by Jessica Ackerman, PA-C.
Psoriasis is a chronic condition that causes thickened, inflamed scaly plaques on the skin. We aren’t sure exactly why some people get psoriasis and why others do not. Like many conditions, it may be multifactorial, and the underlying cause may include a combination of genetic and immune factors. Most commonly, psoriasis plaques appear on the elbows, knees, and the scalp, although they can affect any area of the body, including the hands or nails. Certain subtypes of psoriasis can affect areas of body folds, such as the underarms or the groin. Psoriatic Arthritis, a condition closely linked to Psoriasis, affects the joints, and can be common in individuals with skin involvement.
How is Psoriasis Different from Eczema?
While both conditions can cause inflamed patches on the skin, there are multiple differences between these two distinct conditions. Psoriasis plaques tend to be thicker and more scaly than eczema patches, and tend to be much more well-defined. While eczema is often present from infancy or childhood, psoriasis oftentimes tends to appear later in adolescence/early adulthood, sometimes even later. While psoriasis can certainly be itchy, one of the primary symptoms of eczema is a persistent itching sensation so intense that an individual cannot help but scratch. Often, individuals with eczema are more likely to be affected by asthma or seasonal allergies. Treatment options for these two conditions vary, so it is important to differentiate between them prior to initiating treatment.
How is Psoriasis Treated?
There are a multitude of treatment options for Psoriasis, and thankfully new treatments are being approved all the time. Which particular treatment is recommended often depends on the extent of the body surface area (BSA) involved, as well as the patient’s age and any other medical conditions. For smaller areas of skin involvement, topical medications such as ointments, creams, or foams can be prescribed. For larger areas of skin, light therapy can be utilized, as we know that psoriasis commonly improves when the skin is exposed to UV light. Individuals with a history of skin cancer might not be considered candidates for this treatment option, so it is important to discuss any past medical history when deciding how best to proceed with treatment. Systemic oral medication options include methotrexate, cyclosporin, acitretin, and apremilast make up some of the more commonly prescribed oral medications for psoriasis. While they can provide effective clearance of the skin, some of these medications may only be prescribed to certain individuals depending on their medical history. Biologics are a newer class of systemic treatments administered by injection at regular intervals. These tend to result in high rates of skin clearance and are generally well-tolerated by most patients. We encourage anybody with psoriasis to have a conversation with your provider to come up with the best treatment plan possible.