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Psoriasis

What is Psoriasis?

An estimated 7.5 million Americans suffer with psoriasis, a non-contagious, chronic skin condition. Often identified by patches of red, scaly skin, psoriasis occurs when the immune system sends out incorrect signals that cause skin cells to grow too quickly. With psoriasis, cells build up on the top layer of skin, creating patches of itchy, dry skin. The most common locations for psoriasis are on the elbows, knees, or trunk, but it can develop anywhere on the body.

Psoriasis is thought to be an autoimmune disease, which arises from an overactive response by the body towards substances and tissues normally present in the body. In the case of psoriasis, white blood cells, called T cells, attack healthy skin as if to fight off infection or heal a wound. Instead of new cells moving to the outermost layer of skin in a normal manner, they develop more rapidly. The dead skin can’t slough off fast enough to keep up, so thick, scaly areas form on the skin’s surface.

Usually, the first occurrence of psoriasis happens sometime between ages 15 to 35. However, approximately 20,000 children under age 10 also live with psoriasis. Although psoriasis seems to have a genetic component, not everyone with that gene develops the disease.

What are the signs and symptoms of Psoriasis?

Each case differs based on the individual, but people with psoriasis often experience at least one of the following symptoms:

Burning, itching, or soreness
Cracked, dry skin that can bleed
Patches of red skin with silvery scales
Pitted, ridged, or thickened nails
Stiff, swollen joints

If you think that you could have psoriasis, contact your doctor and schedule a complete exam.

Triggers
Because psoriasis is chronic, anyone with the condition will live with a cycle of flare-ups and remissions over a lifetime. Typically, patients with psoriasis may develop initial symptoms or experience flare ups because of various triggers, including

Certain medications
Cuts, scrapes, burns, or other damage to the skin
Diet
Excessive alcohol use
Other infections such as strep throat
Smoking
Stress
Weather

What are the different types of Psoriasis?

There are six main types of psoriasis:

1) Plaque Psoriasis (Psoriasis Vulgaris)
About 80 percent of people diagnosed with the disease have plaque psoriasis, or psoriasis vulgaris. Plaque psoriasis often appears as on the elbows, knees, and lower trunk in the form of raised, red lesions topped with silvery scales.

2) Guttate Psoriasis
Usually found on the limbs or trunk, guttate psoriasis primarily appears in patients younger than age 30. Guttate psoriasis presents as small, water-drop-shaped sores and can occur because of an illness or injury to the skin.

3) Inverse Psoriasis
With inverse psoriasis, patients develop smooth, shiny lesions that are bright red in color. Most often seen in people who are overweight, inverse psoriasis strikes the armpits, around the genitals, near the groin, and under the breasts.

4) Pustular Psoriasis
When you have pustular psoriasis, white blisters filled with pus and surrounded by red skin will appear either in localized areas or all over your body. Because the pus is made of white blood cells, it is not contagious. Certain things can trigger pustular psoriasis, such as irritating topical treatments, infections, overexposure to ultraviolet radiation, and stress.

5) Erythrodermic Psoriasis
Characterized by a fiery red rash coupled with extreme burning or itching, erythrodermic psoriasis is the least common kind of psoriasis. Triggers for erythrodermic psoriasis include severe sunburn, corticosteroids, other medications, or another type of psoriasis that has flared up.

6) Psoriatic Arthritis
In addition to causing pitted, discolored nails, psoriatic arthritis also presents with the swollen, painful joints that often accompany arthritis. Usually psoriatic arthritis isn’t as crippling as other forms of arthritis, but it can cause stiffness and progressive joint damage.

What treatments are available at the dermatologist for Psoriasis?

Currently, no cure exists for psoriasis. Treatments are designed to minimize discomfort and encourage healing. When determining the best treatment, your doctor will take into account the severity of the psoriasis. Mild to moderate psoriasis covers 3 to 10 percent of your body, while psoriasis is considered moderate to severe when it covers more than 10 percent.

