ASK A DERMATOLOGIST

I am suffering from pulmo plantar psoriasis and have been on medication. It gets worse in cold weather. Is this condition related to gut function and immunity?

Psoriasis is not an auto-immune disease. However, psoriasis is an immune-mediated skin disorder. It does not occur due to a weakness of immune system. It is also not related to gut malfunction. Yes, changes in weather do have a certain degree of influence on activity/severity of psoriasis. The skin lesions of psoriasis can be few in number or can be multiple and extensively involving most of the body, where it is called generalised psoriasis. The treatment of hypertrophic palmoplantar psoriasis is extremely difficult. In this form, the lesions are mostly very itchy and the vigorous scratching by the sufferers significantly injures the affected skin areas which then invite bacteria, leading to secondary bacterial infections. In these cases use of strong topical steroids without prescribing an oral antibiotic cover can lead to a dramatic worsening of the skin condition. Similarly, the broken skin areas can also be an easy site of penetration for external irritants, like detergents of various forms, perfumes, after-shave lotions and even peeling or holding citrus fruits can also make the existing psoriasis worse by causing a superimposed irritant contact dermatitis. Please visit an experienced dermatologist at the earliest who will formulate a suitable treatment plan and strategy to manage your psoriasis.

I am a 16-year-old and my complexion is becoming dry and dark. I eat healthily. I also have undereye circles and my lips are dark, making me appear tired. Please, help!

From your query, most of the skin changes you have described suggest that you probably were, or still are, suffering from some degree of atopic dermatitis. All the pigmentary changes listed by you could be a part of post inflammatory sequel. At the same time, we are also suspecting that you are passing through some degree of psychosocial anxiety and its resultant distress is making you relatively more conscious about your outlook and appearance. We would like to positively reassure you that with the modern options of available treatments, your skin complaints can be successfully treated. Consult an experienced dermatologist. The treatment programme could include topical skin lightening creams, gentle chemical peels or skin pigment-diluting lasers. Meanwhile, the one thing that you can and should do is avoid excessive sun exposure, as it could worsen your condition.

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