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The symptoms of psoriasis

People with psoriasis often master the art of hiding their plaques and bodies, so much so that sometimes even those around them don't really know what to expect. What is psoriasis? What does a psoriasis flare-up or outbreak look like? What are the symptoms of psoriasis? A better knowledge of the disease makes it possible to better manage it, better accept it and challenge a large number of misconceptions. The first of these consists in believing that psoriasis is not a real disease: "it's all in the head", "it's attention seeking". It most certainly isn’t!!! The symptoms of psoriasis are very real indeed!!

Psoriasis plaques, the most visible symptom

The most visible symptom of psoriasis is psoriasis plaques.

Plaques are more or less extensive, are red underneath and white on top. This "color code" is the result of the mechanisms that take place in the skin.
  • The red color is a result of inflammation involving a large number of immune cells. Everything overreacts, everything becomes inflamed, like a fire that starts and spreads.
  • The white is a result of the thickening of the skin, due to the accelerated multiplication of keratinocytes. The white flakes are of varying thickness and are known as scales.
Removing these scales is very tempting but will not get rid of plaques any faster. On the contrary, by scratching and removing the scales, we prevent the skin from repairing itself and healing, we prolong the symptoms, and the whole psoriasis flare-up starts again!

Itching related to psoriasis

Another symptom of psoriasis, less visible but equally important, is itching.

The skin is covered with nerve endings that react to heat, cold, pain, etc. In the case of psoriasis, these nerve endings are aggravated, which leads to prickling, tingling, stinging, heating and burning sensations, as well as itching. Patients experience this itching everywhere, all the time, even at night. It becomes impossible to avoid scratching, but also impossible to bear others' looks while doing so.

Patients can experience embarrassment, shame and fear of judgment and may just want to go home, isolate themselves and scratch even more!! 

Other psoriasis symptoms

Other psoriasis symptoms are present on a case-by-case basis:
  • Skin dryness is sometimes mild, sometimes more intense, which increases the feeling of discomfort and tightness.
  • With nail psoriasis, the nails become damaged and this can interfere with daily activities.
  • In the case of scalp psoriasis, the scalp can be very irritated, due to excessively aggressive scratching and washing.
Psoriasis is a chronic disease. However, the different symptoms of psoriasis are not continuously present on the skin. They come and go, in the form of more or less severe psoriasis flare-ups, usually depending on environmental conditions, how well treatment is applied, the intensity of scratching, etc. Not all psoriasis flare-ups are of equal severity. Certain activities or certain seasons can increase the risk of a flare-up. 

Doctors know the symptoms of a disease, and it is this knowledge that allows them to diagnose one disease rather than another. For psoriasis, this is often done at first glance because the symptoms are so distinctive. This is known as a clinical diagnosis.

But in some cases, the symptoms of psoriasis may indicate another disease. This is called a differential diagnosis: Be aware, however, it is not always one or the other, and sometimes it is possible for patients to have more than one skin disease at the same time.

In summary

It is best to avoid jumping to conclusions, comparing yourself to others or seeking advice in forums. Only a dermatologist can confirm a diagnosis.

In summary, psoriasis in its skin form consists of itchy, red and white plaques.
  
For a person who does not have psoriasis, this short description may suggest that psoriasis "is nothing really" or "no big deal”, whereas for a person with the disease, it is often exactly the opposite. 

Plaques are visible, they make the skin uncomfortable, they disrupt people's daily lives and relationships with others. Psoriasis symptoms significantly affect quality of life.

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