Psoriasis Support Group

Psoriasis is an immune-mediated disease which affects the skin and joints. When it affects the skin it commonly appears as red scaly elevated patches called plaques. Psoriasis plaques frequently occur on the elbows and knees, but can affect any area of skin including the scalp and genital area. Psoriasis can vary in severity, from minor localised patches to extensive or even complete skin coverage. Fingernails and toenails are often affected (psoriatic nail dystrophy). Psoriasis can also cause inflammation of the joints. This is known as psoriatic arthritis. Psoriatic arthritis can affect any joint but is most common in the joints of the fingers and toes. This can result in a sausage-shaped swelling of the fingers and toes known as dactylitis. Psoriatic arthritis can also affect the hips, knees and spine (spondylitis).

The prevalence of psoriasis in Western populations is estimated to be around 2-3%. It affects both sexes equally and occurs at all ages.

Several factors are thought to aggravate psoriasis. These include stress and excessive alcohol consumption. Individuals with psoriasis may also suffer from depression and loss of self-esteem. As such, quality of life is an important factor in evaluating the severity of the disease. There are many treatments available but because of its chronic recurrent nature psoriasis is a challenge to treat.

Dermatologists are the medical specialists with expertise in psoriatic treatment and research.

Depending on the severity and location of outbreaks, individuals may experience significant physical discomfort and some disability. Itching and pain can interfere with basic functions, such as self-care, walking, and sleep. Plaques on hands and feet can> prevent individuals from working at certain occupations, playing some sports, and caring for family members or a home. The frequency of medical care is costly and can interfere with an employment or school schedule.

Individuals with psoriasis may also feel self-conscious about their appearance and have a poor self-image that stems from fear of public rejection and psychosexual concerns. Psychological distress can lead to significant depression and social isolation.

Dermatologists generally treat psoriasis in steps based on the severity of the disease, size of the areas involved, type of psoriasis, and the patient's response to initial treatments. This is sometimes called the "1-2-3" approach. In step 1, medicines are applied to the skin (topical treatment). Step 2 uses ultraviolet light treatments (phototherapy). Step 3 involves taking medicines by mouth or injection (called systemic therapy).

Over time, affected skin can become resistant to treatment, especially when topical corticosteroids are used. Also, a treatment that works well in one person may have little effect in another. Thus, doctors often use a trial-and-error approach to find a treatment that works, and they may switch treatments periodically (for example, every 12 to 24 months) if a treatment does not work or if adverse reactions occur.

Psoriasis is a chronic, meaning lifelong, condition because there is currently no cure. People often experience flares and remissions throughout their life. Controlling the signs and symptoms typically requires lifelong therapy.