Posted by Katarina Fajfar
on March 18, 2025
Psoriasis is a skin disease that is classified as an erythematosquamous dermatosis. This type of dermatosis is characterized by redness of the skin (erythema) and scaling. Two other skin diseases are also included in this type of dermatosis, namely Lichen planus and Pityriasis rosea.
Psoriasis – who does it affect?
Psoriasis is also called psoriasis. It is named after the Greek word psora, which means itch. It is one of the most common dermatoses, affecting between 2-4% of people in the Western world. The sexes are approximately equally represented in this skin disease, with whites being affected more often than blacks. The disease most often occurs between the ages of 20 and 40.
Psoriasis is a chronic and in most cases hereditary disease.
The tendency to develop psoriasis is hereditary. However, environmental triggers such as infections (especially streptococcal infection), certain medications, alcohol, psychological stress, injury and skin irritation cause the disease to manifest.
Psoriasis is a multifactorial disease. The probability of a child of a parent with psoriasis developing the disease is 10–20 percent, and increases significantly if both parents have psoriasis, when it is 60–70 percent. Psoriasis is also an immune-mediated disease, and the human immune response plays an important role in the development and maintenance of the disease, which functions incorrectly in psoriasis. Once the inflammatory response mediated by T lymphocytes is initiated, it has the ability to sustain itself. This explains the chronic nature of the disease.
What is characteristic of psoriasis?
Psoriasis usually progresses in a similar way to atopic dermatitis, in the form of exacerbations and improvements. It usually improves in the summer and worsens in the winter. Psoriasis is characterized by irregular keratinization of the skin. The cells of the lower layer of the epidermis divide too quickly and consequently travel faster towards the surface of the skin, where they are sloughed off. A healthy skin cell needs 357 hours to divide, while in psoriasis it takes only 37 hours. In healthy skin, the transition of an epidermal cell from the lower to the upper layer of the epidermis takes between 28 and 35 days, while in psoriasis this time is shortened to 4–7 days. At the same time, skin cells mature incorrectly and the epidermis is unable to perform its barrier function – that is, to protect the organism from harmful external influences.
There are several types of psoriasis.
Psoriasis has many clinical forms that differ greatly from each other.
Plaque psoriasis
Plaque psoriasis is called psoriasis vulgaris. It is the most common clinical form of the disease. It accounts for more than 85% of psoriasis cases. This form of the disease is characterized by sharply demarcated red bumps or papules that merge into larger plaques or plaques. The plaques are covered with silvery-white scales. Plaque psoriasis symmetrically affects characteristic areas of the skin, most often the elbows and knees. Plaques often appear in the lower back area, but they can occur anywhere. Many patients experience itching or a burning sensation in the affected skin area.
Guttate psoriasis
Guttate psoriasis, or guttate psoriasis, is the second most common form of this skin disease. It often occurs as the first outbreak of psoriasis in young people due to a streptococcal infection. The skin develops a large number of red bumps or papules all over the body that peel, but the peeling is less pronounced than in plaque psoriasis. Often the skin changes disappear over time, but the disease can later develop into chronic plaque psoriasis.
Inverse psoriasis
Inverse psoriasis, or psoriasis inversa, is a rarer form of psoriasis that affects large skin folds. It mostly occurs under the breasts, armpits, belly button, groin, and the fold between the buttocks and navel. In this form of psoriasis, red plaques or scales appear on the skin, with little or no scaling.
Pustular psoriasis
Pustular psoriasis is also called pustular psoriasis or psoriasis pustulosa. It is a special form of psoriasis where sterile pus-filled blisters or pustules form. This type of psoriasis most often affects the palms and soles of the feet. Very rarely, the skin of the entire body is affected.
Erythrodermic psoriasis
Erythrodermic psoriasis or psoriasis erythrodermica is a very serious form of psoriasis that can develop from plaque psoriasis. The skin of the entire body is red, thickened and coarsely scaly. The patient is affected, has a slightly elevated temperature, and loses heat, water and electrolytes through the inflamed skin. This is a dermatological emergency!
Psoriasis can also affect the scalp and nails
Psoriasis can often affect the scalp. This type of psoriasis is called scalp psoriasis or psoriasis capillitii. Scalp psoriasis is characterized by the fact that it does not cause hair loss.
Nail psoriasis or psorasis unguium is often associated with other forms of the disease. It affects 15-50% of psoriasis patients. Dotted pits appear on the nails, and the nail at the end separates from the base. The nail is often thickened. It may happen that nail psoriasis is the only presentation of the disease. In this case, there are no characteristic scaly plaques on the skin.
Psoriasis treatment
Treatment of psoriasis largely depends on the severity of the disease. Usually, the first step is to assess the skin involvement to determine the state of the psoriasis and then determine the treatment. There are several indices for assessing skin involvement. One of the simplest is BSA (Body Surface Area). One patient's palm represents 1% of the skin surface. This allows us to very quickly assess the proportion of skin affected. If up to 10% of the skin is affected, it is mild psoriasis, if between 10 and 20% of the skin is affected, it is moderate psoriasis, and if more than 20% of the skin is affected, it is severe psoriasis.
There are many medications and treatments for psoriasis. Despite great progress in the field of psoriasis, treatment can currently clear the skin, but it does not completely cure psoriasis. Treatment for the disease is usually lifelong. Also, there is currently no medication that is effective for all patients, so treatment must be tailored to each individual.
Mild psoriasis is usually treated topically, i.e. with medications in the form of creams, ointments, gels and lotions. For moderate to severe psoriasis, phototherapy and systemic treatment in the form of tablets, capsules, injections or infusions are suitable.
Skin care for psoriasis
Regular, daily skin care with indifferent (care) preparations is of utmost importance. These moisturize and soften the skin. They prevent dryness and thus reduce peeling and the appearance of cracks, and also relieve itching and irritation. Because they help maintain the skin's barrier function, they also protect against skin infections and the entry of irritating substances and allergens into the skin. Care preparations do not contain medicinal ingredients and are available in the form of creams, ointments, lotions, as well as soap and oil bath substitutes. Occlusive preparations are oily and prevent water evaporation due to the oily layer on the skin's surface. They are suitable for dry, thickened or cracked skin. Moisturizers or humectants bind water in the upper layers of the epidermis and retain it there. Some care preparations contain both occlusive substances and moisturizers. Oil baths and soap substitutes or syndet are also indispensable because they do not dry out the skin when washing.
To relieve itching, we recommend AtopicBalm. Apply it to the itchy areas of skin.
Occlusive preparations are oily and prevent water evaporation due to the oily layer on the skin's surface. They are suitable for dry, thickened or cracked skin. They help maintain the skin's barrier function, and also protect against skin infections and the entry of irritants and allergens into the skin. We recommend SOSbalm, which also contains nourishing essential oils, which are also attributed with antifungal and antibacterial effects.
Regular, daily skin care with indifferent (nurturing) preparations is of utmost importance. These moisturize and soften the skin. Moisturizers or humectants bind water in the upper layers of the epidermis and retain it there. They prevent dryness and thus reduce peeling and the appearance of cracks, and also relieve itching and irritation. We recommend RenewCream, which, with the addition of selected essential oils and CBD resin, also helps to regenerate the skin faster.
Oil baths and soap substitutes or syndet are also indispensable because they do not dry out the skin when washing.
However, if you have problems with psoriasis on your scalp, we recommend our shampoo for sensitive and itchy scalp.
This blog post was created in collaboration with Cosmedoc.si.