Treating Mild to Moderate Psoriasis
If you have mild to moderate psoriasis, your doctor will likely recommend a combination of over-the-counter medications, prescription topical treatments, and light therapy/phototherapy.

Over-the-Counter (OTC) Medications
The two active ingredients in over-the-counter medications approved by the FDA for psoriasis are coal tar, which inhibits the quick overgrowth of cells, and salicylic acid, which makes the outer layer of skin shed. Other OTC treatments may help, like:

Scale lifters to loosen and eliminate scales so that medicine can penetrate the sores
Bath solutions, such as Epsom salts, Dead Sea salts, or oilated oatmeal, that reduce itching and remove scaling
Occlusion, which covers the areas treated with topical treatments applications, to improve absorption and effectiveness
Anti-itch products like calamine lotion or hydrocortisone creams
Moisturizers to keep skin hydrated, reduce symptoms, and encourage healing

Prescription Topicals
Designed to inhibit the overgrowth of cells and lessen inflammation, prescription topicals include:

Anthralin, which reduces the skin cell growth related to plaque
Calcipotriene will flattens lesions, removes scales, and slow cell growth. Often used in treatment of psoriasis on the scalp and nails.
Calcipotriene and Betamethasone Dipropionate. By combining Calcipotriene with betamethasone dipropionate, this treatment addresses the itch and inflammation common to psoriasis as well as flattening lesions, removing scales, and minimizing cell growth.
Calcitriol, an active form of vitamin D3, helps limit extraneous skin cell production
Tazarotene, a topical retinoid that slows down cell growth
Topical steroids are the most commonly used medications for psoriasis, and they work by reducing inflammation, swelling, and redness

Phototherapy (light therapy)
Exposure to ultraviolet light can provide relief from psoriasis. With careful monitoring, the UVA and UVB rays from the sun can reduce symptoms. Excimer lasers treat specific areas affected by psoriasis, while pulse dye lasers provide not only targeted treatment, but also destroy the blood vessels that promote the development of psoriasis.

Treating Moderate to Severe Psoriasis
For patients with moderate to severe psoriasis, treatment involves prescription medications, biologics and phototherapy (light therapy).

Prescription Medications
Based on the location, severity, and type of psoriasis, your doctor will prescribe an oral medication, such as acitretin, cyclosporine and methotrexate.

How does psoriasis affect your nails, eyes, and joints?

Nails: Psoriasis can cause changes in the appearance and structure of the nails, such as pitting, discoloration, thickening, loosening, or crumbling. These changes can affect the function and comfort of the nails, as well as the self-esteem of the person with psoriasis.
Eyes: Psoriasis can cause inflammation in the eyes, leading to a condition called uveitis. Uveitis can cause symptoms such as eye pain, redness, blurred vision, sensitivity to light, or floaters. If left untreated, uveitis can damage the eye and impair vision.
Joints: Psoriasis can cause inflammation in the joints, resulting in a type of arthritis called psoriatic arthritis. Psoriatic arthritis can cause symptoms such as joint pain, stiffness, swelling, reduced range of motion, or deformity. Psoriatic arthritis can affect any joint in the body, but it is more common in the fingers, toes, spine, and pelvis. Psoriatic arthritis can also affect the tendons and ligaments that attach to the bones.

FAQ About Psoriasis

Can psoriasis affect other parts of the body besides the skin?

Psoriasis can affect other parts of the body besides the skin, such as the nails, scalp and joints. In some cases, it may also be associated with other conditions such as psoriatic arthritis.

Can certain foods trigger psoriasis?

Certain foods, such as processed foods, alcohol, and gluten-containing foods, may trigger psoriasis in some individuals. It’s important for people with psoriasis to work with a dermatologist or a dietitian to identify any specific food triggers and to develop a diet plan that works best for them.

When should I see a dermatologist for psoriasis?

