Psoriasis: Definition and Treatment

General measures

  • Avoid dehydration and irritation of the skin by balanced skin care. Suitable care products are a greasy skin care in combination with keratolytics (agents to remove the scales).
  • Avoidance of strong mechanical stress on the skin.
  • Avoiding synthetic underwear, this is not very breathable and promotes a damp environment. Instead, wear loose cotton clothing.
  • Observance of general hygiene measures!
  • Nicotine restriction (refrain from tobacco use), including avoidance of passive smoking for children.
  • Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day).
  • Aim for normal weight! Obesity promotes the area and friction in the intertrigines.Determination of BMI (body mass index, body mass index) or body composition using electrical impedance analysis and, if necessary, participation in a medically supervised weight loss program.
  • Review of permanent medication due topossible effect on the existing disease.
  • Avoidance of psychosocial stress:
    • Stress
  • Avoidance of environmental stress:
    • Avoidance of chemical and mechanical skin irritation.
    • Thermal skin irritation such as sunburn.

Conventional non-surgical therapy methods

  • One possible form of treatment is PUVA (psoralen plus UV-A). This involves applying a substance called psoralen to the affected skin area, which sensitizes the skin to sunlight and UV radiation and then irradiating it with UVA light.Irradiation without this substance with UVA or UVB light is also possible and is called selective ultraviolet irradiation (SUB).
  • Indication: induction therapy for moderate to severe psoriasis vulgaris, especially if large areas.
  • The combination with topical vitamin D3 derivative may be recommended; furthermore, the combination with corticoids and dithranol.
  • Contraindications: increased photosensitivity, increased risk of skin cancer, ciclosporin (cyclosporin A), pregnancy / lactation; relative: seizure disorders, photosensitizing drugs, skin malignancies in the history, limitation of physical / psychological resilience, compliance ↓; relative for PUVA: severe liver damage, Z.n. therapy with ionizing radiation, arsenic, high cumulative UVA dose.
  • Side effects: Skin irritation with erythema (skin redness), itching; hyperpigmentation, blistering; oral PUVA: nausea.
  • No long-term therapy

Vaccinations

The following vaccinations are advised:

  • Flu vaccination
  • Pneumococcal vaccination

Regular checkups

  • Regular medical checkups

Nutritional medicine

  • Nutritional counseling based on nutritional analysis
  • Nutritional recommendations according to a mixed diet taking into account the disease at hand. This means, among other things:
    • A total of 5 servings of fresh vegetables and fruit daily (≥ 400 g; 3 servings of vegetables and 2 servings of fruit).
    • High-fiber diet (whole grains, vegetables).
  • Observance of the following special dietary recommendations:
    • Keep intake of arachidonic acid (omega-6 fatty acid) low, as it promotes inflammatory processes. It is contained in animal foods, especially pork and pork products and tuna.
    • Increase the intake of eicosapentaenoic and docosahexaenoic acids (EPA and DHA; omega-3 fatty acids) to promote the formation of anti-inflammatory substances in the body. They are contained in fatty marine fish such as salmon, herring and mackerel.
  • Selection of appropriate foods based on the nutritional analysis.
  • See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
  • Detailed information on nutritional medicine you will receive from us.

Physical therapy (including physiotherapy)

  • Phototherapy (UVB radiation) represents an important component of the therapy of psoriasis. Both natural sunlight, for example in the mountains or at the sea, and an artificial light source can be used.

Psychotherapy