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Sure Signs You Have Psoriasis Like Kim Kardashian

Experts explain what you need to know about psoriasis and signs you have it. 
FACT CHECKED BY Emilia Paluszek

Kim Kardashian has one of the best glam squads and access to top-ranking doctors, but that doesn't mean she doesn't struggle with skin issues. The internationally known reality star has dealt with psoriasis for years and openly documents her journey in hopes of helping others. "For the past eight years, although the spots are unpredictable, I can always count on my main spot on my right lower leg, which consistently stays flared up. I have learned to live with this spot without using any creams or medication—I just deal. Sometimes I cover it up and sometimes I don't," she wrote on her sister Kourtney Kardashian's site Poosh.com. Eat This, Not That! Health spoke with several experts who explain what exactly psoriasis is and signs you have it. As always, please consult with your physician for medical advice. Read on—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.

1

What is Psoriasis?

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Dr. Olivia Choi, MD, Ph.D., dermatologist and Associate Director of Dermatology at Janssen says, "Psoriasis affects nearly 8 million Americans and nearly one-quarter of people living with the condition have cases that are considered to be moderate to severe. It's an immune-mediated disease that results in the overproduction of skin cells, which causes raised, red, scaly plaques that may be itchy or painful. This occurs because the immune system is overactive and causes inflammation, which speeds up skin cell growth. Normal skin cells grow and shed in about a month, but with psoriasis, new cells grow in only three to four days and build up on the skin. Psoriasis can appear on any part of the body, even nails, but it's most commonly found on elbows, knees and the scalp, and in severe cases, it can cover large parts of a person's body."

Dr. Jeffrey Hsu, M.D. FAAD Founder of Oak Dermatology adds, "Psoriasis is a common skin disorder, affecting approximately 3% of the US adult population.  Generally psoriasis manifests as red, itchy, scaly plaques. Sometimes it can be mistaken as rashes or eczema unless a patient is examined by a dermatologist. Unfortunately, psoriasis is a chronic condition with periods of remission. Psoriasis can appear on various body parts: scalp, nail, groin, with extremities and trunk being the most common."

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2

What Causes Psoriasis?

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Dr. Simran Sethi, founder of RenewMD Beauty & Wellness explains, "Psoriasis is caused by either or both of the following: genetics, or when the immune system's white blood cells, also known as T-cells, may mutate to attack skin cells. . T-cells do not intend to harm the skin, instead, they are overprotecting the skin based on the overgrowth of skin cells, that is psoriasis. Psoriasis is caused by an excess buildup of skin cells. Generally, skin cells renew every 3-4 weeks, however, with Psoriasis, skin cells turn over at a pace of 3-7 days, causing thick skin patches that are itchy, flaky and tender. Psoriasis is a chronic disease that commonly appears in teen to adult years." 

Dr. Hsu adds, "It is believed that psoriasis is caused by a combination of genetic predisposition and environmental triggers, leading to immunological unbalance and a hyperactive inflammatory state of the skin." 

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3

Who is at Risk for Psoriasis?

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Dr. Sethi reveals, "It is not entirely specific who psoriasis affects. While Psoriasis is common within individuals between ages 15 and up, it is also shown that lighter skin tones, or Caucasian skin, are prone to developing Psoriasis. Individuals with autoimmune disorders or diseases may be prone to developing Psoriasis because of a compromised immune system. The skin is our largest vital organ and because of this, our immune system often responds reactively to ensure the safety and integrity of skin renewal."

Dr. Choi adds, "Psoriasis doesn't discriminate. Symptoms often present between ages 15 and 25, but can start at any age, and men, women and children of all skin tones can develop the disease. Prevalence in the U.S. is reported to be higher in white Americans than those with skin of color, but that is due in part to the fact that people of color are often undiagnosed or misdiagnosed because psoriasis looks different on skin of color. Rather than having a red or pink appearance, in darker skin tones, psoriasis can look violet, gray or even dark brown making it more difficult to see and diagnose."

Dr. Hsu shares, "There are risk factors like stress, smoking or those with certain health conditions like diabetes or heart disease that may have a higher risk of psoriasis. Those who have a family history of psoriasis will have an increased chance of psoriasis as well." 

