Psoriasis

According to the The National Psoriasis Foundation (NPF) 7.5 million people are living with psoriasis in the U.S. and 30 percent will develop psoriatic arthritis.

Psoriasis is a chronic skin condition that dermatologists frequently see in the office. Skin cells turn over every few weeks to allow for new cell development. However, in psoriasis, this process happens too quickly, occurring in days rather than weeks. Thus, there is a build-up of cells resulting in thickened skin.

The cause of psoriasis is not completely known. About a third of people can identify a family member who has psoriasis. There are some known triggers of psoriasis, including strep throat, trauma to the skin, and some medications. However, getting these above mentioned triggers does not necessarily mean you will get psoriasis in the future.

There are several types of psoriasis. A few examples include:

1. Plaque psoriasis: This is the most common type. This appears as thick, often red skin, with a silvery-white scale. Common locations are the scalp, elbows, knees, and lower back.

2. Guttate psoriasis: This type is more common in children and young adults. Spots are small and red, and the scale is often not as thick as in plaque psoriasis.

3. Inverse psoriasis: This type of psoriasis occurs in the folds of the skin, such as under the arms and breasts, and in the groin. Patches are red and smooth, and can sometimes look raw in appearance. The initial diagnosis is often a yeast or fungal infection. These infections are more common in these locations, however, they do not respond to typical antifungal medications.

Psoriasis can also be associated with arthritis. This is known as psoriatic arthritis. Although common to occur together, some people can only have the skin involvement of psoriasis, while others can solely have psoriatic arthritis.

With psoriasis, there is excessive inflammation. As a result, people with psoriasis (and psoriatic arthritis) can be at a higher risk for developing diabetes, abnormal cholesterol, and heart disease. Therefore, like many medical conditions, a multidiscipline approach is necessary for medical care. In this case, individuals with psoriasis should be visiting their primary care physician at least annually.

Psoriasis, being a chronic condition, cannot be cured. It can be controlled with monotherapy, but in many cases combination therapy is needed. Topical medications are beneficial for psoriasis limited to one or a few locations of the body. The primary goal is to reduce inflammation. There are various topical medications, thus, seeing your dermatologist is necessary to make for an individualized regimen. For moderate to severe psoriasis, systemic medications are often needed. These medications can be oral or injectable. While these medications can clear the skin, and some even help joints, they are not without side effects. Therefore, a tailored treatment plan is imperative. Light therapy is another treatment option, especially if systemic medications are contraindicated. Light therapy should be done under the care of a dermatologist, due to skin sensitivity, and the increased risk of developing skin cancer. Light therapy, including the use of UVB and UVA light, can increase the risk of skin cancer, thus doing it under the dermatologist’s care will allow for close monitoring as opposed to one getting exposure on his/her own.

Psoriasis is often easy to identify, but due to the chronicity of the condition, and often having a social and emotional impact, one should seek treatment with a dermatologist in order to improve the condition and quality of life.

DWANA SHABAZZ
Dr. Dwana Shabazz received her undergraduate degree at Xavier University of Louisiana and both her medical degree and masters of public health degree at George Washington University. She remained at George Washington University for her internship in Internal Medicine. She then moved to Los Angeles for her Dermatology Residency at King Drew Medical Center/Harbor-UCLA. Dr. Shabazz has been in private practice in the Northern Virginia area since 2006. She opened her own practice, Renascance Dermatology, in 2013. Dr. Shabazz is a Fellow of the American Academy of Dermatology, a Diplomate of the American Board of Dermatology, and a member of the Women’s Dermatologic Society.