Psoriasis is a serious medical condition.
- Although it can be confused with being “just a rash”, it is actually a chronic (long-standing) disease that causes inflammation of the immune system.
- It is not curable, although it is treatable. See a dermatologist if you are concerned.
- Some patients will have periods of spontaneous remission as well.
- In some cases, it can require hospitalization
About 7.5 million people in the United States have psoriasis
- Occurs in all age groups, but more common in adults than in kids.
- You may have a family history.
- May first appear after having a strep infection, such as strep throat.
- No matter how bad it can appear, it is not contagious!
The rash of psoriasis can appear a lot of ways
- 80-90% get what’s called “plaque psoriasis”, which is where you get a thickened reddish area with a silvery-white scale on top.
- These scales often shed like dandruff and cause a lot of embarrassment for patients. Sometimes people refer to the “heartbreak of psoriasis”
- Most common to get psoriasis over elbows, knees, scalp, hands, and feet.
- There is a tendency to worsen in areas that are traumatized (such as bumped, scratched, or rubbed a lot).
- Sometimes it itches, but sometimes it doesn’t.
- Usually is on both sides of the body, not just one side.
About a third of patients with psoriasis will also get arthritis (called psoriatic arthritis).
- This is a chronic inflammation of the joints, which leads to pain, stiffness, and swelling in joints.
- If untreated, can lead to permanent damage to the joints.
- Patients can have decreased range of motion, morning stiffness, and generalized fatigue/tiredness.
- Often involves the hands, and can cause swollen fingers called “sausage digits”
- Can also involve lower back, wrists, knees, and ankles.
- In 85% of patients, psoriasis begins on the skin first, so they should mention to their dermatologist if they develop joint pain.
- They may need to see a joint doctor as well (rheumatologist).
Although it mostly affects the skin and joints, it can affect many areas of the body.
- Can affect fingernails/toenails, the genitals, and inside the mouth.
- Some patients have a type called “inverse psoriasis” where it affects the body creases. This can get confused with fungal or yeast infections.
- Can be associated with other diseases/conditions, including diabetes, cardiovascular disease, and depression.
- Patients with psoriasis need to have their blood pressure, blood sugar, cholesterol/triglycerides, and weight monitored by their primary care physician.
Patients with psoriasis may have higher risks of other diseases as well.
- They have a higher risk of Crohn’s disease and ulcerative colitis (types of inflammatory bowel disease)
- Increased incidence of lymphoma, heart disease, obesity, type 2 diabetes, and metabolic syndrome
- Depression, suicide, smoking, and alcohol consumption are higher in people with psoriasis too, because this condition has a big psychological and emotional impact on patients’ lives
There are a variety of treatment options:
- Topicals are medications that are applied externally to the skin.
Includes creams, ointments, lotions
There are both over-the-counter and prescribed medications.
- Systemics are medications that are given as pills or shots.
May require bloodwork to monitor you
Used for more extensive or bothersome skin disease, or if you have arthritis
- Light therapy,which is also called phototherapy, is done in a doctor’s office in a special light box.
See a board-certified dermatologist if you are wondering if you might have psoriasis.