Psoriasis

Psoriasis can be difficult to diagnose, because it often looks like other skin diseases. Your doctor may take a small skin sample to examine under a microscope.

There are several different types of treatment for psoriasis. Your doctor will work with you to decide on the best treatment for you, taking into consideration the type of psoriasis you have, where it is on your body, which treatment helps the most and the possible side effects of medications.

People respond differently to treatment, so you may have to try a few different types of treatment before finding one that helps you. Your skin can also become resistant to treatment over time, especially if you are using corticosteroids, so you may have to switch treatments after a while.

Your doctor may recommend that you try one of these or a combination of them:

• Topical treatment, using creams or ointments such as corticosteroids, vitamin D3, retinoids, coal tar or anthralin.
• Light therapy, or phototherapy, which involves having a doctor shine an ultraviolet light on your skin or getting more sunlight. It’s important for a doctor to administer the therapy, since too much ultraviolet light can cause skin damage, increase your risk of skin cancer and make your symptoms worse.
• Systemic treatment, which can include taking prescription medicines or getting injections of medicine. These treatments can have serious side effects, so it’s important to talk with your doctor and keep your appointments to monitor your condition. Here are a few medicines used to treat psoriasis.
  • Cyclosporine, which suppresses the immune system to slow down cell turnover. It can also impair kidney function or cause high blood pressure, so patients should be monitored by a doctor.
  • Methotrexate also suppresses the immune system to slow down cell turnover. It can be taken as a pill or by injection. It can also cause liver damage and decrease the production of blood cells and platelets, so patients should be monitored by a doctor.
  • Retinoids are compounds with properties similar to vitamin A. They may help some people with severe psoriasis who do not respond to other treatments. They can also cause birth defects, however.
  • Biologic response modifiers are injections made from proteins produced by living cells. They suppress the immune system processes that cause the overproduction of skin cells and inflammation. Because they suppress the immune system, they increase the risk of infection and may interfere with patients taking vaccines. They have also been associated with some other diseases, so it’s important for a doctor to monitor patients taking biologics.

Diagnosing and treating psoriasis is a team effort involving you and several types of health care professionals. These may include:

• Internists, who specialize in the diagnosis and medical treatment of adults.
• Dermatologists, who treat skin problems.