Psoriasis

Psoriasis is a chronic inflammatory, non-contagious skin disease that typically progresses in flares. It is characterised by sharply demarcated, reddened patches of skin with silvery-white scaling, often on the elbows, knees and scalp. In a video consultation, the skin findings can be medically assessed on the basis of clear photos, and, subject to the doctor's assessment, a topical therapy can be initiated or continued via a follow-up prescription.

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Overview

Psoriasis is a chronic inflammatory skin disease affecting around two percent of the population in Germany. It is not contagious and typically progresses in flares: phases with pronounced skin changes alternate with calmer periods. It is characterised by sharply demarcated, reddened plaques with silvery-white scaling, preferentially on the elbows, knees, scalp and lower back. Nails and joints can also be involved. Because the appearance of psoriasis is usually very typical, the condition is well suited to a telemedical assessment: on the basis of clear photos, the doctor can evaluate the findings and, subject to medical assessment, initiate a topical therapy. If the diagnosis is already established, an established treatment — for example with corticosteroid preparations or vitamin D3 analogues — can be continued via a follow-up prescription, without waiting for an appointment at a dermatology practice. Treatment is billed as a private service according to the GOÄ fee schedule for privately insured and self-paying patients.

Common causes

Psoriasis is based on a genetic predisposition that leads to a dysregulation of the immune system: skin cells renew themselves much faster than usual, producing the typical scaling and inflammation. Whether and when flares occur depends on individual triggers. Common triggers include emotional and physical stress, infections — particularly streptococcal infections of the respiratory tract —, skin injuries such as scratches, friction or sunburn (the so-called Koebner phenomenon), as well as alcohol and smoking. Certain medications can also worsen or trigger psoriasis; therefore, always mention all medicines you take during the consultation. Cold, dry winter climate aggravates the symptoms in many patients, while sunlight and humid air often improve them. Hormonal changes and excess weight can additionally influence the course. Knowing your personal triggers is an important building block of long-term treatment.

When to see a doctor

A medical assessment is advisable if skin changes appear for the first time and the diagnosis is not yet confirmed, if existing plaques spread or no longer respond to the current therapy, or if itching or visible lesions significantly impair your quality of life. Treatment should also be medically supervised in the case of nail changes or involvement of sensitive regions such as the face, genital area or skin folds. If joint pain, morning stiffness or joint swelling additionally occur, assessment for psoriatic arthritis is important, as early treatment can prevent joint damage. Warning signs of an emergency are extensive reddening of almost the entire skin, rapidly increasing pus-filled blisters with fever or chills, and a pronounced feeling of illness with circulatory problems — in these cases, call the emergency number 112 immediately.

Symptoms & Indications

Sharply demarcated, reddened patches of skin (plaques) Silvery-white scaling of the affected areas Itching or a feeling of skin tightness Involvement of typical sites such as elbows, knees and scalp Dry, cracked skin, sometimes with painful fissures Nail changes such as pitting or discolouration Pinpoint bleeding after scales are removed Occasional joint pain or joint swelling

Treatment Options

  • Topical corticosteroids, subject to medical assessment
  • Vitamin D3 analogues as cream or ointment
  • Keratolytic agents (for example preparations containing salicylic acid or urea) to loosen scales
  • Consistent lipid-replenishing basic skin care with emollients
  • Medicated shampoos for scalp involvement
  • Avoidance of individual triggers such as stress, skin injuries, alcohol and smoking
  • Follow-up prescriptions for established topical therapies after medical review

Important Notes

  • A photo-based visual diagnosis does not replace a physical examination. If the findings are unclear, very extensive or resistant to therapy, a visit to a dermatology practice may be necessary.
  • If you also have joint pain, morning stiffness or joint swelling, psoriatic arthritis should be assessed by a doctor.
  • Extensive reddening of the entire skin, widespread pus-filled blisters (pustules) with fever, chills or pronounced feeling of illness may constitute an emergency – call the emergency number 112.
  • Any prescription is issued solely at the doctor's discretion in the individual case; there is no entitlement to a specific prescription.
HOW IT WORKS

How OpenClinic24 works

STEP 01

Complete the questionnaire

Brief details about your symptoms

STEP 02

Doctor connects with you

Video consultation within minutes

STEP 03

Receive your documents

Prescription, sick note or referral, digitally

…

Estimated wait

~… min wait
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Medical notice: Not a substitute for an in-person medical examination. The information on this page is intended for general guidance only. In an emergency, please call 112.

Frequently Asked Questions

Can psoriasis be reliably assessed from photos?

In many cases, the typical plaques of psoriasis can be assessed well on the basis of clear photos. The doctor evaluates your images together with your description of symptoms and your medical history. If the findings remain unclear or there is doubt about the diagnosis, you will be advised to attend a dermatology practice in person.

Can I get a follow-up prescription for my current ointment or cream?

If you have known, medically documented psoriasis, a private prescription for an established topical therapy — such as corticosteroid preparations or vitamin D3 analogues — can be issued subject to the doctor's assessment. Current photos of the affected skin as well as previous findings or earlier prescriptions are helpful. The decision always rests with the treating doctor; there is no entitlement to a specific product.

What does the treatment cost, and will my insurance cover it?

The video consultation is billed as a private service according to the German medical fee schedule (GOÄ). Privately insured patients can submit the invoice to their health insurer; whether and to what extent it is reimbursed depends on the individual policy. Self-paying patients receive a transparent GOÄ invoice, and the costs are displayed before the treatment.

Is psoriasis contagious or curable?

Psoriasis is not contagious; close contact with affected persons is harmless. It is a chronic disease that, according to current knowledge, cannot be cured but can usually be treated well. Subject to medical assessment, a suitable therapy can clearly relieve the symptoms, and many patients achieve largely clear skin for extended periods.

What can I do myself to prevent flares?

Consistent lipid-replenishing basic skin care stabilises the skin barrier and can help prevent flares. Where possible, avoid known triggers such as stress, skin injuries, vigorous scratching, alcohol and smoking. Also pay attention to infections, particularly of the respiratory tract, as these can trigger flares, and discuss recurring deteriorations with a doctor.