Psoriasis

Psoriasis is a common inflammatory skin condition that affects over 7 million people in the US. Psoriasis is not contagious, so those with it do not pose a health risk to other people.

What causes psoriasis?
It is an autoimmune disease, meaning the body’s own immune system is sending out faulty signals. This causes an increase in the growth cycle of skin cells, which causes the cells to pile up and form the psoriatic lesions.

Who gets psoriasis?
There is some genetic link to psoriasis, so if you have a blood relative with the disease your chances of having psoriasis are increased. It can occur in any age, but most commonly it begins before 35.

Plaque psoriasis on wrist.

Plaque psoriasis in a typical distribution on elbows.

What does psoriasis look like?
There are multiple variations of psoriasis and sometimes more than one type can be present simultaneously.

• Plaque Psoriasis: This is the most common form of psoriasis, affecting 80-90% of those with psoriasis. You will see well defined raised red skin with white scales. It often occurs on the scalp, elbows, knees and trunk, but can be anywhere.
• Guttate Psoriasis: Small red scaly dots and patches throughout the body. It is often seen after a strep infection.
• Inverse Psoriasis: Smooth dry patches that are found in the skin folds under the arms, in the groin and under the breasts. This is often misdiagnosed as a yeast infection, as the appearance can be very similar.
• Pustular Psoriasis: Small blisters filled with clear fluid surrounded by red skin. This is not seen often, but can be very debilitating, especially when the blisters are on the palms of the hands or soles of the feet.
• Erythrodermic Psoriasis: Extremely red skin that looks like a bad sunburn covering much of the body. Oftentimes patients are very ill with this type of psoriasis and may require hospitalization.
• Psoriatic Arthritis: Between 10-30% of psoriasis patients will develop psoriatic arthritis within 10 years of the onset of psoriasis. This causes the joints to become stiff, swollen and painful.

Plaque psoriasis on knee.

What should I expect if I have psoriasis?
Psoriasis is a chronic, long-term disease with periods of remission and flares. You will most likely need to be on long-term medications. There is currently no cure for psoriasis, but newer medications make the long-term management of the disease much easier. There are several trigger factors that may cause flares in your condition. The more common triggers are infections, stress, injury, hormones, smoking, alcohol, seasonal changes, and NSAIDs.

What can I do if I have psoriasis?
It is important to see your dermatologist on a regular basis, especially during times of flare. There are many treatment options available, based on the severity of your disease. These range from topical creams, solutions, gels and ointments, oral steroids, light therapy, PUVA, methotrexate, and oral immunomodulators and biologics which cause the immune system to either stop or ignore the faulty signals being sent out.