Advances in Psoriasis Treatment

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9 Things Doctors Want You to Know About Psoriasis

  • group-of-friendly-healthcare-providers
    Psoriasis From the Physician’s POV
    Most dermatologists see patients come in with psoriasis, an itchy and sometimes painful skin condition, on a regular basis. Doctors have a wide range of effective treatments to choose from, no matter whether you have just a few patches or if it’s widespread. Here’s what three board-certified dermatologists told us about psoriasis.

  • psoriasis-on-elbow
    “It’s easy to recognize, but the severity varies widely.”
    Dr. Steve Feldman, a professor of dermatology at Wake Forest Baptist Medical Center in North Carolina says, “There’s both the typical patient and incredible variability. The average person who has psoriasis may have spots on their elbows and knees and maybe some dandruff.” But he also sees patients with much more severe cases. Michelle Pelle, a dermatologist with MedDerm Associates in San Diego, agrees. “You could have a person walk in with a patch or they walk in and 80% of their body is affected. The range is unbelievable.” 


  • Caucasian woman holding turtleneck sweater over lower half of face
    “We know psoriasis can be hard to live with.”
    Dr. Pelle says some people’s lives “are absolutely run by their psoriasis. It’s a constant struggle to feel like you have to hide it. People are embarrassed. It’s a very uncomfortable condition, and it’s understated how itchy it is.” Ronald Davis, a dermatologist in San Antonio, Texas, adds, “If it’s on the soles, it can be a real problem for people who are on their feet all day. If it’s on the palms it can cause problems with work that requires manual labor—or even typing, if it’s affecting the fingertips.”
      

  • Black woman hugging her knees
    “Psoriasis can affect more than your skin.”
    If you have a mild case, you may be inclined to ignore your psoriasis. But psoriasis is linked to metabolic syndrome, a mix of health risks including obesity, high blood pressure, high cholesterol, and diabetes. It’s important to see a doctor if you think you have psoriasis. “People who have lived with it for years put up with it,” says Dr. Pelle. “Sometimes we have to talk them out of putting up with it if we think it’s better for their overall health.” 
      

  • Doctor Writing Medical Prescription
    “We can usually help you.”
    The medical arsenal against psoriasis is well stocked, including creams and liquids you put on your skin, light therapy, and biologic drugs that target the immune system. “I’ve seen the worst of the worst,” Dr. Feldman says, “but nowadays I can make almost anybody’s psoriasis better. I can get people clear or almost clear. Biologics have made a dramatic improvement in our ability to care for patients.” Dr. Pelle feels no one should have to hide because of psoriasis. “That’s not necessary anymore, because the drugs are so good now and they’re becoming safer by the year.”


  • Female patient showing nurse hand in examination room
    “If you have psoriasis, we will ask you about your joints.”
    Many people think of the skin when they think of psoriasis, but psoriatic arthritis affects the joints, causing pain and damage. Dr. Feldman says, “If the patient is having joint symptoms, you address them the normal way a dermatologist should address joint disorders—by sending them to a rheumatologist. Psoriasis of the skin does not leave a permanent scar when you clear it up, but psoriatic arthritis can scar the joint, so it’s critical that you catch joint involvement early.”


  • Psoriasis on the hairline and on the scalp
    “Psoriasis patients need to do their part.”
    Topical treatments can be messy, but your psoriasis won’t get better if you don’t use them. “One of the most resistant forms of psoriasis is scalp psoriasis,” says Dr. Feldman. “There are three reasons why it doesn’t get better with topical therapy: The most likely reason is poor compliance, the second most likely reason is poor compliance, and the third reason is poor compliance.” He says to be honest and “let the doctor know that you’re not using the treatment. That way they can take that into account when they design the next step.”


  • Group of Women Eating Out
    “We hear big misconceptions about psoriasis.”
    One of the questions Dr. Davis often gets is, “Is this contagious? Can I give this to my wife?” He adds, “And there can also be concern from other employees in the workplace. I stress to the patients that it is absolutely not contagious.” Dr. Pelle says, “People who don’t have it don't realize it has nothing to do with hygiene or infection. Just like all autoimmune diseases, you inherit a gene for it and it needs to be treated just like any other inherited disorder.” 


  • Couple using a laptop and smiling
    “Support is available for people with psoriasis.”
    You don’t have to feel overwhelmed by your psoriasis. “The most important thing I say today,” notes Dr. Feldman, “is to join the National Psoriasis Foundation. By doing that, you can be educated about how to deal with all the social situations which you may be faced with, you can be educated about your risks, you can be educated about the many treatment options you have.”

9 Things Doctors Want You to Know About Psoriasis

About The Author

Nancy LeBrun is an Emmy- and Peabody award-winning writer and producer who has been writing about health and wellness for more than five years. She is a member of the Association of Health Care Journalists and the American Society of Journalists and Authors.
  1. Metabolic Syndrome in Patients with Psoriatic Disease. National Institutes of Health. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3670770/
  2. Psoriasis Linked To Metabolic Syndrome. National Psoriasis Foundation. https://www.psoriasis.org/advance/psoriasis-linked-metabolic-syndrome
  3. Cardiovascular disease the leading cause of death for PsA. National Psoriasis Foundation. https://www.psoriasis.org/advance/cardiovascular-disease-the-leading-cause-of-death-for-psoriatic-ar...
  4. Psoriatic Arthritis Symptoms. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/psoriatic-arthritis/basics/symptoms/con-20015006
  5. Psoriasis. Medline Plus. National Institutes of Health. https://www.nlm.nih.gov/medlineplus/psoriasis.html
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