What is Psoriasis?
Psoriasis is a chronic non-contagious inflammatory skin disorder that is characterized by scaling. Scaling occurs when cells in the epidermis form too quickly and pile up on the surface of the skin. Psoriasis appears most commonly on the elbows, scalp, lower back, palms, soles, armpits, genitals and knees. Psoriasis can also affect the toenails and fingernails.

Psoriasis vulgaris is the most common form of this skin disorder with symptoms of red plaques (patches of thick raised skin) with silvery scales. Other types include pustular psoriasis (with pus filled bumps); erythrodermic psoriasis (red scaly areas usually involving the entire body); guttate psoriasis (characterized by red, tear drop-like spots); and inverse psoriasis (there are smooth red plaques in the skin folds). Psoriatic arthritis (a painful form of arthritis affecting fingers, toes and spine) precedes or follows psoriasis of the skin in one in ten people.
 
Symptoms and Diagnosis
The onset of psoriasis varies widely and lesions range from small patches of dandruff-like scaling to major eruptions covering large areas of skin. Moderate to severe cases lead to painful cracking and splitting of the skin. Other complications can include itching, bleeding, soreness, and aching joints. As with many chronic skin disorders widespread psoriasis often causes emotional stress. It affects women and men equally and occurs in varying degrees throughout an effected person’s life.
An examination by a physician is needed to diagnose psoriasis which in addition to a visual check of the skin may involve a skin biopsy (painless procedure which takes a small sample from a lesion and examines it under a microscope). This will also serve to distinguish the disorder from other similar skin disorders such as dermatitis.

Traditional Medical Skin Care Treatments

Medical treatment is based on the type of psoriasis, its severity, the skin areas involved and how a person responds to initial treatment. Bath treatments and skin care moisturizers are soothing but usually must be combined with more potent remedies. Prescription treatments should be switched periodically as persons become resistant to them or experience adverse reactions.

Topical skin care treatments for psoriasis include corticosteroid creams, lotions, and ointments; synthetic forms of vitamin D3; coal tar; anthralin; topical retinoids; and salicylic acid. The potential side effects of these treatments must be considered for each individual. Long term use of corticosteroids can lead to thinning of the skin and dilated blood vessels. As is the problem with many types of treatments for care of skin with psoriasis the long term use of corticosteroid can lead to the disorder becoming resistant to treatment. Topical retinoids can be irritating to the skin, and women of childbearing age should use them cautiously and discontinue use if they are pregnant or breast-feeding.

If topical skin care treatments do not work, phototherapy (light treatment) is usually tried. Ultraviolet light slows the rapid growth of skin cells and is used when psoriasis has not responded to topical skin care treatments or is extensive. Ultraviolet B (UVB) is usually used to treat psoriasis. The drug PUVA (psoralen plus ultraviolet A) is also used. Treatment with UVB light is considered safer than PUVA. Long-term use of PUVA is associated with an increased risk of skin cancer. Treatments are usually given two to three times a week for a 2 to 3 month period.

New Psoriasis Skin Care Treatments
In the past two years science has revealed new information regarding the cause of psoriasis and as a result new skin care treatments are available and more are being studied. Where past treatments for psoriasis have controlled symptoms these new treatments called biologics are designed to treat the underlying cause of the condition which have been identified as a malfunction in the immune system. T cells within the immune system cause the inflammation in the skin that leads to the appearance of the plaques and scales that are characteristic of psoriasis.

Biologics have to be administered by injection and this is a long term treatment. So far it appears the treatment is well tolerated and has very minimal if any side effects. Long term use of this new treatment is still being studied for possible side effects or intolerance. Biologics can also be combined with other therapies and treatments for care of skin with psoriasis. It sounds promising and would be worth discussing this new therapy as a possible treatment with a physician. The information from the medical community so far on this new treatment looks very promising.

It is clear that psoriasis is a long-term skin disorder that will require a diligent commitment to skin care and treatment even when in remission.


These statements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure or prevent any disease.