What are the Symptoms?

Deep pink, raised patches, covered by white scales, appear on your skin. They usually cause no discomfort, but they may be slightly itchy or sore. You may have anything from a single small patch to many large ones. The most common sites are the knees, elbows and scalp. Less commonly, patches appear under the armpits and breasts, on the genitals, and around the anus. When psoriasis occurs on your hands and feet, it is usually in the form of raised areas with painful cracks or little blisters filled with white fluid. In some cases, your nails become thickened, pitted, and separated from the skin beneath.

Occasionally, psoriasis is associated with a mild form of arthritis, one that resembles rheumatoid arthritis.

What are the Risks?

Psoriasis appears most commonly between the ages of 10 and 30, and tends to run in families. In most cases, it does not affect general health. In the elderly and the very young, however, psoriasis may cause serious illness if the condition is severe and widely spread on the body, and if it is neglected.

What should be done?

Many people learn to live with mild forms of psoriasis. In time, you can become familiar with your particular form of the disorder, and you may be able to avoid the factors that trigger an outbreak. But if you have a severe case, or if it is causing serious discomfort or distress, consult your physician.

What is the Treatment?

Self-help: Sunbathing or using an ultra-violet lamp helps to clear up psoriasis, but a sunburn can make the condition worse.

Professional help: Your physician will probably prescribe one of several ointments, creams or pastes to apply to the affected areas. Among them are steroid preparations, which are effective but, if used over a long period, may damage the skin . Some drugs used to treat psoriasis must be applied very carefully because they burn unaffected skin and may also stain your bedding and clothing.

In many cases, skin medications clear up most of the psoriasis. If they have little effect, the doctor may arrange for you to receive intensive ultraviolet treatment. You may have to be hospitalized for this treatment; intensive therapy should be carried out under medical supervision.

If intensive ultraviolet treatment fails, you may be advised to enter the hospital for one or two weeks to receive intensive applications of a skin preparation, or a treatment involving very low doses of a cytotoxic drug that slows down cell division. This treatment is not used widely because the drug may affect certain other cells in the body.

For most people who have it, psoriasis is a long-term condition, and there is no permanent cure. The condition usually reappears throughout life with varying degrees of severity, though treatment is usually successful in clearing up each outbreak.

What should be done?

Some keloids stop growing, or even disappear, for no apparent reason. If you want one treated for cosmetic reasons, consult your physician, who will probably inject a steroid medication into it. This sometimes makes it smaller. An alternative is X-ray treatment. A keloid can not simply be cut out. This would leave a scar that might turn into another keloid. Removing the keloid and treating the new scar with injections, X-rays, or both may result in only a small scar.

What Causes them?

A corn usually is caused by external pressure, such as that from ill-fitting shoes, or less commonly, from internal pressure, such as that from a protruding underlying bone (due to arthritis, for example).

A callus is an area of thickened skin, generally found on the foot or hand, produced by external pressure or friction. People whose activities or jobs involve repeated trauma (for example, manual laborers or guitarists) commonly develop calluses.

The severity of a corn or callus depends on the degree and duration of trauma.

What are the Symptoms?

Both corns and calluses cause pain. Corns contain a central core made up of a protein called keratin, are smaller and more clearly defined than calluses, and are usually more painful. The pain they cause may be dull and constant or sharp when pressure is applied. “Soft” corns are caused by pressure from a bony prominence. They appear as whitish thickening and are commonly found between the toes. “Hard” corns are sharply delineated and conical and most often appear on the fifth toe.

Calluses have indefinite borders and may be quite large. They usually produce dull pain on pressure, rather than constant pain. Although calluses commonly appear over plantar warts, they’re distinguished from these warts by normal skin markings.

How are they Diagnosed?

Diagnosis depends on a careful physical exam of the affected area and on a history that reveals chronic trauma.

How are they Treated?

The doctor may perform surgical debridement to remove the nucleus of a corn, usually using a local anesthetic. In intermittent debridement, topical drugs called keratolytics are applied to affected areas. Keratolytics cause softening and dissolving or peeling of the horny layer of the skin. Injections of corticosteroid drugs beneath the corn may be needed to relieve pain.

The simplest, best treatment is essentially preventive – avoiding trauma. Corns and calluses disappear after the source of trauma has been removed. Toe pads may redistribute the weight-bearing areas of the foot; corn pads may prevent painful pressure.

People with persistent corns or calluses should see a podiatrist or dermatologist; those with corns or calluses caused by a bony malformation, as in arthritis, should consult an orthopedic specialist.