Psoriasis

Psoriasis represents scaly plaques on the skin that occur from inflammatory dysfunction of the skin. It is not contagious. At times, it may occur with psoriatic arthritis. Therefore, it is important to let your dermatologist and or general doctor know if you have any joint pain or stiffness, particularly if it is worse in the morning.

Who gets psoriasis ?

Anyone from babies to older adults can get psoriasis.

How do I know if I have it ?

It often presents as well demarcated papules or plaques, with silver scale, on the knees or elbows classically. It may also be in the scalp, belly button or upper buttock. Still, if wide spread, it may be on any part of the body. There is also a form in which the lesions look like small tear drops on the trunk (guttate psoriasis), classically related to a recent strep infection and another form in which the plaques are in the folds of the body (intertriginous psoriasis).

How can I treat it ?

There are now many treatments for psoriasis, including topical medicines, light therapy, pills (old and new), as well as injectable medicines (“biologics”). Still, the first line of treatment for mild disease is topical steroids, along with topical vitamin D analogues or calcineurin inhibitors, and in some cases topical retinoids. Sun light generally helps psoriasis and one of the safest treatments in addition to topical therapy is in office light therapy, narrow band UVB therapy (usually done for a few minutes 2-3 times weekly). In certain cases, such as severe scalp psoriasis, steroid scalp injections may be helpful. If there is more than 5% of the total body surface area involved or involvement of areas that cause significant discomfort, systemic therapies such as oral medicines and biologics may be considered. Recent studies have also found psoriasis to be associated with early heart disease, diabetes, and other chronic diseases. Therefore, it is important to eat a balanced diet and exercise regularly.

How can I prevent it ?

It may be difficult to prevent psoriasis at this time. However, good skin care, such as avoiding irritating and fragrant products and using frequent moisturizer will help keep the skin healthier and less itchy. Also, oral supplementation, particularly with vitamin D, but also folic acid and fish oil may also help ones psoriasis. Some patients try a glutten free diet for about 1 month to see if it makes a difference and if not go back to a regular diet. Preventing trauma to the skin can also be helpful, as psoriasis often forms in areas of traumatized skin. Additionally, it may be helpful to treat lesions in a timely fashion to stop the skin from getting further inflamed.

When should I see a dermatologist about it ?

You can see a dermatologist as soon as you know you have psoriasis to confirm the diagnosis and gain advice on treatment options for optimal control.

Additional Resources:
National Psoriasis Foundation
American Academy of Dermatology