What is psoriasis?

If you have psoriasis then you have a common skin condition where your skin develops areas that become thick covered with silvery scales. You are not alone. Millions across the United States have psoriasis, and for the most part, it is chronic and will continue for years. It’s appearance can be quite distressing.

What are the causes and triggers?

Your psoriasis can start in several different ways. For most, it is an inherited condition. But it isn’t passed on in a simple, direct way like hair color, but involves multiple genes. Therefore, it’s not always clear who you inherit it from. Inherited psoriasis usually starts in older childhood or as a young adult. Sometimes, especially in children, a virus or strep throat triggers brief attacks of tiny spots of psoriasis.

For those that are middle-aged, a non-hereditary type of psoriasis develops. This type changes more rapidly than the inherited form, varying in how much skin is involved more unpredictably. Most types have a tendency to come and go, with varied intensity over time.

There are several things that can trigger a flare-up: changes in climate (which we definitely understand in New Hampshire), infections, stress, excess alcohol and a drug-related rash and dry skin.

In addition, certain medications can trigger a flare up weeks to months after starting them. Those include non-steroidal anti-inflammatory drugs (Indocin, Advil, Feldene, and others), blood pressure (beta-blockers such as Tenormin, Inderal), oral steroids such as Prednisone, or medications for depression.

The worst instances of psoriasis tend to occur in those with a disordered immune system (be it for cancer, AIDS or autoimmune disease). Psoriasis areas are made worse by scratching and minor skin injuries or irritations. Your psoriasis may itch or burn and most often occurs over the elbows, knees, scalp, lower back, and palms or soles of the feet. The skin may split or crack in areas that bend.

What are the forms of psoriasis?

Psoriasis can take several forms. The most common form of psoriasis is called plaque psoriasis. It appears as reddened areas a few inches across covere by silvery scales.

Other types of psoriasis are inverse, which occurs in body folds. These inverse patterns (shiny, red patches in areas of friction such as the folds of skin in the groin, armpits or under the breasts), are pustular (blisters of noninfectious pus on red skin), or “erythrodermic” (reddening and scaling of most of the skin). Pustular psoriasis may require hospitalization if there are large areas of invovlement, and guttate psoriasis is that in which the initial onset often follows a group A Strep infection. Erythrodermic is rarer and covers large body areas.

In about 10 percent of cases, psoriasis may affects some of the joints causing discomfort and restricted motion, and even distortion. This is called “psoriatic arthritis.” It often affects only a few fingertips, but it can be severe and widespread. It also may affect the fingernails, toenails and the mucous membranes lining the genitalia and mouth.

What are the treatment options?

Regardless of how it arrives and how it your case looks and feels, you want to feel and look better. This is where the caregivers at Dermatology and Skin Health in Dover come in.

Treatment is based on the severity of the disease and its responsiveness to prior treatments. The lowest level of treatment is topical medicine applied to the skin, the next level involves treatments with ultraviolet light (phototherapy) or Excimer laser (see Excimer laser) and finally, taking medicines internally. Treatments from each level are often combined, or switched around every 12 to 24 months to reduce resistance and adverse reactions.

A treatment that is effective in one person might not work for another. Both trial-and-error and personal preferences often guide treatment. Additionally, over time, psoriasis tends to resist its treatments. The locations, size and amount of psoriasis, prior treatments, and the specific form of the disorder are factored into treatment decisions.

Request an appointment

Call Dermatology and Skin Health, one of the leading dermatologists in New Hampshire and Massachusetts, to schedule an appointment today to help alleviate your case of psoriasis. Caring professionals are waiting to help you. To find out which treatment option will work for you, request a consultation online or give us a call (603) 742-5556 (Dover & Newington), (978) 525-0100 (Peabody), (603) 965-3551 (Londonderry), or (603) 742-5556 (Bedford).

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