Psoriasis — guide.

What psoriasis is

Psoriasis is a chronic, immune-mediated inflammatory disease in which the renewal of skin cells is accelerated from about a month to just a few days. The cells accumulate at the surface and form red, thickened plaques covered with silvery scales. It is not a contagious disease and is not transmitted through contact. It has an important genetic component, and flare-ups are triggered by infections, stress, skin trauma, smoking, alcohol and certain medications. Psoriasis is not just a skin problem: it is associated with psoriatic arthritis, metabolic syndrome and increased cardiovascular risk, which is why it requires a comprehensive approach.

Forms

Plaque psoriasis (vulgaris) — 80% of cases, on the elbows, knees, scalp, sacrum. Guttate — small papules, triggered after infection. Inverse — in skin folds. Pustular and erythrodermic — severe forms. There is also nail involvement and psoriatic arthritis.

Treatment

Topical (mild-to-moderate forms):

• Rich emollients — the foundation.
• Topical corticosteroids (classes II-III).
• Vitamin D analogues (calcipotriol — Daivonex, calcitriol).
• Corticosteroid + calcipotriol combinations (Daivobet).
• Tazarotene, anthralin.
• Tar and salicylate shampoos for the scalp.

Systemic (moderate-to-severe forms, Rx):

• Methotrexate.
• Ciclosporin.
• Retinoids (acitretin).
• Apremilast.
• Biologics: anti-TNF, anti-IL17 (secukinumab, ixekizumab), anti-IL23 (guselkumab, risankizumab).

Phototherapy NB-UVB — effective, good safety profile.

Comorbidities

Psoriatic arthritis (30%), metabolic syndrome, obesity, diabetes, cardiovascular disease, depression, inflammatory bowel disease. Active screening.

OTC and lifestyle

• Rich emollients (urea 10-20%).
• Vitamin D3 — deficiency is common.
• Omega-3 — anti-inflammatory.
• Probiotics.
• Weight loss — improves symptoms.
• Smoking cessation, limiting alcohol.
• Stress management.

Medical disclaimer: the information in this guide is for informational purposes and does not replace the advice of a doctor or pharmacist. For diagnosis and treatment, consult a healthcare professional.