If you have symptoms of psoriasis, such as red, scaly patches on the skin, it’s important to see a dermatologist for proper diagnosis and treatment. A dermatologist can also help to develop an individualized treatment plan and provide guidance on how to manage the condition. If your symptoms persist or worsen, you should also consult with a dermatologist.

Is there a dermatologist near me in Spokane that offers treatment for psoriasis?

Yes. At our Spokane dermatology office we offer treatment for psoriasis to patients from Spokane and the surrounding area. Contact our office today to schedule an appointment.

Hives (Urticaria)

What are Hives?

Hives are raised red bumps (welts) or splotches on the skin that are usually very itchy. They are a type of swelling on the surface of your skin that happen when your body has an allergic reaction to something.

What are the signs and symptoms of Hives?

Individual hives can take from 30 minutes to 36 hours to disappear. Chronic hives, referred to as urticaria, last longer than six weeks to go away, but frequently reoccur. If swelling occurs below the surface of the skin, a condition called angioedema, you should seek medical attention because angioedema can affect the internal organs.

Signs of hives include:

Developing in batches
Often raised
Small, round rings or large patches with a red flare
Usually itch

What are the causes of Hives?

Hives develop when mast cells release histamine and other chemicals into your bloodstream, causing small blood vessels to leak. Generally, hives are an allergic reaction to a food, animal or medication. Sun exposure, stress, excessive perspiration and other more serious conditions, like lupus, can bring on hives.

What treatments are available at the dermatologist for Hives?

Our dermatologist may recommend various treatments and strategies to help manage and alleviate hives, depending on the severity and underlying causes.

Here are some common treatments available at the dermatologist’s office:

Antihistamines: Non-prescription (over-the-counter) antihistamines like cetirizine (Zyrtec), loratadine (Claritin), or fexofenadine (Allegra) can help relieve itching and reduce the severity of hives. Dermatologists may also prescribe stronger prescription antihistamines.
Corticosteroids: Topical corticosteroid creams or ointments can be applied directly to the affected skin to reduce inflammation and itching. Oral corticosteroids may be prescribed for severe cases of hives or when topical treatments are not effective.
Epinephrine (EpiPen): In rare cases of severe hives accompanied by anaphylaxis or difficulty breathing, an epinephrine auto-injector (EpiPen) may be prescribed to quickly relieve symptoms.
Immune-suppressing medications: For chronic or severe cases of hives that do not respond to other treatments, dermatologists may prescribe medications that suppress the immune system, such as cyclosporine or omalizumab (Xolair).
Triggers identification and avoidance: Dermatologists may work with patients to identify and avoid triggers that can exacerbate hives. Common triggers include certain foods, medications, insect stings, physical stimuli (like heat, cold, or pressure), and stress.
Physical therapies: For certain types of hives, such as cold urticaria or pressure urticaria, dermatologists may recommend physical therapies like cold packs or pressure-reducing strategies to manage symptoms.
Allergy testing: If an allergic trigger is suspected, allergen testing may be conducted to identify specific allergens responsible for hives. This can help with avoidance strategies.

FAQ About Hives

Are hives contagious?

Hives are not contagious and cannot be spread from person to person through direct contact.

How long do hives last?

Hives can last anywhere from a few minutes to several days or even weeks. They can be chronic, or recurring, in some cases.

Can hives lead to more serious conditions?

In some cases, hives can be a symptom of a more serious allergic reaction, such as anaphylaxis. If hives are accompanied by difficulty breathing, swelling of the face or throat, or a rapid heartbeat, it is important to seek immediate medical attention.

Is there a dermatologist near me in Spokane that offers treatment for hives?

Yes. At our Spokane dermatology office we offer treatment for hives to patients from Spokane and the surrounding area. Contact our office today to schedule an appointment.

Eczema (Dermatitis)

What is Eczema?

Affecting between nine and thirty percent of the U.S. population, eczema refers to inflammation of the skin. The term eczema actually covers many various skin conditions that produce itchy, dry skin patches. Although it can appear anywhere on the body, eczema usually appears on the creases on the face, arms and legs. Because of the intense itching that accompanies eczema, people often scratch the skin which leads to crusting and oozing.