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4

How Psoriasis Can Affect Your Health and Overall Well-Being

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According to Dr. Sethi, "Though psoriasis is not always uncomfortable or severe, depending on the location of the rash and non-contagious outbreak – psoriasis can certainly be very tender to touch, and if left untreated and/or if the individual's immune system is compromised or weak – psoriasis can cause swelling in the joints and connective tissue, just like arthritis would. Psoriasis' effect on overall health is not as significant as the conditions impact on confidence. Many people with psoriasis report others staring at their skin, often thinking they have a contagious skin condition. This certainly has detrimental effects on psoriasis sufferers and unfortunately, is really the result of lack of awareness about the condition on the part of the general public."

Dr. Choi says,

  • "Psoriasis can have a significant impact on a person's physical and mental health. Physically, psoriasis can cause itchy skin that can crack or bleed, which can be incredibly painful and debilitating for patients. A plaque psoriasis diagnosis can indicate increased risk for other conditions. For example, people with psoriasis are at higher risk for cardiovascular disease and metabolic diseases such as type 2 diabetes.
  • Emotionally, people with psoriasis may face mental health issues as a result of the appearance of their skin. People living with the condition often suffer from embarrassment due to visible signs of psoriasis, which can result in low self-esteem, anxiety and depression.
  • These issues are compounded further for people of color with psoriasis due to inequities in care and other social determinants of health. In a study published inClinical Rheumatology, people of color with psoriasis reported a lower quality of life as a result of the disease compared with white patients.. Another report from the National Psoriasis Foundation found that 72 percent of non-white patients say the condition interferes with their ability to enjoy life. It's important for those affected by psoriasis to discuss the impact of the disease on their emotional and mental health with their healthcare provider."

Anna H. Chacon, M.D. a board certified dermatologist states, "Psoriasis is strongly genetically influenced so family history is a risk factor. Environmental and behavioral factors, like smoking, obesity, and alcohol are found at higher rates in those affected. There are more cases affecting Caucasian patients, but it can be found in other races. There is no differentiation between gender and there is risk of developing this condition. It can begin at any age, although it's less common in children. Peak age for onset is between 30-39 years and 50-69 years."

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5

What Causes a Flare-Up

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Dr. Sethi explains, "There are various reasons for psoriasis to flare up. Usually the triggers are: 

  • Weakened immune systems or immune disorders 
  • injury to the skin (cuts, scrapes, insect bites or sunburn)
  • drinking excessive amounts of alcohol
  • smoking
  • stress
  • hormonal changes, particularly in women (puberty and the menopause)
  • certain medicines – such as (ie: lithium, some antimalarial medicines, anti-inflammatory medicines including ibuprofen, and ACE inhibitors, which are 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 strep throat infection, but it is not too common to develop psoriasis after a streptococcal throat infection."

Dr. Choi explains, "Psoriasis triggers can vary from person to person, but there are some factors that are commonly associated with flare-ups. Stress is of course a common trigger, so it is critical for patients to stay relaxed and find healthy outlets to help cope with stress. Skin injuries as simple as a scratch, scrape or bug bite can result in a flare-up, often occurring in the same spot as the injury – a phenomenon called koebnerization. As a result, while psoriasis can be itchy, we caution patients to avoid scratching whenever possible to reduce the risk of a flare-up. People with psoriasis should pay close attention to their flare-up patterns to help identify their personal triggers, which may help them better manage their disease and feel more in control of their health."

Dr. Hsu says, "Certain environmental triggers can exacerbate Psoriasis. Dryness or sudden change in humidity, stress and infections which alters the immune system, and can set psoriasis. Other factors can include irritants in skincare, allergies, or certain medications."

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6

Signs that Indicate You Could Have Psoriasis

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Dr. Sethi states,

–"If you have flat, plaque like rough textured red lesions on any part of your body or face (including scalp)

–These lesions wax and wane generally

–The plaque-like lesions are typically present on the outside (extensor) surface of the elbows, knees and also commonly present on the scalp."

Dr. Hsu explains, "It is important to note that psoriasis can sometimes be confused with eczema to the untrained eye, these signs are common amongst both conditions and should be seen by a dermatologist for proper diagnosis.

  • Red patches of skin covered with thick, silvery scales.
  • Small scaling spots (commonly seen in children)
  • Dry, cracked skin that may bleed or itch.
  • Itching, burning or soreness.
  • Thickened, pitted or ridged nails.
  • Swollen and stiff joints."

