Psoriasis

What is psoriasis?

Psoriasis is an inflammatory skin disease consisting or red, scaly plaques that most commonly appear on the elbows, knees, and scalp. The plaques typically have a white to silvery appearing scale and can be very itchy or even painful. Although most patients only have skin involvement, psoriasis can also manifest in the joints as psoriatic arthritis. Psoriasis can also affect the nail causing yellowing and crumbling of the nails with an appearance similar to a nail fungal infection.  

What causes psoriasis?

An exact cause of psoriasis isn't known. Psoriasis is due to a combination of genetic factors and environmental factors. Most people who develop psoriasis have some family history of the disease, but this is not always the case. Some environmental factors include infections, medications, and other medical comorbidities. Psoriasis tends to first appear during two peaks of life. The first peak occurs around ages 20-30 and the second peak around ages 50-60, although psoriasis may develop at any time in life. 

How is psoriasis treated?

Psoriasis is treated in a variety of ways depending on the severity. For mild cases, a safe and effective treatment typically starts with use of topical medications such as topical steroids or vitamin D derivatives such as calcipotriene. For more severe cases, systemic medications are typically used including oral medications or injections known as biologics. You have likely seen commercials for biologics such as Humira, Stelara, Cosentyx, Skyrizi, and many others. Other options include treatment with ultra violet light which is referred to as Narrow-band UVB therapy. 

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While there is still no definitive cure for psoriasis, the medications available are highly effective in controlling psoriasis. There is a significant amount of research constantly going into psoriasis and new treatments are continuously being developed.

 

How will I determine the right treatment for me?

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All patients are different and all cases of psoriasis affect patients in different ways. It is important to have a dermatologist comfortable and up to date on all the treatment options to help you decide the best treatment plan for you. Your doctor will weigh factors such as the amount of distress the disease is causing you both physically and emotionally. They will also take into account the overall severity of the disease and presence or absence of joint disease. After considering all factors, your doctor will recommend possible options and counsel you about the benefits of each approach along with the potential risks of each medication. For mild cases, topical therapy alone will likely be all that is needed. For more severe cases, pills or injections with biologics will commonly be recommended. 

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For more information on psoriasis the National Psoriasis Foundation is an excellent source.