A non-contagious skin condition, eczema has no known cause. It does appear to have a hereditary component. Certain things, such as stress, weather and environmental factors can trigger a flare-up of eczema. People with eczema often live with cycles of flare-ups and remissions.

In mild cases of eczema, over-the-counter topical creams and antihistamines can relieve the symptoms. More severe eczema may require stronger medications, such as steroid creams, oral steroids (corticosteroids), and antibiotic pills or antifungal creams to treat any potential infection. Using mild cleansers and keeping skin moist can help control your eczema.

What are the signs and symptoms of Eczema?

Eczema is a condition that causes your skin to become dry, itchy and inflamed. The signs and symptoms of eczema can vary depending on the type, severity and stage of the condition. Some common signs and symptoms of eczema are:

Dry, cracked, scaly or flaky skin
Red, pink, purple, brown or gray patches of skin
Itching, which may be worse at night or during flare-ups
Small, raised bumps that may ooze or crust over
Thickened, leathery or discolored skin from scratching
Swelling or inflammation of the skin
Rash on the face, neck, hands, elbows, knees, ankles, feet or other areas of the body

What are the causes of Eczema?

Eczema is a condition that causes your skin to become dry, itchy and inflamed. The causes of eczema are not fully understood, but they may include:

A genetic variation that affects the skin’s ability to provide protection from bacteria, irritants, allergens and environmental factors.
An imbalance of the bacteria on the skin, which disrupts the skin’s barrier function and triggers an immune system response.
A contact with a trigger in your environment, such as dry weather, fabrics, makeup, smoke, soaps or detergents.
A history or diagnosis of dermatitis, allergies, hay fever or asthma.
A physical or emotional stress, which can cause inflammation in the body.

What treatments are available at the dermatologist for Eczema?

There are different treatments available at the dermatologist for eczema, depending on the type, severity and cause of the condition.

Some of the possible treatments are:

Medicated creams or ointments that control itching, inflammation and infection. These may include corticosteroids, calcineurin inhibitors, antibiotics or antifungals.
Oral medications that suppress the immune system or reduce inflammation. These may include cyclosporine, methotrexate, prednisone, azathioprine or biologics.
Phototherapy or light therapy, which uses ultraviolet (UV) rays to improve the skin’s condition and reduce symptoms.
Patch testing or allergy testing, which helps identify specific substances that trigger or worsen eczema.
Wet wraps or paste bandages, which cover the skin with moist dressings to soothe and protect it.
Lifestyle changes, such as avoiding triggers, moisturizing regularly, using gentle skin care products and managing stress.

The best treatment for eczema depends on your individual situation and preferences. Your dermatologist can help you find the most suitable and effective treatment for your eczema.

How to Avoid Common Eczema Triggers and Irritants

Use a thick moisturizer (emollient) as a soap substitute when washing your body or hands. Avoid soap, bubble bath and shower gel completely, as they can remove the natural oils from your skin and make it dry and itchy.
Wear cotton clothes next to your skin rather than potentially irritating fabrics such as wool. Wash your clothes with non-biological detergents and rinse them well. Avoid fabric conditioners, as they can also cause eczema to flare up.
Keep your skin moisturized regularly, especially after bathing or showering. Apply a non-fragranced, dye-free cream or ointment to lock in the moisture and protect your skin barrier.
Avoid contact with irritating chemicals and substances, such as fragrances, dyes, perfumes, alcohols, soaps and detergents. Wear rubber gloves with a cotton lining when using these products or working with similar chemicals.

The Benefits of Phototherapy for Eczema

Phototherapy is a treatment option that uses ultraviolet (UV) light to improve the symptoms of eczema, such as redness, itching, inflammation and infection. Some of the benefits of phototherapy for eczema are:

It may help clear your skin by reducing the inflammation and destroying the bacteria that cause eczema.
You may experience fewer eczema rashes in the future by strengthening your skin barrier and preventing the entry of external triggers.
It may decrease the need for using topical medications, which can have side effects or lose effectiveness over time.
It may also improve your mood and quality of life by relieving the discomfort and stress caused by eczema.

