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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.

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