Psoriasis is a non-contagious, chronic skin disease which may have periods of relative remission and flares (similar to asthma). The cause of psoriasis is unknown but there appears to be a genetic predisposition. Injury to the skin, severe emotional stress, and infections (i.e. strep throat) can lead to a flare of psoriasis. Psoriasis is predominately a disease of adults, but can occur in childhood. 10-20% of patients also have joint involvement, which can lead to deformity and disability if left untreated. In addition to its physical impact on your skin, psoriasis can also affect your emotional, psychological and social well-being. This visible and lifelong disease may change how you view yourself and interact with others.
While there is no cure for psoriasis, there are fantastic treatments which can control the disease. Treatment of psoriasis depends upon the extent and severity of your disease, as well as the location of the plaques. Mild to moderate psoriasis may be treated with topical steroids, vitamin D or vitamin A-derived topical treatments, and salicylic acid or coal tar preparations. Moderate cases usually respond well to combination therapy with topicals and light treatments. More severe cases and those with associated arthritis may need systemic therapy. Choices include methotrexate, cyclosporine, or Soriatane®. These treatments are not without risk and must be monitored with bloodwork. It is imperative that you obtain the necessary bloodwork to monitor these drugs as liver damage, kidney damage or even death can occur if not properly managed.
Newer medications include biologic meds such as Enbrel®, Amevive®, Raptiva®, Humira® and Remicade®. These medications work to suppress very specific inflammatory mediators (rather than suppressing the entire immune system). They are either injections or intravenous medications and require pre-treatment bloodwork, tuberculosis testing, and periodic monitoring during treatment. They are effective for both psoriatic skin disease and psoriatic arthritis. Dr. George has used all of these drugs and is comfortable prescribing them and managing patients who need more aggressive therapy.