg helped

Aug 18, 2014

Psoriasis

2nd opinion

Dr. Zakia Dimassi Pediatrics

Plaque psoriasis is the most common form of psoriasis. The lesions are small to large in size, well demarcated (the lines that separate them from surrounding healthy skin are prominent), red, scaly (silvery scale) and thickened areas of skin. Most likely, the elbows, knees, and lower back are affected, but it may also arise on any part of the body. It is often accompanied by scalp and nail psoriasis. This is a relatively persistent or chronic pattern psoriasis which, although amenable to improvement with treatment, is difficult to clear completely when relying solely on topical treatments alone.
Plaque psoriasis is divided into 'large plaque' or 'small plaque' psoriasis.
Large plaque psoriasis is thick, well-demarcated, red plaques with silvery scale. This type starts early in life (<40 years) and is often associated with a family history of psoriasis. It can be quite resistant to treatment.
Small plaque psoriasis manifests as numerous lesions a few mm to a few cm in diameter. The plaques are thinner, pinkish, and have a fine scale. It often arises in those over than 40 years of age. This type of psoriasis often responds well to phototherapy.
Patients with chronic plaque psoriasis should be assessed for the following:
 Age of onset of psoriasis
 Current age and gender
 Sites affected by psoriasis
 Symptoms (itch, soreness)
 Categorization of psoriasis (localized or generalized, large plaque or small plaque)
 Extent and severity of psoriasis
 Functional impairment or disability due to the skin disease
 Health problems including blood pressure, weight and body mass index (BMI)
 Smoking status and alcohol intake
 Current medications for psoriasis and other conditions
 Previous treatments and their effect
 Skin phototype (depends on the amount of melanin pigment in the skin. This is determined by constitutional color and the result of exposure to ultraviolet radiation (tanning). Pale or white skin burns easily and tans slowly and poorly: it needs more protection against sun exposure. Darker skin burns less and tans more easily. It is also more prone to develop postinflammatory pigmentation after injury (brown marks).)
 Suitability of systemic therapy
Localized or mild chronic plaque psoriasis is treated initially with one or more of the following effective topical agents:
 Topical steroids
 Coal tar
 Dithranol
 Calcipotriol
If plaque psoriasis is too extensive or severe, phototherapy or systemic agents can be added and are usually very effective. These include:
 Methotrexate
 Acitretin
 Ciclosporin
 Mycophenolate
 Biologics (target the immune system) including adalimumab, etanercept, infliximab and ustekinumab

You are advised to discuss your treatment options with a dermatologist, in order to devise the best treatment plan for your particular case.

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