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Medical Dermatology

Psoriasis

What is psoriasis?

Psoriasis is a serious chronic, multisystem inflammatory disease with that runs in families. It is an autoimmune genetic disease of the skin and joints that effects about 8 million Americans of both sexes. It usually develops between ages 15 and 35, but about 15% of cases develop in children before age 10. It is not contagious but does run in families.

About 30% of people with psoriasis develop psoriatic arthritis, an inflammatory form of arthritis that causes swollen, stiff and painful joints, nail changes and severe fatigue. Studies report that delaying treatment for psoriatic arthritis can cause permanent joint damage.  Oral medications and biologic drugs that target the immune system can fight the symptoms and slow joint damage.

What are the symptoms of psoriasis?

On the skin it causes plaques of red, raised, scaly skin typically on the elbows, knees, scalp. Psoriasis can affect large areas of the skin, and last for long periods as the result of an accumulation of dead skin cells that appear as thick, silvery scales. It is itchy, dry and inflamed skin. Plaques are commonly found on the arms, legs, scalp, trunk, buttocks and other areas. Symptoms can remit and return or flare up caused by triggers.

However, clinical symptoms alone do not account for the devastation of psoriasis on a person’s quality of life, particularly when a child is affected. A common source of embarrassment is the belief that psoriasis is contagious which can cause emotional distress and social avoidance. Physical limitations such as cracking skin on the hands and feet can interfere with the activities of daily life, the ability to play sports and work.

What causes psoriasis?

Numerous factors contribute to the onset and aggravation of psoriasis including genetics, environmental risk factors, infections, lifestyle and medications. Scientists believe that at least 10% of people suffer from inherited genes that trigger psoriasis, but only about 2-3% of Americans develop the disease. Instead, psoriasis develops in people with a genetic tendency that is triggered which activates the disease.

Triggers are different for each person. Common triggers that cause flare ups include stress, medications, injury, infection that activates the immune system, allergies, diet and even weather. There are therapies to help with psoriasis, but there is no cure.

What diseases are associated with psoriasis?

Psoriasis has been linked with other serious medical conditions that are caused by inflammation including heart disease, multiple sclerosis, polycystic ovarian disease, metabolic syndrome, diabetes, depression, cancer and more. In early 2019 new guidelines were released for the treatment of moderate to severe psoriasis that include the recommendation that your dermatologist should work with our primary care physician to rule out comorbidities and treat those that are confirmed.

How is psoriasis diagnosed?

A clinical examination is the primary way to diagnose psoriasis. The hallmark symptom is a plaque of symmetric red patches of skin with a sliver scale that is itchy and painful. Dr. Saini will look for these plaques, nail changes and possible joint involvement. She will also rule out other skin diseases such as contact dermatitis. She will determine the severity of your condition which will help guide her in your treatment.

What are the treatment options?

Psoriasis can be successfully managed but finding the right combination of treatments require trial and error.  Topical treatments are the standard of care for the treatment of mild to moderate disease. When topical treatment provides only limited relief, it may be combined with systemic treatments including phototherapy, and specific oral medications. NY Medical Skin Solutions offers phtototherapy with the phototherapy Biologic therapy is a very potent treatment that targets the immune system for patients with moderate to severe psoriasis who fail to achieve a satisfactory response with traditional systemic drugs. Talk with Dr. Saini about your options.

Contact Dr. Ritu Saini at New York Medical Skin Solutions in New York City. She is a kind and compassionate doctor and a medical expert.


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