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Psoriasis

Psoriasis vulgaris · Lupénka (psoriáza)

What it is

Skin cells turn over in 4 days instead of 28; plaques of silvery scale build up.

Symptoms & signs

  • Well-defined red plaques with silver scale
  • elbows, knees, scalp
  • nail pitting
  • itch
  • joint pain in 30%

🚩 Get help if…

  • call 112 / 911 now Red, peeling skin over most of the body with chills
  • call 112 / 911 now Sudden spreading pus-filled spots with fever
  • see a doctor soon Swollen, painful joints or sausage-like fingers
  • see a doctor soon Fever, cough or sore throat on methotrexate or biologics

Where it strikes

Medical treatment

  • Topical vitamin D analogues with steroids trials support
  • Phototherapy trials support
  • Methotrexate — cheap and effective, with liver and marrow monitoring mixed evidence
  • Biologics (IL-17, IL-23, TNF) — the clearest skin, at thousands a year trials support
  • Apremilast — modest mixed evidence
  • Deucravacitinib, an oral TYK2 inhibitor — approved (FDA 2022, EMA 2023) trials support

Natural & lifestyle

  • Sunlight in moderation
  • weight loss (improves response)
  • alcohol reduction
  • stop smoking
  • stress management
  • emollients
  • Dead Sea therapy

Emerging & experimental

  • Oral IL-23 peptides (icotrokinra)
  • microbiome modulation

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Indigo naturalis ointment — trials show clearing of plaques mixed evidence
  • Fish oil — trials disagree mixed evidence
  • Aloe vera cream — trials disagree mixed evidence
  • Curcumin gel — small trials early / small studies
  • Apple cider vinegar on the scalp — anecdotal anecdotal / traditional

ICD codes