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Psoriasis

Psoriasis is a chronic red, usually scaly rash seen in approximately 2.2% of the population in the U.S.  It is a genetic disease, believed to be autoimmune in nature, although many people are unaware of any relatives with this condition.  Most commonly, the plaques of psoriasis occur on the scalp, elbows and knees, but they can present in any skin area.  Some people have only mild and intermittent disease whereas others may have extensive and recalcitrant psoriasis.  Nail involvement is seen in some and can present as thickened, discolored and/or lifted nails.  Typically, affected nails can have ‘pitting’, ‘oil-drop’ staining and distal ‘splinter hemorrhages’ (longitudinal dried blood under the nail that mimics a splinter). Additionally, people with psoriasis are believed to be at increased risk for arthritis, cardiovascular disease, lymphoma and enthesopathy (inflammation of tendons, ligaments and fascia), due to chronic psoriatic inflammation.

Treatment

There are many treatments for psoriasis and the choice of appropriate therapy will depend on the extent and location of the psoriasis as well as on a person’s medical history and their success or failure with previous treatment modalities. Common treatments are topical steroids and non-steroidal topicals, intralesional steroids, ultra-violet light treatment (phototherapy) and various systemic medications that are administered either orally, through subcutaneous injection or intravenously. Often, combinations of these treatments are utilized in a given patient. Lastly, most people with psoriasis benefit from moisturizing, stress reduction and using a humidifier and a non-drying soap.