Which doctor to choose?
If you have psoriasis and feel that your treatment isn't working, your should definitely consult your dermatologist who will decide if you need to change your current treatment; if yes, you will be prescribed the best available form of therapy. Each patient has the right to ask their doctor about all available medications, the time needed to see if the treatment works, and when to switch to another therapy. Adjustments in treatment are needed if psoriasis becomes increasingly severe. To read more about the current methods in the management of psoriasis, please go to the section: Psoriasis – how to manage it?
Psoriasis is a skin condition that can be very difficult to diagnose. Skin lesions may occur on virtually any part of the body. Psoriasis is most commonly seen on the scalp, ears, elbows, knees, in the lumbar or sacral region of the spine, and on the nails. Despite common belief, psoriasis is not contagious.
The skin on the scalp is very delicate and requires gentle care. Psoriasis on the scalp can be mistaken for dandruff or seborrhoeic dermatitis. The difference is that skin flakes in dandruff are larger, while the scales of psoriasis are thicker and skin flaking is accompanied by strong itching. The diagnosis is based on the clinical presentation. Before proper treatment of scalp psoriasis is initiated, the scales should be reduced to promote absorption of medicines. Hair loss is not a symptom of scalp psoriasis. Psoriasis is a skin condition limited to the epidermal layer of the skin and does not affect fair follicles. Patients are advised to avoid frequent brushing and combing the hair, which can make the symptoms worse.
Ear psoriasis that occurs inside and outside the ears is a specific and very unpleasant condition. The skin inside the ears is very sensitive and moist because of low sun exposure, which makes it a perfect site for bacterial and fungal proliferation. The ears and the surrounding area should be regularly cleaned and carefully dried. Ear psoriasis can cause discomfort associated with the social perception of the disease since skin manifestations of ear psoriasis (flaky scales) can be mistaken for lack of personal hygiene. Ear psoriasis is treated with creams and ointments prescribed by a dermatologist.
A common disorder with psoriasis is psoriatic nail disease. Psoriasis affecting fingernails and toenails causes pitting, thickening, and nail surface irregularities. The nails are weak, brittle, and start to crumble. The affected nails can flake off during daily activities. Symptoms of psoriasis can be seen on one, two, or all fingernails and/or toenails. Diagnosis and management of nail psoriasis requires specialist advice by a dermatologist. In rare cases nail lesions can be the only symptoms of psoriasis.