FAQ About Eczema

Are there different types of eczema?

There are different types of eczema, based on the age of onset and severity of symptoms. The most common type is known as “atopic dermatitis” and it usually begins in infancy and improves or resolves by the age of 6. Another type is “contact dermatitis” which is caused by an allergic reaction to a specific substance.

What are the symptoms of eczema?

Symptoms of eczema can vary from person to person and can range from mild to severe. Common symptoms include: dry, itchy skin, redness and swelling, scaling, cracking, and even bleeding.

How is eczema diagnosed?

Eczema is typically diagnosed by a dermatologist, who will examine the skin and ask about the patient’s symptoms and medical history. A skin biopsy may be done in some cases to rule out other skin conditions.

Can eczema affect other parts of the body besides the skin?

Eczema can affect the eyes, ears, and scalp. In some cases, eczema can also lead to complications such as asthma, allergies, and sleep disturbances.

Can certain foods trigger eczema?

Certain foods, such as dairy, eggs, nuts, soy, and wheat, can trigger eczema in some people. It’s important for individuals with eczema to work with a dermatologist or a dietitian to identify any specific food triggers and to develop a diet plan that works best for them.

Is there a dermatologist near me in Spokane that offers treatment for exzema?

Yes. At our Spokane dermatology office we offer treatment for eczema to patients from Spokane and the surrounding area. Contact our office today to schedule an appointment.

Scabies

What are Scabies?

Scabies is a highly contagious skin condition caused by a mite called Sarcoptes scabiei. The mite burrows into the skin and lays its eggs, leading to intense itching and skin rashes. The itching and rashes are a result of an allergic reaction to the mites and their waste products.

What causes Scabies?

Scabies is caused by the Sarcoptes scabiei mite. The mite burrows into the skin and lays its eggs, causing an allergic reaction and intense itching. Scabies is highly contagious and can be spread through direct skin-to-skin contact, as well as through contact with infested clothing, bedding, and towels.

What treatments are available for Scabies?

Treatment for scabies typically involves prescription medications to kill the mites. The most commonly used medications for scabies are:

Permethrin cream: This topical medication is applied to the entire body from the neck down and left on for 8-14 hours before being washed off.
Ivermectin pills: This oral medication is taken as a single dose, and is effective in treating scabies in individuals with weakened immune systems.
Lindane lotion: This topical medication is used in some cases, but is not recommended as a first-line treatment due to potential toxic side effects.

In addition to treating the affected individual, all close contacts should also be treated to prevent re-infestation. After treatment, itching and skin rashes may persist for several weeks, but should eventually subside.

It is important to seek medical attention for proper diagnosis and treatment of scabies, as well as to rule out any other skin conditions that may mimic scabies. Over-the-counter treatments and home remedies are not recommended for scabies, as they are often not effective and can cause skin irritation.

FAQ About Scabies

How is scabies diagnosed?

A dermatologist can diagnose scabies by examining the skin and performing a skin scraping to look for mites, eggs, or mite feces.

Is scabies curable?

Yes, scabies is curable with proper treatment.

How long does it take for scabies to go away?

With proper treatment, scabies can go away within several days to several weeks. However, itching and skin rashes may persist for several weeks after treatment.

Can scabies be spread through bedding and clothing?

Yes, scabies can be spread through bedding, clothing, and towels, which is why it is important to wash these items in hot water and dry on a hot setting.

Is it safe to return to school or work after being treated for scabies?

Yes, it is safe to return to school or work after being treated for scabies, as long as all close contacts have also been treated.

Is there a dermatologist near me in Spokane that offers treatment for scabies?

Yes. At our Spokane dermatology office we offers treatment for scabies to patients from Spokane and the surrounding area. Contact our office today to schedule an appointment.

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