Women in Motion

Susan Blatt, MD

Psoriasis is a skin condition that usually begins in young adults and continues throughout life.  It is uncomfortable and disfiguring.  In most cases, treatment is only partially successful.  The cause is not clear, but the problem can run in families and seems to involve the immune system. It occurs equally in men and women. It is not contagious.

The rash of psoriasis is red, raised, and scaly.  It is often located on the knees, elbows, and scalp, but can occur anywhere. Patients complain of itching and pain.  Certain triggers may make the rash worse, such as infection, winter weather, or stress. For most patients there are remissions and flare-ups. About a third of psoriasis patients also have arthritis, which can be disabling and difficult to treat. Many also develop abnormal nails and swelling of the fingers. 

Treatment of psoriasis begins with hydrocortisone cream and another cream called calcipotriol. Since the medication cannot easily penetrate the roughened skin, strong hydrocortisone creams are used and also the area may be wrapped with an “occlusive dressing”, after the cream is applied.  An additional type of treatment is exposure to UV light.

Occasionally a person develops extensive lesions involving large areas of skin, which become raw and infected.  This is called generalized pustular psoriasis and it may be life threatening. For this form of psoriasis, drugs have been used that are also used in cancer treatment.  These medications stop the frequent cell division that leads to thickening of the skin.

There are several very new drugs called “biologicals”.  These medications are specifically aimed at the immune problems causing psoriasis. Alefacept is one such drug.  It is given by infection, once a week for 12 weeks.  Some of these new drugs are experimental.

Psoriasis patients are treated by dermatologists.  If they develop joint pains, they need to be referred to a rheumatologist.  Treatment of the arthritis is important, since joint destruction may occur without treatment. The National Psoriasis Society is an excellent resource at www.psoriasis.org.