Dr. Choi says,

  • Raised patches of skin that may be pink, red, violaceous, grey, or dark brown depending on skin tone
    • Known as plaques, these raised patches of skin are one of the hallmark signs of plaque psoriasis. They are often covered in silver or white scales and tend to form on the scalp, elbows, knees, behind the ears, around the belly button or lower back – though they can appear anywhere on the skin.
  • Joint pain, stiffness, or swelling
    • Up to 30 percent of people with psoriasis also suffer from psoriatic arthritis, which causes pain, swelling and stiffness in the joints on any part of the body including fingers, toes and spine. Most people develop psoriasis on their skin before being diagnosed with psoriatic arthritis but for others joint problems may begin at the same time or even before skin patches appear. Psoriatic arthritis can also cause pain at the points where tendons and ligaments attach to your bones — especially at the back of your heel or in the sole of your foot. Psoriatic arthritis can severely damage joints if left untreated so patients with psoriasis should report joint pain to their health care provider.
  • Changes with your scalp or your fingernails
    • Some people with psoriasis may also find that they have scales and plaques on their scalp, which they can even mistake for dandruff. Psoriasis can also cause issues with the fingernails, including denting, discoloration, pitting and crumbling.

Dr. Joey Pietrangelo, MD, FAAD Dermatologist, Memphis Dermatology Clinic  Instructor, University of Tennessee Health Science Center says to look for the following: 

–"Red scaly plaques on the skin.  Many rashes cause red skin but a dermatologist should be able to evaluate and determine if your rash is psoriasis.

–Nail changes.  Dark spots on the nails, lifting of the nail from the nail bed – these can be signs of psoriasis affecting the nail matrix.

Joint Pain. There are numerous causes for joint pain.  Psoriatic joint pain is typically worse in the morning.  Interestingly, you do not need to have skin involvement to have psoriatic arthritis."

7

Psoriasis Treatment Options

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Dr. Sethi says, "Most commonly, if serious, psoriasis can be treated with Corticosteroids, however, since psoriasis is a chronic disease, a useful method to alleviate the appearance and discomfort of these inflamed and itchy patches is to only use skincare products that are free of fragrances, alcohol, large molecular oils, parabens and other synthetic or triggering ingredients. Maintaining a strong skin barrier to protect the skin renewal process, and ensure a healthy lipid barrier may aid in the texture and production of psoriasis and its side effects. I recommend using thick lipid nourishing creams including vaseline for psoriatic lesions. Psoriasis lesions are only treatable using immune modulating medications and not cosmetic procedures. Fortunately, once resolved these lesions tend not to leave behind scars or pigmentation, which means focus on control of the actual disease is more important than exploring cosmetic solutions for the lesions."

According to Dr. Choi, "Although there is no cure for psoriasis, science has come a long way and patients have a number of treatment options that can improve their symptoms. Research shows that prolonged inflammation from psoriasis may lead to psoriatic arthritis and other comorbid health issues, so it's important to work with a healthcare provider to develop a treatment plan that is right for you. Psoriasis treatments are focused on decreasing inflammation to stop skin cells from growing so quickly. Depending on psoriasis severity and how a patient is responding to medication, your dermatologist may prescribe:

  • Topical therapy, such as corticosteroids, vitamin D analogues, retinoids and salicylic acid, among others
  • Phototherapy, such as narrowband UVB or PUVA
  • Oral or injected systemic medications, such as steroids, retinoids, methotrexate, cyclosporine and biologics. Biologics are more advanced medications that are an important option for people with moderate to severe psoriasis. A biologic therapy, such as TREMFYA®, targets specific parts of the immune system that trigger inflammation, to treat the root cause of psoriasis. In clinical studies, at 16 weeks, 7 out of 10 adults with moderate to severe plaque psoriasis saw at least 90 percent clearer skin and more than 8 out of 10 were rated clear or almost clear. Results may vary patient to patient, so you should always speak with a healthcare provider to find the treatment option that best fits your needs. 
  • TREMFYA® is not for everyone; only your doctor can decide if it's right for you. Do not use it if you are allergic to TREMFYA®. TREMFYA® is a prescription medicine that may cause serious side effects, including serious allergic reactions and infections. TREMFYA® affects your immune system.. It may increase your risk of infections and lower your ability to fight them." And to protect your life and the lives of others, don't visit any of these 35 Places You're Most Likely to Catch COVID.
Heather Newgen
Heather Newgen has two decades of experience reporting and writing about health, fitness, entertainment and travel. Heather currently freelances for several publications. Read more