August is Psoriasis Awareness Month

          What is psoriasis? Psoriasis is a chronic, inflammatory disease of the immune system with predominantly skin and joint manifestations. It usually occurs on the scalp, elbows, knees, hands and feet, but may also affect the fingernails and toenails and even inside the mouth. Psoriasis affects approximately 2% of the U.S. population and occurs in two peaks: 20-30 and 50-60 years old; however it can affect all age groups.

What does psoriasis look like? There are several clinical subtypes, including: plaque, inverse/flexural, guttate, erythrodermic and pustular psoriasis. Plaque psoriasis is the most prevalent subtype, with about 80% of patients exhibiting this clinical picture which includes red patches, papules, and plaques that are covered by silvery scales and are sometimes itchy.

How is psoriasis diagnosed and treated? Plaque psoriasis, the most common subtype, is usually diagnosed clinically. Patients with localized plaque psoriasis can be treated topically with high potency steroids in combination with a Vitamin D analog (i.e. calcipotriene). In patients with moderate to severe disease, systemic therapy should be initiated, in addition to topical treatment. Systemic therapy includes, phototherapy, oral medications such as methrotrexate and cyclosporine, and biologic agents such as Humira and Stelera.

It’s important to remember that psoriasis is a lifelong disease that can affect all aspects of a patient’s quality of life. As many as 50% of these patients will experience symptoms of depression, and many others will feel socially stigmatized. As clinicians, it’s important that we address both the physical and emotional consequences of this sometimes debilitating disease.