What is Psoriasis- Robin Lewallen, M.D. FAAD

Psoriasis is one of the most common skin conditions affecting three to five percent of people worldwide. Most commonly, it presents as red or white scaling areas on the elbows, knees, belly button, or scalp. The rash from psoriasis is commonly itchy but may become painful or bleed in some patients. For most people, the skin growth cycle lasts 28 days; however for psoriasis patients the growth rate is increased and can take between three to five days. As a result, the skin cells accumulate (instead of shedding) and form thick red and white areas. 

 

While the skin is the most common organ impacted by psoriasis, between 25 and 33% of patients can also develop psoriatic arthritis which is a degenerative inflammatory condition of the joints. Psoriasis has also been associated with dementia, heart disease, inflammatory bowel disease, diabetes and obesity or metabolic syndrome. Previously, psoriasis was thought to be a disorder of the skin cells, however, it is actually a complex process that involves dysregulation of the normal immune system function. 

 

Genetics does play a role in the formation of psoriasis with around 10% of psoriasis patients having a known relative with the disease. There are also identified genetic mutations seen in some psoriasis patients. Certain triggers can induce or flare psoriasis such as infection, certain medications, stress, injury or trauma. 

 

There are multiple psoriasis subtypes including plaque psoriasis, pustular psoriasis, guttate psoriasis, scalp psoriasis, and inverse psoriasis. Scalp psoriasis can look similar to dandruff. Guttate psoriasis is often associated with streptococcal infection and appears as numerous small coin shaped rough pink areas all over the body. Inverse psoriasis usually involves the armpits, skin under the breasts, genitals, or folds near the groin and buttocks. 

 

Treatments for this condition are varied and tailored specifically for each patient. At Newport Beach Dermatology and Plastic Surgery we utilize topical medicines, light treatments (ultraviolet light and lasers), and systemic medicines. Topical treatments include steroid creams, Vitamin A treatments, and Vitamin D treatments.  Phototherapy treatments may be recommended  by using a full-body or hand-and-foot unit. Finally, systemic medications (oral or injectable) include apremilast, methotrexate, cyclosporine, oral retinoids such as acitretin, and the newest medicines that combat psoriasis known as biologics. 

 

A customized treatment regimen by our team can produce almost completely clear skin even in the most severe cases of psoriasis. 

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