What is psoriasis?
Psoriasis is a chronic skin condition known for causing patches of skin to become itchy, scaly, thick and that change in color to red, white or silvery white. Psoriasis flares can occur anywhere, but most often appear on the scalp, elbows, knees, and lower back.
What causes psoriasis?
This is one of the most difficult parts about a psoriasis diagnosis for many patients. The honest answer is that we don’t know, because such a wide variety of environmental happenings can trigger psoriasis, infections like strep throat, skin injuries, smoking or others.
What is psoriatic arthritis?
About 1 in 4 people who have psoriasis will have psoriatic arthritis , which causes inflammatory and swelling in your joints. As a rheumatologist, these are the patients I am most often treating, because sometimes mild psoriasis without arthritis can be managed by a dermatologist. Once it starts affecting the joints, however, time is of the essence as joints can begin to deteriorate very quickly. Symptoms of psoriatic arthritis include:
- Fatigue and morning stiffness
- Reduced range of joint motion
- Joints and/or tendons becoming swollen, painful and tender
- Swelling fingers and toes
- Nail changes
- Eye redness or pain
Is there a cure for psoriasis or psoriatic arthritis?
Unfortunately, again, the honest answer here is no. Like many inflammatory conditions, the key is managing it through medications or other treatments to the point where you feel better and it doesn’t affect you on a day-to-day basis. Very few are lucky enough for that to happen consistently, so treatment regimen are commonly re-adjusted throughout life to account for the evolution of the disease. Also, stopping treatment often leads to psoriasis returning.
Much like other diseases, psoriasis and psoriatic arthritis can range from mild to severe. Mild will have fewer psoriatic sites or joints effected, while more severe can affect numerous locations including the spine or areas outside the joints.
How is it different than eczema?
While they may appear similar on the skin, they are completely different diseases with different a different root cause (pathology). A few examples:
- Eczema is much more commonly found in children
- It is rare for someone to have both eczema as a child and psoriasis as an adult
- Eczema is itchy for nearly 100 percent of children, while psoriasis is only itchy for about 1 in 3 people who have it.
- Location of the patches are on different locations of the body
How is psoriasis typically treated?
Prescription strength foams, solutions, ointments or topical creams are typically the first step, and medications and light therapy are also possible. For those who have psoriatic arthritis, medication management is typically needed with a particular focus on a class of medications known as DMARDs (disease-modifying anti-rheumatic drugs) which include biologics that are often injected or infused in a rheumatology office or hospital setting.
Can psoriasis spread by contact?
No, psoriasis is not communicable in the way that we think about many other skin diseases. You should have no fear of friends or family touching your skin.
Why does my psoriasis get worse in the winter?
Dry air, less sunlight and colder temperatures can all contribute to what we can ‘flare ups’ of psoriasis. These environmental factors can be counter-balanced with home humidifiers, moisturizers and treatments.
Will my psoriasis or psoriatic arthritis get worse if I get sick?
Potentially. Anything that impacts your immune system can also affect psoriasis, including common illnesses such as the cold, flu, or particularly strep throat. There is evidence that psoriasis can develop from higher levels of streptococcal antibodies that develop from fighting strep throat infections in the system.
What should I do if I am newly diagnosed with psoriasis or psoriatic arthritis, or am having problems controlling it?
For those newly diagnosed, have a conversation with your primary care physician to determine if a referral to a rheumatologist is warranted. If you suspect a diagnosis but don’t have one, we do require a referral to ensure we are helping those people who most require rheumatology care, so please schedule an appointment with a primary care office. There are, unfortunately, a shorten of rheumatologists nationwide and locally, but I am currently accepting new patients.
If you believe your psoriatic arthritis is poorly controlled and would like to see us for another opinion, please call our office at (402) 609-1200 and we will guide you through that process.