PSORIASIS

OVERVIEW

Psoriasis is a chronic, immune-mediated inflammatory skin disease that most commonly appears as raised red plaques covered by silvery-white scale. It is not contagious and may vary widely in severity, distribution, and clinical course.

The exact cause of psoriasis is not fully understood, but it is believed to result from immune system dysfunction, particularly abnormal signaling involving T lymphocytes, leading to accelerated skin cell turnover and persistent inflammation.

Psoriasis may affect:

• Skin
• Nails
• Joints (psoriatic arthritis)

It is a lifelong condition, typically characterized by periods of flare and remission. Flares are commonly associated with stress, infections, medications, or seasonal changes.

EPIDEMIOLOGY AND CLINICAL COURSE

Psoriasis can develop at any age, with peak onset often occurring in:

• Early adulthood (20s)
• Later adulthood (50s–60s)

Once expressed, psoriasis often follows a waxing and waning course over time. While there is no cure, symptoms can often be managed effectively with appropriate medical treatment.

MANAGEMENT APPROACH

Treatment of psoriasis typically involves a combination of therapeutic modalities, selected based on disease severity, distribution, patient preferences, and response to prior therapy.

The primary goals of treatment are to:

• Reduce inflammation and scaling
• Relieve symptoms such as itching or discomfort
• Improve skin appearance
• Prolong periods of remission

A combination or rotational treatment approach is often preferred over long-term monotherapy, particularly with topical medications, as response to a single regimen may diminish over time.

TOPICAL THERAPIES

Topical treatments are commonly used for mild to moderate psoriasis and may include:

• Anti-inflammatory agents
• Keratolytic medications
• Barrier-supportive and moisturizing therapies

Topical medications may be used alone or in combination and are often adjusted over time based on treatment response and tolerance.

PHOTOTHERAPY (UVB)

Ultraviolet B (UVB) phototherapy is a well-established and effective treatment option for many patients with psoriasis. It may be used alone or in combination with topical therapies.

• Treatments are typically administered 2–3 times per week, and occasionally more frequently in selected cases
• Adjunctive agents such as emollients or tar-based preparations may enhance effectiveness
• Prolonged topical steroid use during phototherapy may shorten the duration of remission

Potential side effects of phototherapy include:

• Sunburn-like reactions
• Photoaging
• A possible increased risk of skin cancer, depending on cumulative exposure and treatment modality

For this reason, phototherapy is medically supervised, with careful dosing and monitoring.

Our office offers in-office UVB phototherapy for appropriately selected patients.

SYSTEMIC AND BIOLOGIC THERAPIES

For moderate to severe psoriasis, or when topical and phototherapy treatments are insufficient, systemic medications may be considered.

Biologic therapies target specific immune pathways involved in psoriasis. Examples include tumor necrosis factor (TNF) inhibitors, such as etanercept (Enbrel®) and adalimumab (Humira®).

These medications:

• May be used alone or in combination with other therapies
• Can be highly effective for selected patients
• Require careful medical evaluation and ongoing monitoring

Because biologic therapies affect immune function, they may increase susceptibility to infections and carry other potential risks. For appropriately selected patients, biologics may represent an effective treatment option.

LONG-TERM EXPECTATIONS

Psoriasis is a chronic condition requiring ongoing management. Treatment plans often evolve over time and may require adjustment based on disease activity, response to therapy, and patient needs.

With appropriate care, many patients achieve good symptom control and improved quality of life.

CARE APPROACH

Our office provides comprehensive medical management of psoriasis, including topical therapy, in-office UVB phototherapy, and coordination of systemic treatment when indicated. Care is individualized based on clinical findings and patient-specific risk factors.

📞 Call (847) 518-9999 to schedule a consultation.

MEDICAL DISCLOSURE

This information is provided for educational purposes only and does not replace a personalized medical evaluation. Treatment recommendations vary based on individual clinical findings and medical history. Outcomes may vary, and no specific medical result can be guaranteed.