Loading...
Psoriasis 2017-06-07T15:45:39+00:00

Psoriasis

Psoriasis is a chronic inflammatory skin condition.

It is typically characterised by clearly defined, red and scaly plaques or areas of thickened skin.

Though psoriasis can affect any area of the body, the most common sites are the elbows, knees and scalp.

Who is at risk?

Psoriasis can affect men and women and strike at any age, although there does seem to be greater frequency of onset between the ages of 15 and 25 and the ages of 50 and 60.
Psoriasis tends to be a lifelong issue with periods of greater and lesser severity.

Causes

Psoriasis is caused by the combination of a number of factors including genetics, which often also influences the type of psoriasis and response to specific treatments.

Can it be prevented?

Psoriasis cannot be prevented, particularly where there is a genetic predisposition. However, proper skin care, healthy living, and following the advice or your physician or dermatologist, can reduce both the severity and frequency of incidents.

Among the contributing factors of psoriasis are

  • Infection
  • Skin-related injuries including cuts and burns
  • Obesity
  • Smoking
  • Excessive alcohol
  • Stress
  • Certain medications

People with psoriasis are also more frequently affected by specific health conditions including

  • Inflammatory bowel disease
  • Inflammatory arthritis
  • Inflammation of the eye
  • Cardiovascular disease
Psoriasis word cloud concept

Types of psoriasis

There are several different types of psoriasis depending on the time of onset, the location and the severity. Each type has different expectations for response to treatment. Some of its forms include:

Chronic plaque psoriasis. This form of psoriasis is most often seen on scalp, elbows, knees and the lower back. Flexural (inverse) psoriasis generally affects folds in the skin and genital area and is characterized by smooth, well-defined patches.

Sebopsoriasis can affect the scalp, face, ears or chest and is an overlap of seborrheic dermatitis and psoriasis.

Palmoplantar psoriasis can affect the palms or soles of the feet, often resulting in painful fissures.

Nail psoriasis is often associated with inflammatory arthritis and generally presents as pitting, yellowing or ridging of the nails.

Treatments described

Maintaining good health can be a key factor in long-term maintenance of psoriasis. This includes avoiding smoking, excessive alcohol intake and maintenance of a healthy weight. Psoriasis is generally considered a difficult condition to treat, simply because no one treatment works in every case. Your dermatologist may have to test different therapies to find the right method for you. Specific treatments for the condition include:

Topical therapy

Mild or localized psoriasis is often treated with a topical cream. Depending on the site and severity, options may include an emollient, coal tar preparation, salicylic acid, vitamin D or topical corticosteroids.

Phototherapy

Phototherapy is the use of artificial, ultraviolet light that can be used to treat a variety of skin conditions.  Most of the time psoriasis is improved with phototherapy. The most common type of phototherapy is narrow band ultraviolet B light. It can be administered as a whole body treatment or treatment localized to hands and feet. The treatments are usually done three times per week for 12 weeks.

  • Advantages:
    • Can be very effective
    • No chemicals
    • Quick
    • Can be used in pregnancy
    • Covered by Medicare
  • Disadvantages:
    • May not work
    • May need to travel for treatment
    • Risk of burns and skin cancer (very uncommon)

Systemic  medications

There are a variety of prescription medications that are available to treat psoriasis, depending on the type and severity.

  • Methotrexate
  • Soriatane
  • Cyclosporine

Biologic therapies

Biologic therapies are new medications that can be very effective to control psoriasis. They reduce inflammation by modulating immune system.

Medication Brand name Route of administration Frequency of injections
Infliximab Remicade IV Every 8weeks after loading
Etanercept Enbrel SubQ Every week after loading
Adalimumab Humira SubQ Every 2 weeks after loading
Ustekinumab Stelara SubQ Every 3 mo after loading
Secukinumab Cosentix SubQ Every 4 weeks after loading

“Fabulous care and attention was taken by both Dr. Turchin and her staff. They were incredibly caring and attentive. Most professional and kind.”
“Excellent communication skills, very professional manner and kind. Staff are well trained and helpful. I highly recommend this clinic. “
Barbara Arseneau