Psoriasis is a hereditary, autoimmune inflammatory condition that affects the turnover of skin cells in 7.5 million Americans. There are five different types of psoriasis, the most common being plaque psoriasis. In plaque psoriasis, the top layer of skin cells builds up rapidly causing thick patches and plaques on the skin that are usually red with silvery scales. Affected areas are often itchy, and may even be painful or bleed when scratched. The severity of disease varies for each individual from mild, to moderate or severe.
Areas most commonly affected include elbows, knees, scalp, lower back and in some patients, joints or nails are involved. Psoriasis may also affect the hands and feet and may present with either pustules or dry and cracked skin. Psoriasis is associated with other health conditions including diabetes, heart disease, and depression. There are also many factors that may cause the condition to flare including infections, stress, medications, obesity, and smoking. There is no cure for psoriasis, but there are many treatments that can keep psoriasis under control.
At Sand Lake Dermatology Center we see about 600 psoriasis patients per year. We consider the following treatments when developing individualized treatment plans for psoriasis patients:
- Topical prescription medications – including corticosteroids, vitamin D analogues, and retinoids that are applied at home by patients.
- Narrowband UVB Phototherapy – Ultraviolet B (UVB) light exposure is one type of UV ray emitted by the sun. UVB rays slow the skin cell turnover and can be very effective for patients with a large body surface area affected by psoriasis. Treatments are performed in the office 2-3 times per week, starting with very small doses of light. The time of exposure is increased as treatments continue. NBUVB phototherapy may be used in conjunction with topical or systemic medications.
- Excimer Laser – a concentrated form of UVB light that can be used to target specific localized areas of skin affected by psoriasis without exposing unaffected skin to UV radiation. Treatments are performed in the office 2-3 times per week for a minimum of 12 sessions. Excimer laser may be used in conjunction with topical or systemic medications. Sand Lake Dermatology Center is one of two offices in Central Florida with this treatment option for psoriasis.
- PUVA – Psoralen + Ultraviolet A (UVA) light is also effective for certain types of psoriasis. UVA rays are also emitted by the sun, but are not effective in treating psoriasis if used alone. A light-sensitizing medication psoralen must be used topically or orally with UVA radiation in order to effectively treat psoriasis.
- Grenz Radiation – Grenz rays are similar to UV rays or X-rays, but are delivered at a very low energy resulting in only superficial penetration of the skin. Grenz therapy is used in conjunction with other treatments and targets localized areas of psoriasis. Treatments are performed in the office weekly or bi-weekly depending on the type of psoriasis. Sand Lake Dermatology Center is the only office in Central Florida with this treatment for psoriasis.
- Systemics – medications taken orally or injected that work against psoriasis through the immune system from inside the body. Systemic medications are usually used for patients with moderate to severe psoriasis or psoriatic arthritis.
- Biologics – biologic medications target specific molecules of the immune system in the body. They are most commonly used for moderate to severe psoriasis, psoriatic arthritis, or cases that have been resistant to other treatments. Biologics are usually injected in the office or by the patient at home. Some forms of biologics are given through intravenous administration in a specialized facility.
At Sand Lake Dermatology Center we recognize and celebrate the strength and beauty of our patients and the 7.5 million Americans living with psoriasis. Our staff is currently participating in the National Psoriasis Foundation’s Cycle Challenge to to raise awareness for psoriasis. Through October 31, our staff is having a “wheel” good time biking or cycling to support the National Psoriasis Foundation’s Cycle Challenge.
For more information regarding psoriasis or the Team NPF Cycle Challenge, visit the National Psoriasis Foundation website at http://www.psoriasis.org.
By: Nicole Hill, MPAS, PA-C