Psoriasis

Psoriasis Overview:

Psoriasis is a chronic autoimmune skin condition affecting about 8 million Americans. It is characterized by the rapid buildup of skin cells, resulting in thick, red patches with silvery scales.  Psoriasis is an inflammatory disease that doesn’t just affect the skin.  Research shows that even mild disease may have significant inflammation in the body.  People with psoriasis may also experience other health conditions.  One in three people with psoriasis may also develop psoriatic arthritis. Signs of PsA include swelling, stiffness, and pain in the joints and areas surrounding the joints.

Types of Psoriasis:

There are five types of psoriasis:

Plaque Psoriasis: Plaque psoriasis is the most common form of psoriasis affecting about 80-90 percent of people with psoriasis. Plaque psoriasis appears as inflamed raised scaly plaques.

Guttate Psoriasis: Often develops suddenly after an infection and appears as small, red and round spots.

Pustular Psoriasis: Pustular psoriasis causes pustules, white, pus-filled, painful bumps surrounded by red, inflamed skin.

Inverse Psoriasis: Appears as bright red or dark lesions in skin folds, such as armpits, breast folds and groin.  

Erythrodermic Psoriasis: A rare type of psoriasis that appears as a red, peeling rash that can affect your body temperature and fluid balance. 

You can have more than one form of psoriasis on your body at a time.  

Treatments

Topical Therapies

Topical treatments include creams, ointments, foams and sprays applied directly to the skin and can improve itching and inflammation.  Some commonly prescribed topicals for psoriasis are:

Corticosteroids: Anti-inflammatory topicals that reduce swelling and redness.

Vitamin D Analogs: Products like calcipotriene help slow skin growth and can reduce plaques. 

Retinoids: Topical retinoids, such as tazarotene, help normalize the skin cell life cycle.

Advanced Topicals: Medications like Vtama and Zoryve are non-steroidal treatments that target inflammation through different mechanisms than other topicals and can be used long-term and in sensitive skin areas. 

Phototherapy

Phototherapy involves exposing the skin to ultraviolet light under medical supervision. 

Narrowband UVB Therapy: This treatment uses ultraviolet B light which is particularly effective in treating psoriasis. 

Systemic Medications

Oral systemics moderate-to-severe-psoriasis and psoriatic arthritis, systemic medications influence the entire body.

Methotrexate: An immunosuppressant that slows cell turnover and reduces inflammation. 

Cyclosporine: A potent immunosuppressant that works quickly, but typically only used short-term.

Acitretin: A retinoid that helps normalize the speed of skin cell growth.

Otezla: An oral medication that treats the inflammatory process associated with psoriasis and is not immunosuppressive. 

Sotyktu: An oral targeted medication that reduces the inflammatory response in psoriasis.  

Biologics

Biologics are injectable medications that target specific parts of the immune system and are used for moderate-to-severe psoriasis.  They have revolutionized the treatment of psoriasis and psoriatic arthritis. 

• Enbrel 
• Remicade
• Humira
• Stelara
• Cosentyx
• Taltz
• Siliq
• Tremfya
• Skyrizi

Lifestyle Management 

In addition to medical treatments, lifestyle changes can help manage psoriasis.

Diet: Certain foods may trigger or exacerbate psoriasis such as red meat and processed meats, dairy products, fatty foods, and alcohol.

Stress reduction: Techniques such as regular exercise, yoga and meditation may alleviate stress, which can trigger flare-ups.

Moisturizers: Keeping your skin hydrated can help reduce dryness and scaling.

References

National Psoriasis Foundation
https://www.psoriasis.org/