Psoriasis is a common long-lasting inflammatory skin disease that causes overgrowth of the top layer of skin. The areas affected become thick, red, and scaly, often with a well-demarcated edge from adjacent normal skin, and these areas are called plaques. Plaques can appear anywhere on the skin, but are more common on the knees, elbows, lower back, and the scalp. This skin condition can be somewhat itchy, and repeated scratching can cause plaques to become thickened and more red. Sometimes areas of skin involved with psoriasis can join together and become very large or cover most of the body surface. Sometimes nails can become involved causing pitting, crumbling, or loss of nails.
Psoriasis can begin at any age, but it usually appears between 15 and 30 years of age with about 75% by age 40. It is not contagious and cannot be spread by touch. There is a hereditary component, and people who get psoriasis usually have one or more person in their family who has the disease. Many believe that psoriasis begins after experiencing a trigger such as a stressful life event, strep throat, or starting to take certain medications. New plaques can appear in areas of a cut, scratch, or bad sunburn.
There are several different types of psoriasis, the most common being plaque type, guttate type, inverse type, pustular type, and erythrodermic type. Sometimes people may have more than one type of psoriasis. Plaque type is the most common form of the disease classically with well-demarcated, red, raised areas of skin with a silvery scale. Guttate psoriasis usually appears as numerous small round red spots, often appearing after an illness such as strep throat. Inverse psoriasis is a form of the disease that affects areas where skin touches skin such as the groin and armpits. Pustular psoriasis can cause red, swollen skin with little pus-filled bumps, usually on the palms and soles. Erythrodermic psoriasis can cause the entire body to turn bright red, can cause the body to be too hot or too cold, can be intensely itchy or painful, and can cause a fast heartbeat and dehydration. In some cases, this type may be life threatening.
Your dermatologist will often be able to diagnose this disease by looking at your skin, but sometimes a skin biopsy may be performed in the office to confirm or aid in the diagnosis. It is a long-lasting disease than cannot be cured, but treatment can calm the symptoms and sometimes completely or almost completely clear evidence of the disease. Medicated creams or ointments are often prescribed to be used on areas of skin involved with the disease. If large areas of skin are involved or if there is concern for psoriatic arthritis, medications that suppress parts of the immune system may be prescribed. These might include older agents such as methotrexate or cyclosporine, but your dermatologist may prescribe a newer targeted treatment called a biologic, which is an injectable medication that specifically targets inflammation that causes plaque formation.
We are excited about the many recent advances that have been made in understanding and treating psoriasis. At Summit Dermatology, we look forward to helping provide you with the appropriate treatment to get your skin as clear as possible. Even if you are fairly well controlled on a certain medication but continue to have some areas of skin that won’t clear, there may be another option available to you now that could provide even more control or potentially clear your skin completely.