Psoriasis affects people of all ages, with approximately 7.5 million Americans currently suffering with the disorder. Although it is not contagious, it frequently runs in families and can develop at any point in life. While there is no cure for psoriasis, prompt and aggressive management of this disease is imperative to establish long term control while minimizing the potential for serious complications.
What is psoriasis?
Psoriasis is a chronic inflammatory condition that affects mainly skin and nails; however, 40 percent of patients experience joint involvement that can result in arthritis. In the skin, it is characterized by abnormally rapid growth of cells deep in the dermis, causing layers of epidermis to rapidly build up into red, thick patches with a silvery white, scaly surface. These patches can be any size, occur anywhere on the body and appear suddenly or develop slowly over time. Psoriasis symptoms may include:
- Significant itching
- Joint pain, stiffness or aching (psoriatic arthritis), especially in small joints of hands and feet, ranging from occasional stiffness in the morning to severe swelling and chronic pain
- Nail changes, including prominent thickening, yellow spots, dents (pits) on the nail surface and lifting of the nail from the nail bed
- Considerable emotional stress due to its physical appearance
- Appears in areas of mild trauma such as scratches, burns or scrapes
How is psoriasis treated?
Currently, there is no cure for psoriasis. However, in the last few decades significant advances in available therapeutic options have made this disease highly manageable, even in the most severe cases.
Because psoriasis can manifest along a wide spectrum of severity, from very mild almost imperceptible patches to full body and joint flares, treatment should be tailored to maximize therapeutic benefit while minimizing side effects. The mainstay of psoriasis treatment is a topical prescription agent, especially steroids. In addition, high concentration salicylic acid preparations, vitamin D analogues and retinoids can be beneficial in many cases.
Light therapy, or the use of ultraviolet light in several different forms, is another therapeutic option, especially for widespread skin involvement or persistent areas not responding to topical agents. A board certified dermatologist exposes the skin to specific wavelengths of ultraviolet light over a period of weeks to months. Narrow band UVB (nbUVB) is a particularly effective treatment that exposes the skin to a highly specific band of light that maximizes the therapeutic benefit of phototherapy while minimizing the long-term side effects of UV exposure to the skin.
Treating moderate to severe psoriasis usually involves a combination of treatments including a fairly new class of medications called biologic drugs. Biologic drugs, or “biologics,” are given by intramuscular injection or less commonly intravenous (IV) infusion. Differing from the traditional systemic drugs that affect the entire immune system, biologics target the specific parts of the immune system that create psoriasis.