Psoriasis can have large, scaling, slightly elevated lesions. These lesions are usually found near or at the elbow as well as the forearm, knees, legs, scalp, buttocks, and genital areas. Psoriasis may involve large areas of scaling, such as on the neck and scalp. These small bumps and slightly elevated lesions have the typical white scale of psoriasis. This image displays the fine, scaly, slightly elevated lesions in the armpit (axilla) in psoriasis. In psoriasis, this is a typical elevated lesion with white scale on the knee. This image displays dry, scaly areas of the scalp typical of psoriasis. This image displays widespread red, scaling slightly elevated lesions involving buttocks and lower extremities from psoriasis. Psoriasis of the ear typically involves the ear canal and appears as redness with white scale. This image displays psoriasis, which can develop a thick, white scale. Psoriasis often has white, thick scale that comes off in "plates" when picked, causing bleeding. Psoriasis can be slightly scaly with bright red, well-demarcated areas. This image displays scaly, slightly elevated lesions on the lower back and buttocks, typical locations for psoriasis. Pinkness and scaly skin can cover the soles when psoriasis is on the feet. This image displays thick, white, scaly skin with redness underneath, typical of psoriasis. Psoriasis involving the fingernails may cause an irregular nail plate as well as separation of the nail from the nail bed (onycholysis). This individual also has psoriasis of the skin around the nail. Psoriasis typically has bright red or pink circular, scaling patches, which may be seen anywhere on the body. This image displays pits, roughness, and lifting of the tip of the nail tip typical of psoriasis of the nail. Psoriasis typically has multiple areas of skin involvement with lesions clustered on or near the knees. This image displays yellow, lifted nails from onycholysis, which is frequent in psoriasis. Numerous tiny nail pits are common in people with psoriasis. This image displays minimal scale with subtle redness due to psoriasis.
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Psoriasis  Information for adults

Picture of Psoriasis: Psoriasis can have large, scaling, slightly elevated lesions. These lesions are usually found near or at the elbow as well as the forearm, knees, legs, scalp, buttocks, and genital areas. Divider line
Psoriasis can have large, scaling, slightly elevated lesions. These lesions are usually found near or at the elbow as well as the forearm, knees, legs, scalp, buttocks, and genital areas.
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Treatments Your Provider May Prescribe
There are many prescription-strength treatments that are helpful at controlling psoriasis. For mild or moderate cases, medicines applied directly to the skin (topical treatments) may be prescribed:
  • The mainstay of therapy for psoriasis is topical steroids, either in creams or ointment form. Higher-potency topical steroids are used for the body or scalp, and lower-potency topical steroids are best for the face and skinfold areas. Steroid solutions or liquids can be used on the scalp. Use should be limited to 1–4 weeks at a time because long-term use of steroids can lead to stretch marks (striae) and thinning of the skin.
  • Calcipotriene (Dovonex®) is a vitamin D derivative cream that works as well as steroids, and it is even more effective when combined with topical steroids.
  • Tazarotene (Tazorac®) is a vitamin A-based cream that may be prescribed. Women of childbearing age should be counseled to avoid pregnancy while using tazarotene because this treatment may cause birth defects.
  • Topical immunosuppressants such as tacrolimus (Prograf®) and pimecrolimus (Elidel®) may also be used, but they can cause skin burning and itching and are expensive. These treatments may possibly increase your risk for skin cancer and lymphoma.
  • Coal tar-based therapies and anthralin creams are sometimes used, but they are used less frequently than other treatments because they have an odor, cause skin irritation, and can stain clothing and because neither is any more effective than calcipotriene.
For more extensive psoriasis:
  • If a large percentage of your skin is affected, ultraviolet (UV) light therapies may be considered. These include UVB phototherapy and PUVA (psoralen [a photosensitizer] and UVA therapy). PUVA may increase your risk for non-melanoma skin cancers.
  • Oral medications may be used for extensive psoriasis, including acitretin (made from vitamin A), methotrexate, and cyclosporine. If you are prescribed any of these medicines, you will need to see your doctor regularly so he or she can monitor for possible side effects such as liver and kidney damage.
  • Biologics are the newest medicines to be used for psoriasis. These are proteins that treat psoriasis by blocking certain actions of the immune system. These medications include etanercept (Enbrel®), alefacept (Amevive®), and infliximab (Remicade®). These are very costly and may have serious side effects, including infection, immunosuppression, and cancer.
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Last Modified: 20 Feb 2009
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