Psoriasis is a chronic skin disorder characterized by raised lesions with silvery-white coating that most often occur on the scalp, elbows knees and lower back.
It can range from a very mild, hardly noticeable rash to a severe eruption that covers large areas of the body. In some patients, psoriasis causes nail changes and joint pain (psoriatic arthritis). Psoriasis affects 2% of people and is not contagious, but may be inherited.
The cause of psoriasis is not fully understood, but has to do with a hyperactivity of white blood cells (T-cells) that trigger inflammation in the skin and cause increased turnover. The skin starts to “pile up” in certain areas resulting in the lesions of psoriasis. Flares of psoriasis may occur in the winter, during times of stress, after trauma to the skin (this is called a Koebner Phenomenon), after an infection like strep throat and with certain drugs such as beta-blockers, lithium and anti-seizure medications.
Treatment of psoriasis depends on a patient’s overall health, presence of joint pain and severity of skin involvement. In mild cases, topical corticosteroids and vitamin D analogues are prescribed. Medically monitored and controlled ultraviolet light phototherapy can be helpful for those with more extensive disease. For some patients an immunosuppressant drug or oral retinoids are an option. Those with associated joint disease may benefit from an anti-cancer drug that also works to treat psoriasis, methotrexate.
Psoriasis is not curable, but is controllable. No single approach works for everyone. Therapy is individually tailored and based on your health, goals and a careful assessment of potential risks and benefits of treatment.