Psoriasis, new and better treatment options…

Suzanne-MagannBy Suzanne Magann, PA-C, dermatology physician assistant

What is psoriasis?
A chronic skin disease impacting millions of Americans caused by the body’s immune system attacking skin cells. This results in skin thickening in affected areas because the body is unable to slough off the extra skin cells fast enough. It usually develops in your teens or 20s but can begin at any age. Psoriasis not only plagues skin and nails, it may develop into arthritis of the joints. There’s no cure but a dermatology provider can accurately diagnose it and work with you to treat it to provide relief and minimize its appearance.

Why do we get it?
It’s not known, exactly, but sometimes a specific event may trigger it, such as injury or stress. Genetics may also play a role, so if a family member has it you’re more likely to as well. The skin’s outermost layer (epidermis) is overwhelmed by T cells, a type of white blood cell from the immune system. T cells usually detect and fight unfamiliar substances like bacteria but in psoriasis they attack normal skin cells. Cytokines, such as tumor necrosis factor-α and Interleukin, are released in response causing more inflammation. More skin cells are produced and the cycle continues leading to an overabundance and the thickened plaques classic to psoriasis.

Are there different types?
Yes.  Plaque psoriasis is the most common and is associated with a red rash and thickened plaques covered by silvery scales most often found on the knees, elbows and scalp.  Guttate psoriasis appears as small red patches all over the body.  Pustular psoriasis attacks hands and feet, and resembles small pimples with a red rash. Nail psoriasis involves small indentations and yellow-red discoloration under the nails and lines through them as well as skin lesions. Psoriatic arthritis can affect any joint in your body but mostly hands and fingers. It’s progressive and if left untreated can cause permanent damage.

What can be done about it?
Treatment options include skin creams, oral medications, light therapy and immune-modulating medicine injected into the skin. We individualize your care based on the severity of your plaques, how much of the body is affected and your response to previous therapies. Improvement typically takes at least 8-12 weeks. Healthy skin care is also important like lukewarm bathes, mild non-detergent soaps and daily moisturizing. Topical medications work by decreasing inflammation and slowing down cell production. If psoriasis affects large areas of the body, UVB light treatments may be used by exposing skin to a narrow spectrum of ultraviolet light to decrease inflammation and skin cell production. Oral medications work similarly by suppressing your immune system.  The newest biologic drug therapy, given by injection with close monitoring, is very promising and working to change the lives of our psoriasis patients for the better.

Schedule your appointment online via our Patient Portal or call us at 360-459-1700. We take all major insurance plans, are accepting new patients and have Saturday hours for your convenience.