Psoriasis causes patches of thick red skin and silvery
scales. Patches are typically found on the elbows,
knees, scalp, lower back, face, palms, and soles of
feet, but can affect other places (fingernails, toenails,
and mouth). The most common type of psoriasis is
called plaque psoriasis.
PSORIASIS TRIGGERS
Many people's psoriasis symptoms start or get worse
because of a certain event, called a trigger. Knowing
your triggers may help you avoid a flare-up.
Common psoriasis triggers include:
• An injury to your skin, such as a cut, scrape,
insect bite or sunburn – this is called the
Koebner response
• Drinking excessive amounts of alcohol
• Smoking
• Stress
• Hormonal changes, particularly in women –
for example, during puberty and the
menopause
• Certain medicines – such as lithium, some
antimalarial medicines, anti-inflammatory
medicines including ibuprofen, and ACE
inhibitors (used to treat high blood pressure)
• Throat infections – in some people, usually
children and young adults, a form of
psoriasis called guttate psoriasis develops
after a streptococcal throat infection, but
most people who have streptococcal throat
infections don't develop psoriasis
• Other immune disorders, such as HIV,
which cause psoriasis to flare up or appear
for the first time
What are the Symptoms of Psoriasis?
• Rashes or patches of red, inflamed skin,
often covered with loose, silver-colored
scales; in severe cases, the plaques will
grow and merge into one another,
covering large areas.
• Itchy, painful skin that can crack or
bleed
• Small areas of bleeding where the
involved skin is scratched
• Problems with your fingernails and
toenails, including discoloration and
pitting; the nails may also begin to
crumble or detach from the nail bed.
• Scaly plaques on the scalp
Treatments for Psoriasis
Topical Treatments for Psoriasis
These are drugs you rub directly on your
skin. Along with a good moisturizer, they’re
usually the first thing your doctor will
suggest, especially for mild to moderate
psoriasis. There are over-the-counter (OTC)
and prescription options.
• Steroid creams these slow down
immune cells in your skin.
• Salicylic acid This can soften and
thin scaly skin.
• Calcipotriol This is a strong form
of synthetic vitamin D.
• Tapinarof is a new steroid-free
topical cream that is an aryl
hydrocarbon receptor agonist,
approved to treat plaque psoriasis
in adults.
• Tazorac is available gel or cream
and applied one and twice daily.
Phototherapy for Psoriasis
-Sunlight has been used to treat skin conditions for
thousands of years. Now doctors use machines to
shine ultraviolet (UV) rays directly on your skin.
• Light therapy can slow down fast-growing
skin cells in people who have psoriasis.
• Narrowband UVB therapy. This is a
targeted form of UV light. You’ll stand in a
light box or your doctor will pass another
source of light over your body.
• Excimer Laser therapy (VTRAC). Excimer
laser therapy helps get rid of the red patches
by exposing them to targeted ultraviolet B
(UVB) rays.
• Psoralen + UVA (PUVA). This mixes a
drug called psoralen with ultraviolet A, or
UVA, light.
Systemic Treatments
-Immunosuppressants. If other treatments don’t work
or you have moderate to severe psoriasis, your doctor
might give you drugs to slow down your entire
immune system.
• Methotrexate. This is only for people with
serious symptoms.
• Cyclosporine. This is used most for serious
psoriasis.
• Enzyme inhibitor. Newer drugs such as
apremilast or deucravacitinib can target and
slow down inflammation in certain immune
cells.
• Oral retinoids. Acitretin is a synthetic form
of vitamin A. You take it by mouth. Experts
 aren’t sure why it helps with psoriasis. They based on concomitant comorbidities,
think it’s because retinoids affect how fast potential adverse effects, existing
skin cells grow. quality of life, self-care capability, drug
Natural Psoriasis Treatments
history, caregiver situation, financial
-Lots of people try herbs, vitamins, or other at-
home remedies to ease symptoms. Just
needs, feasibility for follow-up and
remember what works for someone else might patient's preferences.
not work for you. It’s best to talk to your doctor
before you change or add something to your
treatment plan. They’ll let you know what’s
safe.
• Salt bath. This might lift some of your
scales and help you itch less.
• Colloidal oatmeal. Some people say
their skin is less red and itchy when
they soak in an oatmeal bath or apply a
paste to their skin.
• Aloe vera. A cream with 0.5% aloe
might lessen your scales and ease
redness for a short time.
• Apple cider vinegar. This is sometimes
used to ease itching from scalp
psoriasis.

GERIATRIC CONSIDERATIONS

 Determine the drug-induced or drug-

aggravated psoriasis, especially for
patients receiving polypharmacy or
with recent worsening or poor response
to conventional therapy.
 Provide an environment that would
elevate their psychological status to
better improve their perception with
their medication.
 Provide careful attention to quality-of-
life issues, specifically since many
elderly patients may have other
medical, social, and economic
comorbidities that can further
negatively affect their total well-being.
 Severity of psoriasis be assessed on a
more balanced, holistic scale that
incorporates both physical and
psychological parameters.
 Invest on patient and caregiver
education in a multi-faceted, regularly
conducted and practically orientated
manner.
 A simple and individualized treatment
goals should be kept for each patient,