What is it?
Psoriasis is a frequently recurring skin condition associated with a rheumatic disease or autoimmune disorder. Normal skin cells turn over at a certain rate. In psoriasis, the skin turns over 10 times more rapidly causing the epidermis to hyperproliferate or become thicker. There is no cure but the symptoms can be controlled. It often starts in adolescence or young adulthood (16-20 years) or with a smaller peak between the ages of 50 and 60. Caucasians are most often affected. Those at highest risk of coming down with the disease are people with a family history of psoriasis (5-10%) and those with HLA antigens in their blood. Living in cold climates or having emotional stress also increases the risk. Diet does not affect psoriasis.

Signs and Symptoms:
• Red, raised patches of skin with silvery-white scales. If the scales are picked off, small pin-points spots of bleeding known as   Auspitz's sign appear.

• Skin lesions have a predilection for knees, elbows, scalp, intergluteal cleft (between buttocks), palms of hands, and soles of   feet. Psoriasis also has a predilection for sites of trauma. This is called Koebner's phenomenon. This phenomena is not   entirely unique to psoriasis and can occur in other skin disorders.

• Nails may exhibit pinhead-sized pits, peeling, or a red-brown discoloration resembling spots of oil.

• Lesions may itch.

• Joint pain in approximately 7% patients with psoriasis.

• Some lesions may be pustular in nature.

• Good news for pregnant women - disease severity often decreases during pregnancy.

• Diagnosis is usually based on the presence of typical skin lesions. A skin biopsy may also be taken.

Treatment
• Psoriasis is not curable but it is controllable.

• Warm climates help decrease the severity of the disease.

• Keep your skin clean. Avoid breaks in the skin

• Oatmeal baths help loosen scales; add approximately 1 cup per tub.

• Do NOT pick at lesions or scrub them as this will make them WORSE.

• Keep skin from drying out by using waterless cleansers and moisturizers. There are shampoos that contain coal tar or   cortisones.

• Topical cortisones are the mainstay of localized psoriasis treatment.

• Antihistamines help decrease itching. Antibiotics may be needed for secondary bacterial infection.

• More generalized psoriasis may need medications such as methotrexate, cyclosporin, or acitretin (Soriatane)

• Newer medications called biologics are immune-modulating medications that stabilize the abnormal immune response that   causes psoriasis.

• If your physician suggests, exposure of lesions to sunlight may help. Similarly, your doctor may prescribe a regimen of   exposure to a controlled amount of ultraviolet light along with a special medication to increase sensitivity of the skin to   ultraviolet light. This is called PUVA.

• Phototherapy is the use of specific wavelengths of light that have been shown to be very effective in the treatment of   psoriasis. This light occurs naturally as a component of sunlight and is called ultraviolet light. At ADSCI, we use narrow band   UVB lights because they have a therapeutic advantage over traditional Broad Band UVB lights. Narrowband UVB lights   provide faster clearing, less sun burning, and more complete disease resolution.

• We feature the newest light-based technology in the treatment of psoriasis, the excimer laser. The EX-308 excimer laser   creates a concentrated, but painless, beam of ultraviolet light that is delivered to psoriatic lesions through a handpiece that   rests directly on the skin. By precisely targeting only active lesions without exposing healthy skin, the laser safely delivers   high-dose treatment for fast clearing and long remission.