Complaints & connections · borters.ch
An inflammatory disease of the whole body that shows on the skin — which is why joints and vessels also belong in view.
Also known as: psoriasis
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
Psoriasis looks like a skin disease and is at heart an inflammation of the whole body that shows on the skin. Misdirected immune cells give a constant signal; the outer skin then renews many times faster than normal, the cells arrive at the surface unfinished and stack up into the familiar silvery scales. Beneath lies the inflammation, which is why the edge is sharply drawn and the skin red. None of it is catching — the sentence most often missing in everyday life. Two things are frequently considered too late. First the joints: up to about a third of those affected develop an accompanying joint inflammation, and it likes to begin quietly with morning stiffness, one swollen finger or heel pain. Recognised early it can be accompanied differently than after years. Second the vessels and the metabolism: the lasting inflammatory load goes together with a higher risk of high blood pressure, lipid disorders, diabetes and fatty liver. So blood pressure, blood sugar and blood lipids belong to psoriasis, however little that sounds like skin. And the burden of looks and questions is real: shame and withdrawal are part of the picture, not of the category of being oversensitive.
Both are sharply bordered. Psoriasis scales silvery and sits on elbows, knees and lower back; nummular eczema starts moist, itches more and sits on lower legs and backs of the hands.
Psoriasis can come with inflammatory involvement of the spine and the tendon insertions. Low back pain, heel pain or a whole swollen toe therefore belong mentioned.
Regular, rich moisturising loosens scale, eases itch and improves how everything else works. It only works if it runs daily — not only during a flare.
Morning stiffness beyond half an hour, a swollen finger or toe, pain in heel or lower back belong mentioned. The joint form is better accompanied early than late, because damage does not go back.
Not because the skin causes them, but because the same inflammatory load stands behind them. Regular checking is as much part of the treatment in extensive psoriasis as the ointment is.
Common ones are tonsil infections, heavy emotional strain, injuries to the skin, and some medicines such as certain blood-pressure and malaria drugs, or stopping cortisone tablets abruptly. A flare often has a history of two to four weeks before it.
Both are linked to more severe courses and poorer response to treatment. That is a well-documented connection and not a question of lifestyle judgement.
Moderate daylight improves the patches in many people. Sunburn by contrast is an injury to the skin and can trigger new patches at exactly that place.
At the pool, at the hairdresser, at work: the sentence takes the ground from most of the looks. Where shame and withdrawal remain, support is part of the treatment and not an add-on.
In the folds the two look confusingly alike — and both are regularly taken for fungus there.
Anyone who has ever lived in the tropics or subtropics can carry a threadworm unnoticed for decades. Under cortisone or a treatment with antibodies it can multiply massively. So this question belongs before the treatment starts — checked with antibodies in the blood and the eosinophils.
A threadworm can stay silent in the gut for decades and, under cortisone, biologicals or other immune suppression, flood lung and bloodstream. Anyone who ever went barefoot in the tropics or subtropics is looked for beforehand with a blood test — one effort, and it prevents the worst course this worm has.
Ointments with cortisone or vitamin D derivatives slow the skin’s over-fast cell division. Biologics pick out single messengers of the immune system. Both keep flares small; the predisposition stays, so this is about time spans, not an end point.
About two in a hundred people have psoriasis. It starts at two age peaks, around twenty and around fifty. Roughly one in four to five also develops joint symptoms — usually years after the skin.
Classically on elbows, knees, lower back and scalp. The sharp edge separates them from eczema, which fades out at its border.
The skin answers an injury with a new patch at exactly that spot. That explains streaks along scratch marks and borders at belt lines.
These places are overlooked because you cannot see them. Stubborn scaling at the hairline is often not ordinary dandruff.
Small dimples as if made by a needle, yellowish spots under the plate, a lifting edge. Nail involvement is at the same time a pointer to a higher risk of the joint form.
The joint form often begins like this, not with many joints at once. A finger swollen along its whole length like a sausage is an especially typical sign.
In many people psoriasis itches considerably. Cracks on hands and heels hurt and restrict daily life more than the appearance does.
Psoriasis and sugar metabolism hang together — with extensive involvement the risk of diabetes and heart disease is raised, independent of weight. This is why blood pressure, sugar and blood fats belong to the care, not only the skin.
The most important point: cortisone as a tablet or injection can trigger a severe flare on stopping — up to the pustular form. On the skin it is the treatment, inside the body it is the exception here.
Derivatives of the vitamin D hormone are one of the standard treatments on the skin — they slow the too-fast cell division. That is one of the few examples of a hormone becoming an ointment.
Weight, alcohol, Mediterranean pattern.
Vitamin D derivatives for application are standard; the blood level is another question and is measured.
Skin and airways belong to the same functional circle in TCM. That psoriasis, asthma and bowel inflammation occur together more often fits this picture — today’s explanation for it is called inflammation, not meridian.
For skin conditions Chinese formulas have been studied in Europe, with mixed results and one recurring problem: contaminated preparations or ones spiked with cortisone. The origin matters more here than the formula.