We asked you about the treatment to this skin rash… and the answer is….
a. Coal Tar
This is the classic salmon pink rash of psoriasis. You can see the surface has a scaly appearance.
As the rash in psoriasis is palpable and spread over an area of >0.5cm it is called a plaque not a macule – (If it was an impalpable area of colour change it would be called a patch).
Skin psoriasis is treated by emmollients, vitamin D analogues, coal tars, dithranol, topical steroids and oral retinoids. Methotrexate and Anti TNF therapy in addition to other immune modulating therapies are used in severe cases. Remember the four main types:
- plaque (seen here)
- pustular (pustules often occuring on the hands and feet)
- guttate ( teardrop lesions -sometimes occuring following a streptococcal infection)
- erythrodermic (diffuse skin involvement – potentially lifethreatening)
Capsaicin is a Rubefacient: a topical skin irritant. Its use is based on the principle that irritation of the skin produces a “distracting” effect from the pain from OA/ neuropathy (e.g. post herpetic neuralgia).
It is used topically for osteoarthritis and neuropathic pain.
Capsaican is the “active” ingredient in chillies which gives them their heat. Its use over a rash like psoriasis would be liable to produce excruciating pain and significant inflammation.