Psoriasis is a noncontagious, lifelong skin disease which may have periods of relative remission and flares (similar to asthma). As many as 1/50 patients has psoriasis. Higher risk for developing psoriasis is associated with a family history of the disease, use of systemic steroid medications, and high stress levels. Psoriasis can also occur after a strep infection.
The most common form, plaque psoriasis, appears as raised, red patches or lesions covered with a silvery white buildup of dead skin cells, called scale. It is often itchy and may affect skin anywhere on the body, including the nails.
Psoriasis may also be associated with joint involvement—and this should be assessed during your visit. Psoriatic arthritis may lead to joint deformity if left untreated over time.
Treatment of psoriasis depends upon the extent and severity of your disease as well as the location of the plaques. Mild to moderate psoriasis may be treated with topical steroids, vitamin A-derived topical treatments, and salicylic acid or coal tar preparations. Moderate cases often respond to a combination of topical medications and narrowband UVB phototherapy (performed in our office under physician supervised care).
Severe psoriasis and psoriatic arthritis may be treated with methotrexate, cyclosporine, or Soriatane®. Each of these drugs carries systemic risks and they must be monitored with labwork. It is imperative that you obtain the necessary labwork to monitor these drugs as liver damage, kidney damage or even death can occur if not properly managed. Our staff provides limited prescriptions of these meds and will not refill them unless the labwork has been completed and is within normal limits.
Newer medications include the biologic medications such as Enbrel®, Otezla®, Stelara®, Cosentyx®, Humira® and Remicade®. These medications work to suppress very specific inflammatory mediators (rather than suppressing the entire immune system). They are either injections or intravenous medications. They effective for both psoriatic skin disease and psoriatic arthritis.