Psoriasis on nails and hands


Psoriasis on hands, feet and nails

Psoriasis on the palms and soles of the feet can lead to:

Some lifestyle changes can alleviate the discomfort of hand, foot, and nail psoriasis.

Treatment of hands and feet
The traditional local treatment of palms and soles of the feet includes treatment with:

A combination of these three agents can lead to a better result than the single application.
A combination that is very effective consists of:

  • Clobegal ointment
  • Dermo-fat base

Moisturizers, mild soaps and soap substitutes are other effective products.

Calcipotriol may be effective in treating psoriasis on the hands and feet.
Wear cotton gloves so that the medication does not get on sensitive skin areas, such as facial and skin folds.
Some doctors recommend alternating use of calcipotriol and cortisone.

Systematic medications If topical medications
do not help, the doctor may prescribe:

  • Methotrexate
  • Ciclosporin
  • Sorias (acitretin)

Methotrexate can improve many cases of psoriasis on the palms and soles of the feet within four to six weeks.

Light therapy The risks of side effects of light therapy
are reduced by the combination of:

  • low-dose oral retinoids and
  • UVB or UVA

The combination of low oral retinoid doses with phototherapy PUVA or UVB is one of the most effective therapies available for psoriasis on the palms and soles of the feet.

Pustular psoriasis on the palms and soles of
the feet Local treatments for pustular psoriasis, such as cortisone and products containing tar and coal, are usually the first therapy. The doctor may also:

  • phototherapy,
  • oral retinoids,
  • Prescribing methotrexate

Acitretin (Neotigasone, Zorias) may be a long-term solution for pustular psoriasis.
In difficult cases of palmo-plantar psoriasis, doctors may prescribe a biologic drug, such as:

  • Etanercept
  • Golimumab
  • Ustekinumab

Psoriasis on nails

Nail changes occur in up to 50% of people with psoriasis and in at least 80% of patients with psoriatic arthritis.
The most common nail problems are:

  • Spotted nails or floating — superficial or deep dimples formation
  • Deformations – changes in normal nail shape
  • Thickening or brittleness of the nails
  • Inycholysis – detachment of the nail from the nail bed
  • Discoloration – unusual nail coloration, for example yellow-brown

Treatment of nail psoriasis
Since psoriasis affects the nails during their formation, nail psoriasis is difficult to treat.
It is difficult to penetrate the nail bed with local medicines.
The cortisone infiltrations into the nail bed are very painful and have been carried out with varying results.
The following treatment options exist for nail psoriasis:

1. Local therapy based on:

  • Urea
  • Aspirin
  • Retinoids

2. Recovery, including:

  • Peeling of the nail
  • Gel or nail polish based on vitamin A derivatives
  • Artificial nails
  • surgical removal

3. Systemic therapy

4. Biological therapy, for example:

  • Infliximab
  • Adalimumab

Psoriasi and nail fungus
Onychomycosis is a fungal infection that causes nail thickening and can be associated with nail psoriasis.
It can be treated with systemic fungal agents.
About one-third of people who have nail psoriasis also suffer from a fungal nail infection.

Psoriasis in the genital area

The most common type of psoriasis of the genital region is psoriasis inversa.
This form of psoriasis manifests itself with lesions of the following severity:

  • Red
  • Dry
  • Smooth

This type of psoriasis can pass without dandruff.
There are different genital areas that can be affected by psoriasis.

Pubic region
The pubic region is the area above the male and female genitals.
This area can be treated in the same way as scalp psoriasis.
The skin of the pubic region is more sensitive than the scalp.

Upper thigh Psoriasis on the upper thigh
and in the groin area usually manifests itself in the form of many small spots of the following severity:

  • Round
  • Red
  • Flaky

Psoriasis between the thighs becomes irritated again and again, especially when the thighs rub against each other while walking and running.

Body folds between thighs and groin As a rule, psoriasis appears as a non-scaly and whitish-reddened rash in the body folds between the thigh and groin
The skin may have rhagades (cracks).
Overweight people who sweat a lot may have a skin change called intertrigo. This is caused by the mutual friction of the thighs.

Genital area: psoriasis of the vulva and psoriasis of the penis
Psoriasis of the vulva often appears as a patch formation of the following severity:

  • Red
  • Smooth
  • With damp dandruff
  • With clearly defined margins

Scratching in this area can provoke:

Genital psoriasis usually affects the skin of the vulva and does not affect the mucous membrane.
In general, psoriasis does not affect the urethra.

Psoriasis of the penis can manifest itself with many small red plaques on:

  • Acorn
  • Penile shaft
  • Scrotum (scrotum)

The rash caused by psoriasis can be scaly (on the penile shaft), but also smooth and shiny (on the glans).

Genital psoriasis affects circumcised and uncircumcised men.

and perianal area
psoriasis in the area of the anus:

  • is red and non-scaly,
  • causes itching.

Psoriasis in this area can be confused with:

The presence of these conditions can make it difficult to treat psoriasis.
Rectal examinations and skin cultures can confirm the condition.
Symptoms of psoriasis may include:

  • Fluid-secreting skin
  • Intense redness
  • Skin dryness
  • Itch

Gluteal folds
Psoriasis in the gluteal fold can be red as well as:

  • Non-scaly
  • With significant scaling

The skin is not as sensitive in this area as in the groin.

Treatment of genital psoriasis
Genital psoriasis usually responds well to treatment.
Due to the skin sensitivity in the genital area, therapy must be carried out with appropriate caution. Local products and ultraviolet (UV) light are widely used. Usually, doctors do not prescribe systemic drugs for genital psoriasis.
However, this can happen if the psoriasis is pronounced and resistant to topical drugs, or if it occurs simultaneously on other parts of the body.

Psoriasis in body folds

Inversa psoriasis can occur in the following folds of the body:

  • Shoulders
  • Under the breast

Friction and sweat can irritate psoriasis.
Steroids are often used to treat inverse psoriasis in body folds.
These areas of the body are susceptible to yeast and fungal infections. This is why corticosteroids are sometimes used in combination with other medicines.
Other topical therapies may be effective in treating psoriasis in skin folds, for example:

  • Calcipotriol (Daivonex)
  • Tar and coal products
  • Cignolin

However, medicines containing tar and Cignolin can also irritate the skin. They should therefore be used with caution and under the supervision of a doctor.
People with severe psoriasis inversa may also occasionally need systemic medications to keep the disease under control.

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