Psoriasis is a common immune disorder in which skin cells reproduce quickly and accumulate to form thickened patches or plaques that are red and scaly. Genetics and environment can both contribute to the development of psoriasis, with up to 70% of patients having a family history of the disease.
Psoriasis can appear at any age, with a third of patients having their first occurrence before age 20. The most common areas affected are the scalp, elbows, knees, and trunk. Psoriasis is a chronic condition that can sometimes be unpredictable; it is not uncommon to have periods of remission or exacerbation of this skin disorder, as it can wax and wane over time.
There are a few types of psoriasis, defined below:
- Plaque- Classic lesion consisting of red, circular plaques with a stuck on silvery-white scale. May start as small pinpoint lesions that join together to form a larger one. Removal of the scale results in pinpoint sites of bleeding.
- Guttate: “Drop-Like” lesions that are small round or oval plaques on the trunk and extremities, often appearing in childhood or young adulthood. Can be triggered by Group A Strep Infections.
- Scalp Psoriasis: Can appear as classic plaque psoriasis or with softer salmon colored patches termed Sebopsoriasis. Areas can extend onto the forehead, around the ears, and on the neck.
- Inverse Psoriasis: Affects areas of the groin, armpits, under the breasts, and intergluteal areas. Areas appear bright red and are more smooth and shiny.
- Pustular Psoriasis: Often seen in adults this commonly affects the palms and soles of hands and feet. Pustular psoriasis can affect other parts of the body as well. Lesions are typically white (non-infectious) blisters surrounded by red skin.
- Psoriatic arthritis: When joints of psoriatic patients become red, tender, and swollen.
Injury to the skin may worsen psoriasis. This is called the Koebner Phenomenon. Examples of types of injury- getting sunburnt, worsening of pre-existing skin diseases (Eczema), trauma (scuffs and scrapes), and even friction from tight garments.
Treatment: There are a variety of topical, systemic (oral or injectable) and UV light treatments for psoriasis.
- Topical Steroids: First Line therapy for use on the trunk and extremities. Apply to affected areas twice daily (BID)
- Tar: Can be applied overnight topically(Psoriasin), or in the form of a bath (Cutar or Balnetar)
- Tarazotene Gel: 0.05% and 0.1% gel/cream
- Intralesional Steroid Injections:
- UV Light:
- Systemic Therapy: