Psoriasis/Dermatitis

Psoriasis

Psoriasis is a chronic skin condition that affects nearly 3 million Americans per year. Psoriasis symptoms include red, inflamed, thickening, and scaly skin. It is generally quite itchy and bothersome. In some mild cases, patients may not even know they have psoriasis. In very severe cases psoriasis plaques can cover the entire body.

Any part of the body can be affected by psoriasis, but commonly affected areas include scalp, flexural surfaces, such as knees and elbows, hands and feet, and lower back and buttocks. The fingernails and toenails may be affected by psoriasis and may appear as pitting in the nails or thickening or crumbling. Arthritis is also common with psoriasis.

Psoriasis is not contagious and cannot be passed from one person to another by contact. However, some studies suggest there could be a genetic link to predisposition for the development of psoriasis. The cause of psoriasis is unknown, but there are many treatments available to help patients control their disease and regain quality of life.


There are five types of psoriasis:

  • Plaque Psoriasis–This is the most common type of psoriasis. This type of psoriasis shows up as thickened, red patches that may have a white or silvery appearance due to the buildup of dead skin cells. These plaques can be painful and itchy and may crack causing bleeding.
  • Guttate Psoriasis–Affecting about 10% of psoriasis sufferers, this type of psoriasis presents as small, red dots and can be triggered by strep infection. This type generally starts in childhood or young adulthood.
  • Inverse Psoriasis–Occurring in the folds of the skin, armpits, behind the knees, and around the genitals, this type of psoriasis appears as very red lesions. Patients affected by inverse psoriasis are usually suffering from another form of psoriasis elsewhere on the body.
  • Pustular Psoriasis–Pustular psoriasis presents itself as white blisters surrounded by reddened skin. Like all psoriasis types it is noncontagious and not an infection. This type of psoriasis generally affects hands and feet.
  • Erythrodermic Psoriasis–An extremely rare, but severe form of psoriasis that only affects about 3% of psoriasis sufferers. The skin appears fiery and extremely red and can be extremely painful and itchy. The skin can come off in sheets and this form of psoriasis can be life-threatening and flares should be treated by a doctor immediately.

Roughly 30% of people who suffer from psoriasis may have symptoms of psoriatic arthritis. This can be worsened by uncontrolled psoriasis. The doctors can help recognize the symptoms of psoriatic arthritis and help develop treatment plans to help ease discomfort.


There are many treatment options out there to help patients achieve and maintain good disease management and reduce the effects psoriasis can have on a patient’s quality of life. Every person is different and we strive to make a customized treatment plan that works best for each individual. More than one treatment option may be used to help manage the disease.

Treatment options include:

  • Topical treatments–This could include the use topical corticosteroids, coal tar, zinc pyrithione shampoos, and creams and lotions.
  • Oral Medications–This could include the use of systemic drugs, such as Methotrexate and Soriatane®, or oral biologics, such as Otezla®.
  • Phototherapy–Also known as light therapy, this involves the use of specialized equipment that emits specific wavelengths of UVA and UVB light rays.
  • Biologics–This type of treatment is administered through an injection. These drugs block certain parts of the immune system to help reduce or eliminate symptoms of psoriasis. These drugs include Humira®, Cosentyx®, Stelara®, Enbrel®, Taltz®, and others are coming to market.

Psoriasis is a complex disease and there is no cure. However, attaining disease control with expert guidance and the development of an effective treatment plan is possible. Our office strives to provide workable treatment options for all of our patients and help them to achieve better quality of life while treating their disease.

For more information about psoriasis, visit the National Psoriasis Foundation’s website.


Dermatitis

Dermatitis means inflammation of the skin, however it can be characterized as itchy, red, and dry. In severe cases of dermatitis there may be blisters, crusts, and cracks in the skin that may ooze or bleed. There are many types of dermatitis as well.

The main categories of dermatitis are:

  • Contact Dermatitis–Contact dermatitis can be caused by an allergic reaction or when irritants come into contact with the skin. There are many things that may cause this reaction; such as plants like poison ivy or poison oak, metals such as nickel, or chemical such as harsh detergents or cleaning agents. There are many causes of contact dermatitis and you dermatologist may be able to help you identify triggers and give advice on how to avoid them in the future.
  • Nummular Dermatitis–This type of dermatitis is characterized by distinct disk-shaped red plaques. These can appear anywhere on the body, but are common on the trunk, arms, and legs. It can be brought on in people who live in dry, hot climates as well as in people who take frequent hot showers.
  • Atopic Dermatitis/Eczema–This type of dermatitis is usually associated with triggers from stress and allergies. This can be characterized by extremely dry, itchy skin that can develop scale and blisters. The winter season seems to promote eczema.
  • Seborrheic Dermatitis–Also known as cradle cap in infants and dandruff in adults. This type of dermatitis can affect the scalp, face, and genitals. It is characterized by greasiness, scaling and reddish or yellowish color.
  • Stasis Dermatitis–This type of dermatitis generally occurs in people who have trouble with circulation that may be brought on by a number of diseases including heart disease and varicose veins. Blood pooling and fluid build-up cause swelling which leads to skin irritation if left untreated. This generally occurs in the lower legs.

There are several ways our doctors use to diagnose and treat dermatitis. In the case of irritant or allergic contact dermatitis they may recommend a skin patch test done in the office to help determine specific triggers. They may also do a biopsy to help narrow the diagnosis.

Treatment options for dermatitis may vary depending on the type and severity of your dermatitis. Everyone’s skin is different and our doctors strive to give each patient a treatment plan tailored to their needs. This includes the use of topical creams, over the counter and prescription, foams, solutions for scalp irritation, and even light therapy. While there is not cure, our doctors work with patients to find solutions that fit their lives and help control their disease.

For more information about dermatitis www.aad.org.

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