Psoriasis

How our skin specialists can help with psoriasis

Our dermatologists have extensive experience in the diagnosis and management of psoriasis. We understand the impact psoriasis can have on your quality of life and are committed to finding a solution that will control it for you as effectively and safely as possible. We have all treatment options available to us from prescription creams to phototherapy all the way to the very effective new biologic agents.

We can find a solution for people of all ages to allow them to enjoy their life without psoriasis being a major burden.

We have a wonderful highly experienced psoriasis nurse, Tracey McCann who is here to help you too.

If you have psoriasis you are not alone. Just over two per cent of the world’s population – men, women, children, and even newborn babies – endure the symptoms of psoriasis.

Around 120,000 Victorians suffer from some form of psoriasis.

As yet we cannot cure psoriasis but can certainly control it very effectively.

This is an often hidden condition, but we are here to help. It is common for psoriasis sufferers to feel anxious, embarrassed, unattractive or depressed.

 

What is psoriasis?

Psoriasis is a common, chronic skin condition, which develops when a part of the immune system becomes overactive and instructs the skin cells to divide and grow at a faster pace. This leads to the skin developing inflamed red raised patches with silver white scales.
Psoriasis commonly affects the skin, scalp nails and joints. It is not caused by dirty skin and is definitely not contagious.

Psoriasis can be associated with arthritis, which can cause painful physical, functional and psychological disability. Early detection is important to reduce complications and delay the onset of severe symptoms.

Being given a formal diagnosis is important. There are other skin conditions that can be mistaken for psoriasis. Our dermatologists can make a diagnosis and then help you treat the condition with the right medicines, etc.

Psoriasis tends to have periods when it flares up and you will experience more symptoms while at other times it may seem to be dormant and hence you will notice fewer symptoms. Unfortunately psoriasis does not go away completely and there is no cure available.

Psoriasis can affect people in different ways. The severity and extent varies from person to person and can fluctuate a lot or just a little over time.

What causes psoriasis?

We have learned that a person’s immune system and genes play an important role in developing psoriasis. The genetic inheritance is complex and it seems there are many genes that must interact to cause psoriasis. Psoriasis is not strictly genetic but one third of sufferers have a family member who also has psoriasis.

The cause has nothing to do with cleanliness and it is not contagious. It cannot be spread from person to person. You cannot catch psoriasis from someone else or by touching a psoriasis lesion.

Many people have one or more family members with the condition but sometimes it can occur without a family history. Also while you may have a blood relative who has psoriasis, not everyone who inherits the genes for psoriasis get it.

The condition onset usually occurs in people in their early twenties, however there is also a smaller peak onset between 55-60 years of age. Children may also have psoriasis triggered through strep throat or hormonal changes.

Diet is not thought to be a factor, however excessive alcohol consumption and smoking can make your symptoms worse as well as interfering with some treatments.

Types of Psoriasis

Many people think that psoriasis is a single skin condition but there are actually 5 major types of psoriasis. Knowing more about your type will help you make more informed decision about you treatment methods.

Each type of psoriasis has very distinct characteristics and symptoms that can appear on the skin in a variety of ways.

Plaque Psoriasis

  • This is the most common form of psoriasis affecting 80-90% of patients
  • Looks like patches of raised round to oval, red skin covered by silvery white scale
  • Scalp elbows and knees are common locations

Guttate Psoriasis

  • Occurs in about 2% of psoriasis patients
  • Often appears 2-3 weeks after a cold, especially a Strep throat
  • Guttate psoriasis often starts in childhood or young adulthood and presents as small pink dots on the torso, arms, and legs
  • Can respond well to ultraviolet light phototherapy

Inverse Psoriasis

  • Develops in the folds of the skin eg armpits, groin, under the breasts or crease of the buttocks
  • The skin looks raw with smooth patches
  • Most people with inverse psoriasis will have another type of psoriasis at the same time on another part of the body

Pustular Psoriasis

  • Mostly found in adults, pustular psoriasis appears as white blisters of noninfectious pus surround by red skin
  • Occurs most often on hands and feet

Nail Psoriasis

  • May affect up to 55 per cent of patients with psoriasis
  • Commonly seen in psoriasis patients who also have psoriatic arthritis
  • Nails may loosen from the nail bed, crumble, be pitted, thickened and/or discoloured

Erythrodermic Psoriasis

  • A severe form of psoriasis that affects most of the body with widespread redness of the skin and shedding of scales of the sheets
  • Commonly occurs on people who have unstable plaque psoriasis
  • It is a rare form of psoriasis affecting approximately 3% of people suffering psoriasis during their lifetime

Understanding your condition is the first step to help you take charge of the best decisions for your treatment.

What triggers psoriasis?

External factors often flare psoriasis. These include stress, skin injury, sunburn, winter weather, medications, skin infections and hormones.

Certain medications are associated with triggering psoriasis, including:

  • Lithium
  • Antimalarials: Plaquenil, Quinacrine, chloroquine and hydrochloroquine
  • Inderal
  • Quinidine
  • Indomethacin

If you are taking any of these medications, please follow this link for how you might be affected and speak to your GP or healthcare practitioner.

If your psoriasis flares it is worth talking to your doctor about a strep throat test, as this often can be a factor even without symptoms. Flare-ups can also occur following an earache, bronchitis, tonsillitis or respiratory infections.

How can I treat my psoriasis?

Although there is no cure for psoriasis, there are many treatment options available to reduce the physical appearance and discomfort of psoriasis.

Everyone’s triggers are different so it helps if you can identify and manage these. Reducing alcohol, stopping smoking, having a healthy diet, controlling your weight and getting enough sleep are very important.

Mosturisers help prevents water loss from the skin. Apply moisturisers immediately after a bath or shower as this may help to ‘lock in’ moisture.

Medicated shampoos containing coal tar can be purchased from your pharmacist. Rub the shampoo into your scalp well and leave in for 5-10 minutes, rinse and then reapply.

The treatment option prescribed by your dermatologist will be dependent on the type and extent of your psoriasis.

Our Doctors can tailor a specific treatment plan for you as we are able to prescribe all available medications

  • Topical Treatments (creams)
  • Narrow band Ultraviolet Therapy
  • Systemic Treatments (oral medications)
  • Acitretin, Cyclosporin, Methotrexate. Apremilast
  • BiologicsThese medicines are extremely effective and approved for the treatment of moderate to severe plaque psoriasis that has not responded to topical treatments, light therapy or systemic treatments. Biologics are given by injection under the skin or into a vein. They work by blocking specific pathways within the immune system that are responsible for skin inflammation and excessive skin cell turnover.

Medicare Australia has strict criteria that must be met before a dermatologist can prescribe a PBS-funded biological treatment