Psoriasis
Symptoms
Psoriasis features well‑demarcated, thick, silvery scales over red plaques, commonly on the scalp, elbows, knees, and lower back. Lesions can itch, burn, or bleed when scratched. Nail changes include pitting, onycholysis (the nail plate separating from the nail bed), and subungual hyperkeratosis (a buildup of keratin under the nail plate). Joint stiffness or pain suggests psoriatic arthritis. Flare severity ranges from small patches to extensive body‑surface involvement.
Cause
Psoriasis stems from an overactive immune response that accelerates skin‑cell turnover. Genetic predisposition plays a key role, with HLA‑Cw6 being a notable risk allele. Triggers include infections, stress, skin injury (Koebner phenomenon), and certain medications (e.g., beta‑blockers). Obesity, smoking, and alcohol can worsen disease. The pathogenesis involves Th17 and Th1 cytokine pathways, particularly IL-17, IL‑23, and TNF‑α.
Treatment
Topical corticosteroids, vitamin D analogues, or retinoids are first‑line for mild disease. Phototherapy with narrow‑band UVB helps widespread lesions. Systemic agents like methotrexate, cyclosporine, or acitretin treat moderate to severe cases. Biologic therapies targeting TNF‑α, IL‑17, or IL‑23 offer high efficacy with tailored safety profiles. Lifestyle modifications—weight loss, reduced alcohol intake, and stress management—support control.
Dr. Beth Schulz-Butulis
Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper mattis, pulvinar dapibus leo.