Psoriasis is a non-contagious, chronic inflammatory skin disease which may have periods of relative remission and flares. Patients with psoriasis have a genetic predisposition for the disease, which develops due to a combination of immune, genetic and environmental factors. Certain cells of the immune system signal the top layer of skin, the epidermis, to grow too quickly and stop shedding properly. This causes the scaly buildup that most commonly affects the skin of the elbows, knees, scalp, lower back, buttocks and penis. The joints are also affected in up to 30% of patients, which can lead to deformity and disability if untreated. Injury to the skin, severe emotional stress, and infections (i.e. strep throat) can lead to a flare of psoriasis. Psoriasis is predominately a disease of adults, but can occur in childhood.
In addition to its physical impact on your skin, psoriasis can also affect your emotional, psychological and social well-being. This visible and lifelong disease may change how you view yourself and interact with others. Patients with psoriasis have higher rates of depression, and organizations such as the National Psoriasis Foundation can offer support.
While there is no cure for psoriasis, there are fantastic treatments which can control the disease. 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 D or vitamin A derived topical treatments, and salicylic acid or coal tar preparations. Moderate cases usually respond to combination therapy with topicals and light treatments. More severe cases and those with associated arthritis may need systemic therapy, which may include pills or injections. Oral therapies include methotrexate, cyclosporine, or Soriatane®. These treatments are not without risk and must be monitored with lab work. Your dermatologist will order this lab work to monitor these drugs.
Newer injectable medications called biologics specifically target the immune system, and include Stelara®, Enbrel®, 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 and require pre-treatment blood work, tuberculosis testing, and periodic monitoring during treatment. They are effective for both psoriatic skin disease and psoriatic arthritis.
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